Clinical characteristics and mortality risk in relation to obstructive and central sleep apnoea in community-dwelling elderly individuals: a 7-year follow-up

Age Ageing. 2012 Jul;41(4):468-74. doi: 10.1093/ageing/afs019. Epub 2012 Mar 22.

Abstract

Background: little is known about demographic and clinical characteristics associated with sleep-disordered breathing (SDB) and obstructive sleep apnoea (OSA) or central sleep apnoea (CSA) in community-dwelling elderly. We also examined these (OSA and CSA) associations to all-cause and cardiovascular (CV) mortality.

Methods: a total of 331 community-dwelling elderly aged 71-87 years underwent a clinical examination and one-night polygraphic recordings in their homes. Mortality data were collected after seven years.

Results: a total of 55% had SDB, 38% had OSA and 17% had CSA. Compared with those with no SDB and OSA, more participants with CSA had a left ventricular ejection fraction <50% (LVEF <50%) ischaemic heart disease (IHD) and transient ischaemic attack (TIA)/stroke. There was no difference in the rate of IHD and TIA/stroke between OSA and no SDB, but more LVEF <50% was found in those with OSA. CSA significantly increased the risk for all-cause (P=0.002) and CV mortality (P=0.018) by more than two times. After adjustments for CV disease, diabetes and the biomarker NT-pro-brain natriuretic peptide CSA associations to all-cause mortality and CV mortality lost significance.

Conclusion: OSA, in persons >75 years does not appear to be associated with cardiovascular disease (CVD) disease or mortality, whereas CSA might be a pathological marker of CVD and impaired systolic function associated with higher mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging*
  • Cardiovascular Diseases / mortality*
  • Cardiovascular Diseases / physiopathology
  • Cause of Death
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Humans
  • Independent Living*
  • Kaplan-Meier Estimate
  • Male
  • Proportional Hazards Models
  • Risk Assessment
  • Risk Factors
  • Sleep
  • Sleep Apnea, Central / mortality*
  • Sleep Apnea, Central / physiopathology
  • Sleep Apnea, Obstructive / mortality*
  • Sleep Apnea, Obstructive / physiopathology
  • Stroke Volume
  • Sweden / epidemiology
  • Systole
  • Time Factors
  • Ventricular Function, Left