Abstract
Background The prevalence of obstructive sleep apnoea (OSA) is growing as the population is ageing. However, data on the clinical characteristics of elderly OSA patients and their adherence to positive airway pressure (PAP) treatment are scarce.
Methods Data of 23,418 30–79-year-old OSA patients prospectively collected into the ESADA database during the period 2007 to 2019 were analysed. Information on PAP use (h·day−1) in association with a first follow-up visit was available for 6547 patients. The data was analysed according to ten-year age-groups.
Results The oldest age-group was less obese, less sleepy, and had a lower AHI compared to middle-aged patients. The insomnia-phenotype of OSA was more prevalent in the oldest age group than in the middle-aged group (36%, 95% CI 34–38 versus 26%, 95% CI 24–27, p<0.001). The 70–79-year-old group adhered to PAP therapy equally well as the younger age groups with a mean PAP use of 5.59 h·day−1 (95% CI 5.44–5.75). PAP adherence did not differ between clinical phenotypes based on subjective daytime sleepiness and sleep complaints suggestive of insomnia in the oldest age-group. A higher score on the Clinical Global Impression Severity (CGI-S) scale predicted poorer PAP adherence.
Conclusion The elderly patient group was less obese, less sleepy, had more insomnia symptoms, and less severe OSA, but rated to be more ill compared with the middle-aged patients. Elderly OSA patients adhered to PAP therapy equally well as the middle-aged. Low global functioning (measured by CGI-S) in the elderly patient predicted poorer PAP adherence.
Footnotes
This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.
Conflict of Interest: A.L. has reported a grant from Turku University Foundation.
Conflict of Interest: U.A. has reported a grant from EU Horizon 2020 (Sleep Revolution), and lecture fee and support for attention in a scientific meeting from ResMed, membership at the advisory board of Wello Oy and the national Task Force the Current Care Guidelines of Adult Sleep Apnoea.
Conflict of Interest: M.R.B. has reported honoraria for lectures Bioprojet and Jazz and advisory board of Bioprojet.
Conflict of Interest: L.G. has reported an unrestricted collaboration grant with the ESADA network from Bayer AG, Germany, grants from Swedish Heart and Lung Foundation, LUA-ALF Gothenburg Region, EU Horizon 2020 (Sleep revolution), EUROSTAR (Apnoeaway and WATCH-IT), clinical trial contract and license on pharmacological treatment in OSA for Desitin, lecture fees from Astra Zeneca, Lundbeck, ResMed, and Philips, chairing National guidelines for treatment in OSA and the National quality registry for sleep apnea (SESAR), being a steering group member of the European quality registry for sleep apnea (ESADA), LRPC member for the European Respiratory Society, Assembly 4, and member of examination committee for the European Sleep Research Society.
Conflict of Interest: J.H. has reported grants from ResMed Inc, Philips Respironics and Bayer Pharma to develop the ESADA database (grants for institution), speaker bureau of Desitin GmbH and Itamar Medical, two granted patents related to pharmacological therapy in OSA, and payed appointment with DSMB Respicardia.
Conflict of Interest: T.S. has reported grants from Finnish Anti-Tuberculosis Association Foundation, Jalmari and Rauha Ahokas Foundation, Tampere Tuberculosis Foundation, Research Foundation of the Pulmonary Diseases, EU Horizon 2020 (Sleep Revolution), and a Governmental grant 13542 of the Turku University Hospital (grants for institution), lecture fees from the Finnish Medical Society Duodecim, Chiesi, ResMed, and Jazz Pharmaceuticals; and chairing the National Task Force for Current Care Guidelines for Adult Sleep Apnoea. Other authors have nothing to declare.
This is a PDF-only article. Please click on the PDF link above to read it.
- Received September 28, 2022.
- Accepted December 18, 2022.
- Copyright ©The authors 2023
This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions{at}ersnet.org