Sleep Med Psychophysiol.  2023 Dec;30(2):36-40. 10.14401/KASMED.2023.30.2.36.

Continuous Positive Airway Pressure Treatment in Elderly Patients With Obstructive Sleep Apnea

Affiliations
  • 1Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Obstructive sleep apnea (OSA) is prevalent among the elderly, with incidence rising due to aging trends. Clinical manifestations in the elderly differ significantly, deviating from conventional risk factors such as male gender and obesity. Postmenopausal women experience a notable surge in OSA prevalence, while traditional features like snoring and high body mass index (BMI) diminish. Limited evidence exists on elderly OSA progression, but untreated cases elevate stroke, cognitive decline, and heart failure risks. Continuous positive airway pressure (CPAP) emerges as the most effective treatment. CPAP therapy proves effective for elderly OSA patients, enhancing sleep quality, addressing nocturia, and improving neurobehavioral outcomes. Elderly individuals often require lower CPAP pressures, with positive effects observed on cardiovascular risk factors and neurobehavioral disorders. Overcoming challenges like nocturnal awakenings and comorbidities, age does not significantly impact PAP adherence. Education, troubleshooting, and emphasizing therapy benefits are vital. Addressing adherence factors in the elderly, including depression, is pivotal. Individualized strategies, considering aging-related challenges and comorbidities, are imperative for successful PAP treatment in this population. Despite potential hurdles, PAP therapy remains a valuable intervention, even for those with dementia.

Keyword

Aging; Continuous positive airway pressure; Obstructive sleep apnea syndrome; Sleep related breathing disorder
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