title: Sleep disordered breathing in the elderly: a three year longitudinal cohort study.
abstract: The objective of this investigation was to assess the association between the presence of sleep disordered breathing (SDB) and daytime sleepiness, body mass index, hospitalisation, and survival. To this end, a prospective longitudinal study was conducted in the elderly population consisting of 80 patients of either sex over the age of 65 years admitted to a city hospital in Germany without any history of SDB. All patients met the following exclusion criteria: age <65 yr, heart failure, and chronic obstructive lung disease. Baseline anthropometric and cardiorespiratory (one-night portable polygraphic recording) data, and a standardized sleep and sleepiness-questionnaires (Epworth Sleepiness Scale, ESS) were obtained in 1999. A second screening was conducted in 2003. Thirty one women and 34 men completed the follow-up after 3 years. These patients were divided into two subgroups: (i) no clinically relevant SDB and (ii) SDB (apnea-hypopnea index, AHI, >or=5 plus excessive day time sleepiness, ESS, >9). Six men and 3 women fulfilled the criteria of SDB. Thirty three percent of patients with SDB and 20% of patients without SDB died during the follow-up period. Duration of hospital stay was 35 days for the SDB patients and 20 days for patients without it. Body weight and sleepiness did not change significant over the 3-year period between the two cohorts. We conclude that the presence of SDB was associated with a 1.5-fold higher mortality and longer hospital stay in elderly patients over a period of 3 years even in persons without previous history of SDB. Daytime sleepiness was a better predictor than AHI or BMI for death.
authors.affiliation: Kliniken St. Antonius, Akademisches Lehrkrankenhaus der Heinrich-Heine-Universität Düsseldorf, Zentrum für Innere Medizin - Schwerpunkt Pneumologie, Wuppertal, Germany. claus.hader@antonius.de
authors.forename: C
authors.initials: C
authors.lastname: Hader
authors.forename: M
authors.initials: M
authors.lastname: Hinz
authors.forename: A
authors.initials: A
authors.lastname: Welz-Barth
authors.forename: K
authors.initials: K
authors.lastname: Rasche
mesh_terms: D000368:Aged; D015992:Body Mass Index; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000453:epidemiology*; D011795:Surveys and Questionnaires