Influence of age in clinical presentation of obstructive sleep apnea in males

Abstract

Obstructive sleep apnea (OSA) shows increasing prevalence with age. Existing data comes mainly from young and middle age patients. Data from older patients is lacking

Purpose: to investigate the age specific differences in clinical presentation of male adults with OSA

Methods: Retrospective study of all male adult patients visited our sleep unit and submitted in sleep study during a 4-month period. Patients were stratified in age-groups, A:18-44-year-old (YO) B:45-64 YO and C:≥65 YO. Patients symptoms, comorbidity, reason for referral and Apnea Hypopnea Index (AHI) were recorded. Chi-square test and one-way ANOVA were used for statistics-p<0.05.

Results: 275 men with median age 53 (18-86) were included–group A-28.4%, B-52%, C-19.6%. More patients in group C visited the hospital following doctor’s referral, whereas groups A and B presented mainly due to symptoms. In terms of symptoms self-reported by the patients, group C reported less frequent snoring and fatigue. When doctor asked for symptoms group C reported more nocturia and memory disturbances but less fatigue and gastroesophageal reflux. Patients of group A complaint more for heavy-head. Comorbidity increased with aging. BMI, sleepiness and AHI did not differ between age groups. Among patients of group C, those that visited sleep unit following doctor’s referral reported higher prevalence of chocking, morning headaches, heavy head and fatigue compared to those that were self-referred due to symptoms.

Conclusion: Age influences the clinical presentation of OSA in males. Older patients represent the minority of patients undergoing sleep study. They visit sleep unit mainly following specialty doctor referral although they are highly symptomatic.