Sleep disordered breathing in an elderly community-living population: Relationship to cardiac function, insomnia symptoms and daytime sleepiness

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. (c) 2009 Elsevier B.V. All rights reserved.