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. 2020 Feb 10;17(3):1120.
doi: 10.3390/ijerph17031120.

Positional Obstructive Sleep Apnea Syndrome in Elderly Patients

Giannicola Iannella  1   2 , Giuseppe Magliulo  1 , Cristina Anna Maria Lo Iacono  3 , Giulia Bianchi  4 , Antonella Polimeni  5 , Antonio Greco  1 , Andrea De Vito  2 , Giuseppe Meccariello  2 , Giovanni Cammaroto  2 , Riccardo Gobbi  2 , Marco Brunori  3 , Milena Di Luca  6 , Filippo Montevecchi  7 , Annalisa Pace  1 , Irene Claudia Visconti  1 , Claudia Milella  1 , Carmen Solito  1 , Stefano Pelucchi  4 , Luca Cerritelli  4 , Claudio Vicini  2   4
Affiliations

Positional Obstructive Sleep Apnea Syndrome in Elderly Patients

Giannicola Iannella et al. Int J Environ Res Public Health. .

Abstract

Background The purpose of this study was to evaluate the prevalence of position-dependent obstructive sleep apnea (POSA) in elderly patients (≥65 years old). Adult (range 19-65 years old) and elderly patients were also compared in order to show differences in the incidence of POSA between these two groups of patients. Methods A prospective bi-center study was performed between January 2018 and May 2019. A total of 434 participants underwent polysomnography (PSG) study at home (Embletta MPR). Body position during the PSG recordings was determined. Patients were subdivided in two groups: those aged between 19 and 65 years old (adult patients) and ≥65 years old (elderly patients). POSA patients were defined using Cartwright's system, Bignold classification, and the new Amsterdam Positional OSA Classification (APOC). Results The prevalence of POSA in elderly patients differed according to the classification system used: 49.3% using Cartwright's classification system, 20.5% with the Bignold classification, and 22.6%, 38.9%, and 5.4% of APOC 1, APOC 2, and APOC3 sub-classes were respectively identified for the APOC classification system. No difference between adult and elderly patients regarding the prevalence of POSA was observed. No statistical differences emerged between the two groups of patients in terms of supine (p = 0.9) and non-supine AHI (p = 0.4). Conclusions A significant number of elderly patients could be considered treatable with positional therapy according to the APOC classification. However, the efficacy and applicability of positional therapy in elderly patients must be confirmed by further research.

Keywords: aging effects; obstructive sleep apnea; polysomnography; positional sleep apnea.

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Conflict of interest statement

The authors declare no conflict of interest. No funders were present in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Multi-variable analysis of possible risk factors for POSA.
See this image and copyright information in PMC

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