Sleep disordered breathing in an elderly community-living population: Relationship to cardiac function, insomnia symptoms and daytime sleepiness
Received 21 August 2008; received in revised form 14 January 2009; accepted 20 January 2009.
Abstract
Objective
To describe the prevalence of sleep disordered breathing (SDB) and its relationship to systolic function, different insomnia symptoms as well as excessive daytime sleepiness (EDS) in elderly community-living people. This has not been investigated previously.
Method
Three hundred thirty-one subjects (71–87 years) healthy enough to be independently living in their own homes underwent echocardiographic examinations and sleep respiratory recordings. Questionnaires were used to evaluate insomnia symptoms and EDS.
Results
Mild SDB (AHI 5–15) was found in 32%. Moderate SDB (AHI 15–30) occurred in 16%, and 7% had severe SDB (AHI>30). Median AHI was significantly higher (p<0.001) in those with mildly impaired systolic function (AHI 11.7) and moderately impaired systolic function (AHI 10.9) compared to those with normal systolic function (AHI 5.0). Impaired systolic function was associated with central sleep apnea (CSA) but not with obstructive sleep apnea. Concerning insomnia symptoms and EDS, only difficulties in initiating sleep correlated significantly (p<0.05) with AHI.
Conclusion
SDB is common among the elderly. CSA may be related to impaired systolic function/heart failure. However, detection of SDB in this population may be problematic since insomnia symptoms and EDS correlated poorly with SDB.
aDepartment of Cardiology, Linköping University Hospital, S-58185 Linköping, Sweden
bDepartment of Medicine and Health Sciences, Division of Cardiovascular Medicine, Faculty of Health Sciences Linköping University, S-58185 Linköping, Sweden
cDepartment of Clinical Neurophysiology, Linköping University Hospital, S-58185 Linköping, Sweden
dInstitution of Clinical and Experimental Medicine, Linköping University, S-58185 Linköping, Sweden
eDepartment of Medicine and Health Sciences, Division of Nursing Science, Linköping University, S-58185 Linköping, Sweden
Corresponding author. Address: Department of Cardiology, University Hospital, S-58185 Linköping, Sweden. Tel.: +46 13 222223; fax: +46 13 222224.
ABSTRACT