Ng Susanna S S, Chan Tat-On, To Kin-Wang, Chan Ken K P, Ngai Jenny, Tung Alvin, Ko Fanny W S, Hui David S C
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong.
PLoS One. 2015 Mar 16;10(3):e0119829. doi: 10.1371/journal.pone.0119829. eCollection 2015.
This study assessed the prevalence of obstructive sleep apnea syndrome (OSAS) and CPAP adherence in the elderly Chinese in Hong Kong.
We conducted a sleep questionnaire survey among the elders aged ≥60 years in the community centres followed by level 3 home sleep study (Embletta). Subjects with an apnea hypopnea index (AHI) ≥ 15/hr alone and those with AHI ≥ 5/hr plus either cardiovascular risk factors or Epworth Sleepiness Score (ESS) ≥ 10 were offered CPAP treatment.
Altogether 819 subjects were interviewed with mean (SD) age of 73.9 (7.5) years, BMI 24.2 (3.6) kg/m2, neck circumference 34.9 (3.4) cm and ESS 6.6 (5.2). Daytime sleepiness was reported by 72.4%, snoring loudly 5.1% and witnessed apnea 4%. Among 234 subjects who underwent home sleep study, 156 (66.7%), 102 (43.6%), 70 (29.9%) and 45 (19.2%) had AHI ≥ 5, ≥ 10, ≥ 15 and ≥ 20/hr respectively, with the prevalence increasing with age and BMI. In the sample, 149 subjects (63.7%) were classified as having OSAS, as defined by an AHI ≥ 5/hr with associated symptoms, involving 81 men (74.3%) and 68 women (54.4%). Neck circumference and snoring frequency were the only positive independent factors associated with the AHI and the diagnosis of OSAS. Among 141 subjects who were offered CPAP treatment, 30 accepted CPAP prescription with improvement of ESS and cognitive function over 12 months with CPAP usage of 4.2 (2.2) h/night.
This study showed a high prevalence of OSAS among the community elders in Hong Kong. Home CPAP acceptance was low but there was significant improvement of subjective sleepiness and cognitive function among those on CPAP treatment.
本研究评估了香港老年华人中阻塞性睡眠呼吸暂停综合征（OSAS）的患病率及持续气道正压通气（CPAP）的依从性。
我们在社区中心对年龄≥60岁的老年人进行了睡眠问卷调查，随后进行三级家庭睡眠研究（Embletta）。单独呼吸暂停低通气指数（AHI）≥15次/小时的受试者以及AHI≥5次/小时且伴有心血管危险因素或爱泼华嗜睡量表（ESS）≥10分的受试者接受CPAP治疗。
共对819名受试者进行了访谈，其平均（标准差）年龄为73.9（7.5）岁，体重指数（BMI）为24.2（3.6）kg/m²，颈围为34.9（3.4）cm，ESS为6.6（5.2）。72.4%的受试者报告有日间嗜睡，5.1%的受试者大声打鼾，4%的受试者有目击性呼吸暂停。在234名接受家庭睡眠研究的受试者中，AHI≥5、≥10、≥15和≥20次/小时的分别有156名（66.7%）、102名（43.6%）、70名（29.9%）和45名（19.2%），患病率随年龄和BMI的增加而升高。在该样本中，149名受试者（63.7%）被归类为患有OSAS，定义为AHI≥5次/小时并伴有相关症状，其中男性有81名（74.3%），女性有68名（54.4%）。颈围和打鼾频率是与AHI及OSAS诊断相关的仅有的阳性独立因素。在141名接受CPAP治疗的受试者中，30名接受了CPAP处方，在使用CPAP 12个月期间，ESS和认知功能有所改善，每晚使用时间为4.2（2.2）小时。
本研究表明香港社区老年人中OSAS的患病率较高。家庭CPAP的接受率较低，但接受CPAP治疗的受试者的主观嗜睡和认知功能有显著改善。
