Obstructive Sleep Apnea in the Elderly: Extent of the Problem and Therapeutic Options |
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| Authors: | Douglas Mayson Tomas G Neilan Karim Awad Atul Malhotra |
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| Institution: | 1.Division of Neurology,Mount Sinai Medical Center,New York,USA;2.Division of Cardiology, Department of Medicine,Massachusetts General Hospital,Boston,USA;3.Division of Sleep Medicine, Department of Medicine,Brigham and Women’s Hospital,Boston,USA;4.Division of Sleep Medicine, Department of Medicine,Brigham and Women’s Hospital,Boston,USA |
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| Abstract: | Obstructive Sleep Apnea (OSA) is an underdiagnosed and potentially serious disorder that is more common but less well characterized in older adults than in the middle-aged. With aging, anatomic and physiologic changes to the upper airway make it prone to collapse. Except in female nursing home residents and older adults with excessive daytime sleepiness, there is no association between OSA and mortality in the elderly. In comparison to the middle-aged, cardiovascular consequences also are substantially attenuated in the elderly; however, the limited existing evidence supports a relationship between OSA and arrhythmia, heart failure, stroke, and cognitive dysfunction. Currently, the diagnosis of clinically significant OSA in the elderly is similar to that of the general population. Special care to a patient’s physical and cognitive impairments is critical to consider when administering CPAP, oral appliances, and surgery in older adults. |
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