Clinical phenotype of obstructive sleep apnea in older adults: a hospital-based retrospective study in China

BackgroundThe prevalence of obstructive sleep apnea (OSA) in older people (aged over 65 years) is high. However, OSA in older populations has not received sufficient attention. This study examined the clinical phenotypic characteristics of older patients with newly diagnosed OSA.MethodsA total of 110 older patients (>= 65 years) and 220 younger patients (< 65 years), matched by gender, body mass index (BMI), and apnea-hypopnea index (AHI), were enrolled in this retrospective study. Clinical manifestations, comorbidities, and polysomnographic results were compared between the two groups, and correlations between age >= 65 years and OSA comorbidities were explored.ResultsNocturia was more common in older patients with OSA, as with lower sleep efficiency, longer wake after sleep onset, increased stage N1 sleep, and decreased stage N3 sleep and average SpO(2). The proportions of older OSA patients who had comorbid hypertension, coronary artery disease (CAD), chronic obstructive pulmonary disease, and ischemic stroke were significantly higher than those of younger patients. The incidence of tonsillar enlargement and pharyngeal narrowing was lower in older patients. Age >= 65 years was an independent risk factor for patients with OSA to have hypertension (OR: 1.89, 95% CI: 1.11-3.21), CAD (OR: 4.83, 95% CI: 2.29-10.21), and ischemic stroke (OR: 2.92, 95% CI: 1.02 to 8.38).ConclusionsThe presence of OSA in older adults was associated with significant abnormalities of sleep architecture, aggravated nocturnal hypoxia and increased risks of hypertension, CAD, and stroke, which can be distinguished as a unique clinical phenotype.

Automated summary

This study examined the clinical phenotypic characteristics of older patients with newly diagnosed obstructive sleep apnea (OSA) and found that older patients displayed more symptoms and comorbidities associated with OSA, such as nocturia and decreased sleep quality. Additionally, being aged 65 years or older increased the risk of developing hypertension, coronary artery disease (CAD), and ischemic stroke.