Abstract
Background: The prevalence of obstructive sleep apnea (OSA) increases with age. Treatment often includes positive airway pressure (PAP) therapy. Previous studies have shown that continuous PAP use is correlated with disease severity and symptoms. We hypothesized that PAP acceptance rates in elderly patients with OSA would be lower than in younger patients with OSA and examined factors associated with acceptance.
Methods: We reviewed the charts of 315 patients with OSA (apnea-hypopnea index ≥ 5) who were treated at our hospital from 2008 to 2011 with PAP therapy. All underwent PAP titration testing before PAP prescription. Patients were grouped by their age: young (25–40 years, n = 35), middle (41-65 years, n = 169), and elderly group ( > 65 years, n = 111). Demographic variables, excessive daytime sleepiness (EDS), overnight polysomnography (PSG) study variables, PAP acceptance, and PAP adherence were compared. Regression analysis was performed to identify factors associated with acceptance.
Results: Elderly patients with OSA experienced less excessive daytime sleepiness and less pronounced alterations in overnight PSG variables than patients in the other groups, but had more cardiovascular comorbidities. The PAP acceptance rate (overall 125/315, 39.7%) was significantly lower in the elderly group compared with the young group (31.5% vs. 60%, P = 0.011). PAP acceptance was associated with fewer comorbidities, higher EDS, and higher AHI severity, but not age. PAP adherence was not associate with age.
Conclusions: PAP acceptance is low in elderly patients in Taiwan. PAP acceptance, instead of PAP adherence, is the critical issue in clinical practice concerning elderly patients with OSA. Future studies are needed to resolve the key obstacles to PAP acceptance among elderly patients with OSA.
Footnotes
- ↵*Corresponding Author: Yao-Kuang Wu, MD, Division of Pulmonary and Critical Care Medicine, Buddhist Tzu Chi General Hospital, Taipei Branch, Taiwan, No.289, Jianguo Rd., Xindian Dist., New Taipei City 231, Taiwan, Tel: +886-2-66289779 Ext. 5709, Fax: +886-2-66289009, E-mail: drbfci{at}yahoo.com.tw
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