Effects of age on the clinical features of men with obstructive sleep apnea syndrome

Background: There is little information on the differences in polysomnographic findings in obstructive sleep apnea syndrome (OSAS) between elderly and young or middle-aged adults.

Objectives: The aim of this study was to elucidate the clinical characteristics of elderly patients compared to young or middle-aged patients with OSAS.

Methods: A total of 757 male patients who were found to have OSAS (apnea-hypopnea index, AHI > or = 5) were enrolled. After nocturnal polysomnography, patients also completed the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale.

Results: The patients were divided into three groups: ages 20-44 (n = 254), ages 45-64 (n = 373), and ages 65-86 (n = 130). Body mass index (BMI) and the proportion of overweight patients (BMI > or =25) were lower in the elderly group (ages 65-84) than in the other age groups (all p < 0.01). However, in the elderly group, there was a significant correlation between AHI and BMI (r = 0.28, p < 0.01), and BMI was a significant determinant of AHI (beta = 0.30, p < 0.01). In addition, the elderly group showed a high percentage of apneas among apneas and hypopneas ( p = 0.02) and increased duration of apnea-hypopnea (p < 0.01) compared to the other age groups.

Conclusions: Despite the occurrence of OSAS in the elderly with low BMI, the influence of body weight on the severity of OSAS was still significant in elderly patients. Age-related high collapsibility of the upper airways could explain the higher percentage of apneas and longer duration of apnea-hypopnea in the elderly compared to young or middle-aged patients with OSAS.