Sleep Apnea and Obstructive Airway Disease in Older Men: Outcomes of Sleep Disorders in Older Men Study.
To evaluate the association between obstructive airway disease (OAD) and sleep apnea in older men.



A community-based cross-sectional study of 853 community-dwelling older men (mean age 80.7 ± 4.1 years [range 73 to 90]) across 6 centers in the United States from the Outcomes of Sleep Disorders in Older Men Study. Sleep was objectively measured using full in-home polysomnography and lung function was objectively measured using spirometry. The association of OAD (pre-bronchodilator FEV1/FVC ratio < 0.7 and FEV1 < 80% predicted) and sleep apnea (apnea-hypopnea index [AHI] ≥ 15 events/hour) was assessed using logistic regression.



OAD and sleep apnea were identified in 111 (13.0%) and 247 (29.0%) men, respectively. In univariate analysis, participants with OAD had a lower AHI (mean ± SD; 8.7 ± 11.7 vs. 12.7 ± 13.8, P = 0.0009) and a lower prevalence of sleep apnea (14.4 vs. 31.1%, P = 0.0003) compared to participants without OAD. OAD remained independently associated with a lower odds of sleep apnea (odds ratio 0.30, 95% CI 0.16 to 0.55, P = 0.0001) after adjustment for demographics, body composition, smoking, and potential mediators (arousal index, time spent in rapid eye movement sleep). Individuals with OAD and sleep apnea (n = 16) had an increased arousal index and lower oxygen saturation level as compared to individuals with OAD alone (P values < 0.05).



Obstructive airway disease was associated with a lower prevalence of sleep apnea in a cohort of community-dwelling elderly men, and unexplained by differences in adiposity or sleep architecture. Although uncommon in this cohort, coexisting sleep apnea and OAD was associated with increased sleep fragmentation and nocturnal oxygen desaturation compared to OAD alone.
Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Ying Y
YY
Zhao
California Pacific Medical Center Research Institute, San Francisco, CA.
Terri
T
Blackwell
Department of Medicine and Division of Epidemiology & Community Health, University of Minnesota, Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MN.
Kristine E
KE
Ensrud
California Pacific Medical Center Research Institute, San Francisco, CA.
Katie L
KL
Stone
San Francisco Sleep Disorders Center, Division of Pulmonary, Critical Care, & Sleep Medicine, University of California, San Francisco, CA.
Theodore A
TA
Omachi
Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Susan
S
Redline
D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D017286:Polysomnography; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D013147:Spirometry; D014481:United States / Q000453:epidemiology
aging; obstructive airway disease; obstructive sleep apnea; overlap syndrome; sleep quality