IngentaConnect Prevalence and Correlates of Sleep-Disordered Breathing in Older ...

Abstract:

OBJECTIVES:

To determine the prevalence and distribution of sleep-disordered breathing and associated correlates in a large cohort of older men using several standardized definitions. DESIGN:

Cross-sectional analyses. SETTING:

Six U.S. communities. PARTICIPANTS:

Polysomnography was performed on 2,911 participants of the Outcomes of Sleep Disorders in Older Men Sleep Study (mean age±standard deviation 76.38±5.53; body mass index 27.17±3.8 kg/m²). MEASUREMENTS:

Three outcomes were assessed: sleep-disordered breathing (respiratory disturbance index ≥15), obstructive apnea (obstructive apnea index ≥5), and central apnea (central apnea index ≥5). RESULTS:

The prevalence of moderate-severe sleep-disordered breathing was estimated to be 21.4% to 26.4%. Multivariable logistic regression models demonstrated that age (adjusted odds ratio (AOR) per 5-year increase =1.24, 95% confidence interval (CI)=1.15-1.34), obesity (AOR=2.54, 95% CI=2.09-3.09), Asian versus Caucasian race (AOR=2.14, 95% CI=1.33-3.45), snoring (AOR=2.01, 95% CI=1.62-2.49), sleepiness (AOR=1.41, 95% CI=1.11-1.79), hypertension (AOR=1.26, 95% CI=1.06-1.50), cardiovascular disease (AOR=1.24, 95% CI=1.19-1.29), and heart failure (AOR=1.81, 1.31-2.51) were independently associated with sleep-disordered breathing; snoring (AOR=2.10, 95% CI=1.67-2.70), age (AOR per 5-year increase=1.27, 95% CI=1.18-1.38), obesity (AOR=1.48, 95% CI=1.21-1.82), and heart failure (AOR=1.60, 95% CI=1.15-2.24) were associated with obstructive apnea; and age (AOR=1.33, 1.17-1.50) and heart failure (AOR=1.88, 95% CI=1.17-3.04) were associated with central apnea. CONCLUSION:

Regardless of definition, a high prevalence of sleep disorders is observed in community-dwelling older men. Qualitatively similar associations were observed between sleep disorders and snoring, obesity, and comorbidities, as reported for middle aged populations. Asian race was associated with sleep-disordered breathing.

Keywords: sleep apnea; geriatrics; cohort study

Document Type: Research article

DOI: 10.1111/j.1532-5415.2007.01290.x

Affiliations: 1: Departments of Medicine and Pediatrics, Case School of Medicine, Cleveland, Ohio; 2: San Francisco Coordinating Center and California Pacific Medical Center Research Institute, San Francisco, California; and Departments of 3: Psychiatry and 4: Medicine, School of Medicine, University of California at San Diego, San Diego, California.

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