Long-term follow-up of sleep disordered breathing in older adults.
OBJECTIVE
The current study was designed to determine whether, with increasing age, sleep apnea improves, becomes worse, or stays the same.


BACKGROUND
There is a high prevalence of sleep disordered breathing (SDB) in older adults, but little is known about longitudinal changes. This study followed older adults to examine the natural history of SDB.


METHODS
Subjects were randomly selected community-dwelling elderly (n=427). A subset of subjects was studied approximately every 2 years over an 18-year period. Overnight sleep recordings and sleep questionnaires were completed at each time point.


RESULTS
Multiple linear regression showed that three variables were associated with change in respiratory disturbance index (RDI):body mass index (BMI) at initial visit (P=0.001), change in BMI (P=0.02), and a consistent self-report of high blood pressure (P=0.005). RDI increase was associated with BMI increase and presence of self-reported high blood pressure.


CONCLUSIONS
The changes in RDI that occurred were associated only with changes in BMI and were independent of age. This underscores the importance of managing weight for older adults, particularly those with hypertension.
Department of Psychiatry, University of California, San Diego, and Veterans Affairs San Diego Healthcare System, 92161, USA. sancoliisrael@ucsd.edu
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Ancoli-Israel
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Gehrman
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Kripke
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Stepnowsky
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Mason
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Cohen-Zion
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Marler