Sleep-disordered breathing was associated with lower health-related quality of life and cognitive function in a cross-sectional study of older adults

Stephanie A Ward^{1

2

3}, Elsdon Storey¹, Danijela Gasevic^{1

4}, Matthew T Naughton^{5

6}, Garun S Hamilton^{7

8}, Ruth E Trevaks¹, Rory Wolfe¹, Fergal J O'Donoghue^{9

10}, Nigel Stocks¹¹, Walter P Abhayaratna^{12

13}, Sharyn Fitzgerald¹, Suzanne G Orchard¹, Joanne Ryan¹, John J McNeil¹, Christopher M Reid^{1

14}, Robyn L Woods¹

Affiliations

¹ School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria.
² Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Kensington, New South Wales.
³ Department of Geriatric Medicine, Prince of Wales Hospital, Randwick, New South Wales.
⁴ Centre for Global Health Research, Usher Institute, The University of Edinburgh, Edinburgh, UK.
⁵ Department of Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia.
⁶ The Central Clinical School, Monash University, Melbourne, Victoria, Australia.
⁷ Department of Lung, Sleep, Allergy and Immunology, Monash Health, Clayton, Victoria, Australia.
⁸ School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
⁹ Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia.
¹⁰ Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia.
¹¹ Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.
¹² College of Health and Medicine, Australian National University, Acton, Australian Capital Territory, Australia.
¹³ Academic Unit of Internal Medicine, Canberra Hospital, Garran, Australian Capital Territory, Australia.
¹⁴ Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia.

PMID: 35580042
PMCID: PMC9540665
DOI: 10.1111/resp.14279

Sleep-disordered breathing was associated with lower health-related quality of life and cognitive function in a cross-sectional study of older adults

Stephanie A Ward et al. Respirology. 2022 Sep.

. 2022 Sep;27(9):767-775.

doi: 10.1111/resp.14279. Epub 2022 May 17.

Authors

Affiliations

¹ School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria.
² Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Kensington, New South Wales.
³ Department of Geriatric Medicine, Prince of Wales Hospital, Randwick, New South Wales.
⁴ Centre for Global Health Research, Usher Institute, The University of Edinburgh, Edinburgh, UK.
⁵ Department of Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia.
⁶ The Central Clinical School, Monash University, Melbourne, Victoria, Australia.
⁷ Department of Lung, Sleep, Allergy and Immunology, Monash Health, Clayton, Victoria, Australia.
⁸ School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
⁹ Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia.
¹⁰ Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia.
¹¹ Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.
¹² College of Health and Medicine, Australian National University, Acton, Australian Capital Territory, Australia.
¹³ Academic Unit of Internal Medicine, Canberra Hospital, Garran, Australian Capital Territory, Australia.
¹⁴ Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia.

PMID: 35580042
PMCID: PMC9540665
DOI: 10.1111/resp.14279

Abstract

Background and objective: The clinical significance of sleep-disordered breathing (SDB) in older age is uncertain. This study determined the prevalence and associations of SDB with mood, daytime sleepiness, quality of life (QOL) and cognition in a relatively healthy older Australian cohort.

Methods: A cross-sectional analysis was conducted from the Study of Neurocognitive Outcomes, Radiological and retinal Effects of Aspirin in Sleep Apnoea. Participants completed an unattended limited channel sleep study to measure the oxygen desaturation index (ODI) to define mild (ODI 5-15) and moderate/severe (ODI ≥ 15) SDB, the Centre for Epidemiological Studies Scale, the Epworth Sleepiness Scale, the 12-item Short-Form for QOL and neuropsychological tests.

Results: Of the 1399 participants (mean age 74.0 years), 36% (273 of 753) of men and 25% (164 of 646) of women had moderate/severe SDB. SDB was associated with lower physical health-related QOL (mild SDB: beta coefficient [β] -2.5, 95% CI -3.6 to -1.3, p < 0.001; moderate/severe SDB: β -1.8, 95% CI -3.0 to -0.6, p = 0.005) and with lower global composite cognition (mild SDB: β -0.1, 95% CI -0.2 to 0.0, p = 0.022; moderate/severe SDB: β -0.1, 95% CI -0.2 to 0.0, p = 0.032) compared to no SDB. SDB was not associated with daytime sleepiness nor depression.

Conclusion: SDB was associated with lower physical health-related quality of life and cognitive function. Given the high prevalence of SDB in older age, assessing QOL and cognition may better delineate subgroups requiring further management, and provide useful treatment target measures for this age group.

Keywords: ageing; cognition; dementia; quality of life; sleep-disordered breathing.

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Conflict of interest statement

Resmed leased some of the ApneaLink Plus devices used in the study and provided the nasal cannula for the devices free of cost. Garun S. Hamilton and Matthew T. Naughton have both received equipment free of charge for use in research from Resmed, and Garun S. Hamilton from Phillips Respironics and Air Liquide Healthcare for the same purpose. Fergal J. O'Donoghue has received a grant from Resmed for research purposes and also received equipment free of charge to conduct research from Resmed and Phillips Respironics.

Figures

**FIGURE 1**
Recruitment flow chart of participants in the final study cohort. ASPREE, ASPirin in Reducing Events in the Elderly; h, hour; n, number; SNORE‐ASA, Study of Neurocognitive Outcomes, Radiological and retinal Effects of Aspirin in Sleep Apnoea

See this image and copyright information in PMC

Comment in

The role of obstructive sleep apnoea in cognitive dysfunction of the elderly: A therapeutic target or Pandora's box?
Mansfield DR. Mansfield DR. Respirology. 2022 Sep;27(9):684-685. doi: 10.1111/resp.14299. Epub 2022 Jun 7. Respirology. 2022. PMID: 35672269 No abstract available.

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Sleep-disordered breathing was associated with lower health-related quality of life and cognitive function in a cross-sectional study of older adults

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Sleep-disordered breathing was associated with lower health-related quality of life and cognitive function in a cross-sectional study of older adults

Authors

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Conflict of interest statement

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