School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria.
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Kensington, New South Wales.
Respirology. 2022 Sep;27(9):767-775. doi: 10.1111/resp.14279. Epub 2022 May 17.
The clinical significance of sleep-disordered breathing (SDB) in older age is uncertain. This study determined the prevalence and associations of SDB with mood, daytime sleepiness, quality of life (QOL) and cognition in a relatively healthy older Australian cohort.
A cross-sectional analysis was conducted from the Study of Neurocognitive Outcomes, Radiological and retinal Effects of Aspirin in Sleep Apnoea. Participants completed an unattended limited channel sleep study to measure the oxygen desaturation index (ODI) to define mild (ODI 5-15) and moderate/severe (ODI ≥ 15) SDB, the Centre for Epidemiological Studies Scale, the Epworth Sleepiness Scale, the 12-item Short-Form for QOL and neuropsychological tests.
Of the 1399 participants (mean age 74.0 years), 36% (273 of 753) of men and 25% (164 of 646) of women had moderate/severe SDB. SDB was associated with lower physical health-related QOL (mild SDB: beta coefficient [β] -2.5, 95% CI -3.6 to -1.3, p < 0.001; moderate/severe SDB: β -1.8, 95% CI -3.0 to -0.6, p = 0.005) and with lower global composite cognition (mild SDB: β -0.1, 95% CI -0.2 to 0.0, p = 0.022; moderate/severe SDB: β -0.1, 95% CI -0.2 to 0.0, p = 0.032) compared to no SDB. SDB was not associated with daytime sleepiness nor depression.
SDB was associated with lower physical health-related quality of life and cognitive function. Given the high prevalence of SDB in older age, assessing QOL and cognition may better delineate subgroups requiring further management, and provide useful treatment target measures for this age group.
睡眠呼吸障碍(SDB)在老年人群中的临床意义尚不确定。本研究旨在确定在相对健康的澳大利亚老年队列中,SDB 的患病率及其与情绪、日间嗜睡、生活质量(QOL)和认知的相关性。
本研究为一项来自睡眠呼吸暂停阿司匹林放射学和视网膜影响的神经认知结果研究的横断面分析。参与者完成了一项无人值守的有限通道睡眠研究,以测量氧减指数(ODI)来定义轻度(ODI 5-15)和中重度/严重(ODI≥15)SDB,采用中心流行病学研究量表、Epworth 嗜睡量表、12 项简明健康状况调查问卷(SF-12)和神经心理学测试来评估。
在 1399 名参与者(平均年龄 74.0 岁)中,36%(273/753)的男性和 25%(164/646)的女性患有中重度 SDB。SDB 与较低的生理健康相关 QOL 相关(轻度 SDB:β系数 [β] -2.5,95%置信区间 -3.6 至 -1.3,p<0.001;中重度 SDB:β -1.8,95%置信区间 -3.0 至 -0.6,p=0.005),与较低的整体认知功能相关(轻度 SDB:β -0.1,95%置信区间 -0.2 至 0.0,p=0.022;中重度 SDB:β -0.1,95%置信区间 -0.2 至 0.0,p=0.032),与无 SDB 相比。SDB 与日间嗜睡或抑郁无关。
SDB 与较低的生理健康相关生活质量和认知功能相关。鉴于老年人群中 SDB 的高患病率,评估 QOL 和认知功能可能更好地确定需要进一步管理的亚组,并为该年龄组提供有用的治疗目标措施。