Continuous positive airway pressure adherence declines with age in elderly obstructive sleep apnoea patients

Abstract

Obstructive sleep apnoea (OSA) is an important public health problem with an estimated prevalence of 5–15% in the general population. This increases with age, peaking at 20–25% in individuals aged >65 years. This high prevalence of OSA in the elderly will presumably continue to grow as a consequence of the increasing longevity of the general population [1]. It is therefore not surprising that there is a steady increase in the percentage of patients >65 years of age referred to sleep units for suspicion of OSA and subsequently receiving continuous positive airway pressure (CPAP) therapy. One Spanish study that analysed 51 000 sleep studies from 16 sleep units revealed that one in four of these studies was performed in individuals aged ≥65 years, and that 69% of these were eventually treated with CPAP [2]. Despite this high prevalence, there is little information about long-term CPAP adherence in this population, especially in the very elderly (aged >80 years). We thus aimed to analyse the relationship between age at diagnosis and long-term CPAP adherence, in a large cohort of OSA patients aged ≥65 years who had been prescribed CPAP treatment.

Clinical characteristics and positive airway pressure adherence among elderly European sleep apnoea patients from the ESADA cohort

“…Our results confirmed the results of previous smaller studies [ 29 , 30 ] addressing adherence to CPAP therapy in elderly patients with OSA, but also produced contradictory results to some other studies [ 20 ]. In our study, elderly people aged 70–79 years adhered to PAP therapy at least as well as the middle-aged patients.…”

“…Therefore, there are not only health related but also social and economic incentives to actively treat elderly OSA patients. However, the data of CPAP adherence in the elderly patients are conflicting [19,20,21].…”

Telehealth Technology Application in Enhancing Continuous Positive Airway Pressure Adherence in Obstructive Sleep Apnea Patients: A Review of Current Evidence

“…Patient characteristics such as age ( 17 , 18 ), gender ( 17 , 19 ), race ( 20 ), and smoking status ( 21 ) could affect adherence, although these factors were not consistent determinants of CPAP adherence ( 12 ). For example, the adherence to CPAP positively correlated with age was reported in a retrospective study ( 17 ), but a large cohort study showed a negative correlation with age, particularly in those aged >75 years old, which may be due to the body sickness, sleeping time, or sleep quality of the elderly can affect the adherence of CPAP ( 18 ). Smokers caused decreased CPAP adherence compared to non-smokers ( 21 ), which is attributed to those smokers being more susceptible to upper airway discomfort, the greater severity of OSA, and as a result, less likely to take advice from healthcare providers ( 21 ).…”

A primer on sleep for MFTs: Implications and practical considerations

“…Not only is it important that MFTs be aware of these changes, but also MFTs can play a role in highlighting the specific sleep hygiene recommendations as discussed above. In addition, some may use a CPAP; as adherence rates are typically poor (Martinez-Garcia et al, 2019), MFTs could collaborate and follow-up with other health care providers to address compliance issues from a BPSS perspective.…”