Department of 'Organi di Senso', University "Sapienza",Viale dell'Università, 33, 00185 Rome, Italy.
Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy.
Int J Environ Res Public Health. 2020 Feb 10;17(3):1120. doi: 10.3390/ijerph17031120.
The purpose of this study was to evaluate the prevalence of position-dependent obstructive sleep apnea (POSA) in elderly patients (≥65 years old). Adult (range 19-65 years old) and elderly patients were also compared in order to show differences in the incidence of POSA between these two groups of patients. A prospective bi-center study was performed between January 2018 and May 2019. A total of 434 participants underwent polysomnography (PSG) study at home (Embletta MPR). Body position during the PSG recordings was determined. Patients were subdivided in two groups: those aged between 19 and 65 years old (adult patients) and ≥65 years old (elderly patients). POSA patients were defined using Cartwright's system, Bignold classification, and the new Amsterdam Positional OSA Classification (APOC). The prevalence of POSA in elderly patients differed according to the classification system used: 49.3% using Cartwright's classification system, 20.5% with the Bignold classification, and 22.6%, 38.9%, and 5.4% of APOC 1, APOC 2, and APOC3 sub-classes were respectively identified for the APOC classification system. No difference between adult and elderly patients regarding the prevalence of POSA was observed. No statistical differences emerged between the two groups of patients in terms of supine ( = 0.9) and non-supine AHI ( = 0.4). A significant number of elderly patients could be considered treatable with positional therapy according to the APOC classification. However, the efficacy and applicability of positional therapy in elderly patients must be confirmed by further research.
本研究旨在评估老年患者（≥65 岁）体位相关阻塞性睡眠呼吸暂停（POSA）的患病率。还比较了成年（19-65 岁）和老年患者，以显示这两组患者之间 POSA 发生率的差异。 2018 年 1 月至 2019 年 5 月进行了一项前瞻性双中心研究。共有 434 名参与者在家中进行多导睡眠图（PSG）研究（Embletta MPR）。PSG 记录期间的体位确定。患者分为两组：年龄在 19 至 65 岁之间的成年患者（成年患者）和≥65 岁的老年患者。使用 Cartwright 系统、Bignold 分类和新阿姆斯特丹体位性 OSA 分类（APOC）定义 POSA 患者。根据使用的分类系统，老年患者 POSA 的患病率不同：使用 Cartwright 分类系统为 49.3%，Bignold 分类为 20.5%，APOC 分类系统中 APOC1、APOC2 和 APOC3 亚类分别为 22.6%、38.9%和 5.4%。APOC 分类系统中未观察到成年患者和老年患者 POSA 患病率之间的差异。两组患者仰卧位（ = 0.9）和非仰卧位 AHI（ = 0.4）无统计学差异。根据 APOC 分类，相当数量的老年患者可能被认为可以通过体位治疗来治疗。然而，体位治疗在老年患者中的疗效和适用性必须通过进一步研究来证实。
