A study in the April 1 issue of the journal SLEEP suggests that the risk of death is more than two times higher in older adults who have sleep apnea and report struggling with excessive daytime sleepiness.
Results of adjusted proportional hazards modeling show that older adults with moderate to severe sleep apnea who reported struggling with excessive daytime sleepiness at baseline were more than twice as likely to die (hazard ratio = 2.28) as subjects who had neither problem. The risk of death was insignificant in older adults with only excessive daytime sleepiness (HR = 1.11) or sleep apnea (HR = 0.74). Participants had a mean age of 78 years at baseline, and about 55 percent (n = 160) died during an average follow-up period of 14 years.
"Excessive daytime sleepiness, when associated with sleep apnea, can significantly increase the risk of death in older adults," said principal investigator and lead author Dr. Nalaka S. Gooneratne, assistant professor of medicine in the University of Pennsylvania Health System in Philadelphia, Pa. "We did not find that being sleepy in and of itself was a risk. Instead, the risk of increased mortality only seemed to occur when sleep apnea was also present."
Gooneratne added that both daytime sleepiness and sleep apnea are common problems, with sleep apnea affecting up to 20 percent of older adults.
According to the American Academy of Sleep Medicine, the most common form of sleep apnea is obstructive sleep apnea, which occurs when soft tissue in the back of the throat collapses and blocks the upper airway during sleep. Older adults also are at risk for central sleep apnea, which involves a repetitive absence of breathing effort during sleep caused by a dysfunction in the central nervous system or the heart. Only four percent of participants had central sleep apnea, and there was no meaningful change in the results when they were excluded from the analysis.
The study involved 289 adults with neither dementia nor depression who were recruited from the community. Seventy-four percent were female. About half (n = 146) had significant levels of excessive daytime sleepiness at baseline, reporting that they felt sleepy or struggled to stay awake during the daytime at least three to four times a week. Sleep apnea was measured objectively by one night of polysomnography in a sleep lab. For analysis, participants were included in the sleep apnea group only if they had an apnea-hypopnea index of 20 or more breathing pauses per hour of sleep, which represents a moderate to severe level of sleep apnea.
Participants were recruited between 1993 and 1998. Survival status was determined by searching the social security death index, with follow-up ending Sept. 1, 2009.
According to the authors, the mechanism by which sleep apnea and excessive daytime sleepiness increase the risk of death is unclear. They suspect that inflammation may be involved, which could increase the risk of other medical problems such as hypertension. It also remains to be seen if treatment reduces the risk of death.
"Future research is needed to assess whether treating the sleep apnea can reduce mortality," said Gooneratne.
The treatment of choice for OSA is CPAP therapy, which provides a steady stream of air through a mask that is worn during sleep. This airflow keeps the airway open to prevent pauses in breathing and restore normal oxygen levels.
The study was supported by the National Institutes of Health through the National Institute on Aging and the National Center for Research Resources.
Help for people who have sleep apnea is available at more than 2,200 AASM-accredited sleep disorders centers across the U.S. An online directory of AASM-accredited sleep centers is available at www.sleepcenters.org.
The monthly peer-reviewed, scientific journal SLEEP is published online by the Associated Professional Sleep Societies LLC, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The AASM is a professional membership society that is the leader in setting standards and promoting excellence in sleep medicine health care, education and research (www.aasmnet.org).
For a copy of the study, "Sleep disordered breathing with excessive daytime sleepiness is a risk factor for mortality in older adults," or to arrange an interview with an AASM spokesperson, please contact Public Relations Coordinator Emilee McStay at 630-737-9700, ext. 9345, or firstname.lastname@example.org.
Emilee McStay | EurekAlert!
WAKE-UP provides new treatment option for stroke patients | International study led by UKE
17.05.2018 | Universitätsklinikum Hamburg-Eppendorf
First form of therapy for childhood dementia CLN2 developed
25.04.2018 | Universitätsklinikum Hamburg-Eppendorf
The more electronics steer, accelerate and brake cars, the more important it is to protect them against cyber-attacks. That is why 15 partners from industry and academia will work together over the next three years on new approaches to IT security in self-driving cars. The joint project goes by the name Security For Connected, Autonomous Cars (SecForCARs) and has funding of €7.2 million from the German Federal Ministry of Education and Research. Infineon is leading the project.
Vehicles already offer diverse communication interfaces and more and more automated functions, such as distance and lane-keeping assist systems. At the same...
A research team led by physicists at the Technical University of Munich (TUM) has developed molecular nanoswitches that can be toggled between two structurally different states using an applied voltage. They can serve as the basis for a pioneering class of devices that could replace silicon-based components with organic molecules.
The development of new electronic technologies drives the incessant reduction of functional component sizes. In the context of an international collaborative...
At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.
At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...
There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?
At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...
So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics
Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...
25.05.2018 | Event News
02.05.2018 | Event News
13.04.2018 | Event News
25.05.2018 | Event News
25.05.2018 | Machine Engineering
25.05.2018 | Life Sciences