Posadas Tomas, Oscullo Grace, Zaldívar Enrique, Garcia-Ortega Alberto, Gómez-Olivas José Daniel, Monteagudo Manuela, Martínez-García Miguel Angel
Pneumology Department, Hospital Universitario y Politécnico La Fe, 46015 Valencia, Spain.
J Clin Med. 2020 Feb 17;9(2):546. doi: 10.3390/jcm9020546.
The population pyramid is changing as a result of the ever-increasing life expectancy, which makes it crucial to acquire an in-depth understanding of the diseases that most often affect the elderly. Obstructive sleep apnoea (OSA) affects 15%-20% of the population aged over 65 years. Despite this prevalence, there have been very few specific studies on the management of OSA in this age group, even though over 60% of the patients aged over 65-70 years who attend sleep units with suspicion of OSA receive treatment with continuous positive airway pressure (CPAP), on the basis of an extrapolation of the positive results achieved by CPAP in clinical trials involving middle-aged males. However, the latter's form of presentation, evolution and, probably, prognosis comparing with OSA are not the same as those of elderly patients. Recent clinical trials performed on an exclusive series of elderly patients have shed light on the possible role of CPAP treatment in elderly patients with OSA, but there are still many questions that need to be answered. The physiological increase in the number of sleep-related disorders with the passing of years, and the lack of validated diagnostic and therapeutic tools for this age group are probably the greatest obstacles to define, diagnose and treat OSA in the elderly.
由于预期寿命不断延长,人口金字塔正在发生变化,这使得深入了解最常影响老年人的疾病变得至关重要。阻塞性睡眠呼吸暂停(OSA)影响15%-20%的65岁以上人群。尽管患病率如此之高,但针对该年龄组OSA管理的具体研究却非常少,尽管超过60%的65-70岁因疑似OSA就诊于睡眠科的患者基于CPAP在涉及中年男性的临床试验中取得的阳性结果推断,接受持续气道正压通气(CPAP)治疗。然而,与OSA相比,后者的表现形式、病情发展以及可能的预后与老年患者并不相同。最近对一系列老年患者进行的临床试验揭示了CPAP治疗在老年OSA患者中的可能作用,但仍有许多问题需要解答。随着年龄增长,与睡眠相关疾病数量的生理性增加,以及该年龄组缺乏经过验证的诊断和治疗工具,可能是在老年人中定义、诊断和治疗OSA的最大障碍。