Continuous Positive Airway Pressure Treatment Reduces Mortality in Elderly Patients with Moderate to Severe Obstructive Severe Sleep Apnea: A Cohort Study

PLoS One. 2015 Jun 11;10(6):e0127775. doi: 10.1371/journal.pone.0127775. eCollection 2015.

Abstract

Obstructive sleep apnea (OSA) is much more prevalent in older people than in middle-aged or young populations, and has been associated with cardiovascular disease. Continuous positive airway pressure (CPAP) is the first-line therapy for OSA, but its long-term clinical benefit in the elderly is unclear. Here, we carried out a prospective cohort study to explore the survival rate and incidence of cardiovascular events in elderly patients with moderate to severe OSA who did or did not receive CPAP treatment. The study included 130 patients (104 male, 26 female; mean age: 77.8 ± 6.2 years) who were followed up for a mean of 5 ± 2.54 years (range, 1-8 years). Thirty-six patients received CPAP and 88 had no CPAP. The results showed that mortality in the untreated group (21.6%) was significantly higher than in the CPAP group (5.6%). Kaplan-Meier survival analysis showed that the survival rate in the CPAP group was 94.4%, which was markedly higher than the rate of 78.4% in the untreated group. The incidence of cardiovascular events was 13.9% in the CPAP group and 55.7% in the untreated group. The present study provides evidence that CPAP can reduce mortality in older patients with moderate to severe OSA, and lead to a good long-term prognosis. The study also indicates that death in older OSA patients is associated with cardiovascular disease and diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / etiology
  • Cohort Studies
  • Continuous Positive Airway Pressure*
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Multivariate Analysis
  • Prospective Studies
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / complications
  • Sleep Apnea, Obstructive / mortality
  • Sleep Apnea, Obstructive / therapy*

Grants and funding

This study was supported by grants from the National Key Clinical Department, National Key Discipline (No. Y3016), Guangdong Key Laboratory For Diagnosis and Treatment of Major Neurological Diseases(No. 2010A060801005), Guangdong Technological grant (No. 2008B030301188, 2012B031800107), and Guangdong Department of Science & Technology Translational Medicine Center grant (No. 2011A080300002).