Onen Fannie, Higgins Susan, Onen S-Hakki
Service de Gériatrie, CHU Bichat Claude Bernard, Paris, France.
J Am Med Dir Assoc. 2009 Mar;10(3):207-10. doi: 10.1016/j.jamda.2008.10.008. Epub 2009 Jan 9.
To describe the clinical features and therapeutic response to continuous positive airway pressure (CPAP) in elderly obstructive sleep apnea syndrome (OSAS) patients with sleepiness and falling-asleep-related injured falls.
In 2 geriatric units, 4 consecutive OSAS patients with falling-asleep-related injured falls were diagnosed. They were treated with CPAP and followed for 9 to 24 months.
Mean age at initial observation was 82 years. All patients shared the following characteristics: self-reported daytime sleepiness, falling-asleep-related injured falls, recurrent fall history, medical comorbid conditions, PSG confirmed OSAS, and successful treatment with CPAP. They declared resolution of sleepiness and attention without any further fall under CPAP therapy.
A causal relationship exists between OSAS and falling-asleep-related injured falls in the elderly. Treatment of OSAS with CPAP can improve attention, daytime vigilance, and consequently gait and balance control and prevent falls in these patients.
描述老年阻塞性睡眠呼吸暂停低通气综合征(OSAS)患者出现嗜睡及与入睡相关的跌倒损伤时的临床特征及对持续气道正压通气(CPAP)的治疗反应。
在2个老年病房中,连续诊断出4例患有与入睡相关的跌倒损伤的OSAS患者。对他们进行CPAP治疗并随访9至24个月。
初次观察时的平均年龄为82岁。所有患者均具有以下特征:自述白天嗜睡、与入睡相关的跌倒损伤、反复跌倒史、合并内科疾病、多导睡眠图(PSG)证实为OSAS以及CPAP治疗成功。他们宣称在CPAP治疗下嗜睡和注意力问题得到解决,且未再发生跌倒。
老年患者中,OSAS与与入睡相关的跌倒损伤之间存在因果关系。CPAP治疗OSAS可改善注意力、白天警觉性,进而改善步态和平衡控制,并预防这些患者跌倒。