Sleep-disordered breathing in the elderly: is it distinct from that in the younger or middle-aged populations?

Kitakata, Hiroki; Kohno, Takashi; Fukuda, Keiichi

doi:10.21037/jtd.2018.03.179

Cited by 11 publications

(7 citation statements)

References 27 publications

(22 reference statements)

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“…Majority (48.3%) of the patients in this study were classified as having Class 2 ASA, which is in agreement with a similar study conducted by Edwin Seet and colleagues (5). In this study, the prevalence of OSA was seen to be higher among elderly patients, which is consistent with previous studies that undertook sleep-disorder studies in the elderly population (15,16).…”

Section: Discussionsupporting

confidence: 92%

Stop-bang questionnaire as a screening tool for obstructive sleep apnoea in the surgical population: a prospective observational study

Shetty¹,

Soori²

2023

Biomedicine

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Introduction and Aim: Obstructive sleep apnoea (OSA) is a type of sleep-related breathing disorder characterized by repetitive episodes of partial and complete pharyngeal collapse causing a reduction or total cessation of airflow during sleep. Undiagnosed, it increases the intraoperative and postoperative complications. This study aimed to screen patients undergoing surgical procedures for OSA using a validated self-report STOP-Bang questionnaire. Materials and Methods: This prospective observational study was conducted in a tertiary care hospital between June and November 2021 and included 174 patients posted for elective surgery. A modified STOP-Bang questionnaire was used to evaluate participants for OSA. Documentation also included the difficulty in mask holding, number of attempts at laryngoscopy and intubation, the type and size of the endotracheal tube, and attempts to place a supraglottic airway device. Results: The prevalence of self-reported OSA was 5.2% (n=9) among the 174 participants included in this study. Among the patients (n=98) who underwent general anaesthesia 32 had difficult airways, among which 20 (62.5%) had a predictor of difficult airway and two had OSA. One among the 2 OSA patients had other predictors of difficult airway. No statistical significance was observed between OSA and the difficult airway (p=0.723). However, a clinically significant association was seen for difficult mask holding for patients with OSA but having no other predictors of difficult airway. Conclusion: Using the STOP-Bang questionnaire to screen OSA in patients undergoing general anaesthesia or sedation can help the anaesthesiologist manage difficult airways more effectively.

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Section: Discussionsupporting

confidence: 92%

Stop-bang questionnaire as a screening tool for obstructive sleep apnoea in the surgical population: a prospective observational study

Shetty¹,

Soori²

2023

Biomedicine

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“…5 Although sleep-disordered breathing is known to be more prevalent in the elderly, there were only 2 patients (4.54%) between 63 and 78 years of age. 6 This could be explained by the fact that the elderly, being concerned about other more severe health issues, do not seek help for sleep-disordered breathing and its consequence. Pearson's correlation coefficient between BMI and ESS is 0.190 (weak correlation) with a p-value of 0.222 (not significant).…”

Section: Discussionmentioning

confidence: 99%

The Utility of Epworth Sleepiness Scale to Screen Moderate and Severe Obstructive Sleep Apnea Preoperatively to Predict Difficult Airway

Soori

D’sa

Hosmane

2021

Journal of Health and Allied Sciences NU

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Introduction Obstructive sleep apnea (OSA) is sleep-disordered breathing characterized by repetitive episodes of partial or complete upper airway collapse in sleep leading to apnea and/or hypopnea, desaturations, sleep disruptions, and cardiovascular changes. OSA is a known cause for difficult airway, especially mask ventilation. Daytime sleepiness is one of the hallmark symptoms of OSA. So, we used the Epworth sleepiness score (ESS) in patients suspected of OSA undergoing a sleep study. Methods Overall, 44 subjects suspected to have OSA and undergoing polysomnography were included in the study. The socio-demographic details and the complaints were recorded and the Epworth sleepiness questionnaire was administered. The severity of OSA was graded as per the American Academy of Sleep Medicine using the apnea hypopnea index. Results A total of 44 patients were included in the study. Out of these, 19 were mild, 13 moderate, and 12 severe OSA cases, respectively. ESS of more than 10 showed a positive predictive value of 81.25% and specificity of 85% in screening patients with moderate and severe OSA. But the sensitivity and negative predictive value was only 54.16 and 60.71%, respectively. Conclusion ESS being a simple questionnaire can be easily used preoperatively. A score of more than 10 effectively diagnoses moderate and severe OSA, but less than 10 cannot rule out OSA

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“…Risk factors for OSA include increasing age, obesity, narrowed airways (physiological or pathologic), hypertension, chronic nasal congestion, smoking, diabetes, family history of sleep apnea, and male sex 33,34. The impact of OSA on cardiovascular risk factors and morbidity, as well as mortality, has been well established 35. In recent years, there has been a growing body of research illustrating the relationship between OSA and cognitive impairment.…”

Section: Sdbmentioning

confidence: 99%

“…33,34 The impact of OSA on cardiovascular risk factors and morbidity, as well as mortality, has been well established. 35 In recent years, there has been a growing body of research illustrating the relationship between OSA and cognitive impairment.…”

Section: Sdbmentioning

confidence: 99%

Sleep disturbances, sleep-disordered breathing, and cognitive impairment in older adults: perioperative implications

Qian

Wong

2022

International Anesthesiology Clinics

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The mechanisms behind sleep have been studied in the last few decades, illustrating a complex process of sleep-wake cycles regulated by interactions and connections between various regions and nuclei in the brain. Many of these regions are involved in memory and cognitive function. 1 Sleep also changes with increasing age, with observed changes in individuals over 60 years including decreased total sleep duration, decreased slow-wave sleep and rapid eye movement (REM), increased time awake after sleep onset (WASO), and decreased sleep efficiency. 2 While some of these changes may be physiological, others may be due to neurocognitive or neurodegenerative processes.The impact of sleep disturbances is multifaceted. Poor sleep is associated with reduced cognitive, affective, and physiological responses to stressors, 3 physical diseases across all organ systems, 4 and mood disorders. 5 Mounting evidence also supports a link between sleep disturbances, including poor sleep quality, excessive daytime sleepiness, and both short (typically <6 h of sleep a night) and long (typically > 9 h of sleep a night) sleep duration with cognitive impairment. Furthermore, sleep disturbances, sleep-disordered breathing (SDB), or abnormal respiratory patterns occurring during sleep also increase the risk of cognitive decline in older adults (age over 60 y), and may also increase the risk of various postoperative complications including postoperative delirium (POD).The objective of this review is to examine the current evidence regarding the effect of and proposed mechanisms behind sleep disturbances and SDB [with a focus on obstructive sleep apnea (OSA)], with cognitive decline and impairment. The possible association of sleep disturbances and SDB with postoperative complications will be discussed, along with the potential utility of continuous positive airway pressure (CPAP) therapy and sleep hygiene in preventing these complications.

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Sleep-disordered breathing in the elderly: is it distinct from that in the younger or middle-aged populations?

Cited by 11 publications

References 27 publications

Stop-bang questionnaire as a screening tool for obstructive sleep apnoea in the surgical population: a prospective observational study

Stop-bang questionnaire as a screening tool for obstructive sleep apnoea in the surgical population: a prospective observational study

The Utility of Epworth Sleepiness Scale to Screen Moderate and Severe Obstructive Sleep Apnea Preoperatively to Predict Difficult Airway

Sleep disturbances, sleep-disordered breathing, and cognitive impairment in older adults: perioperative implications

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