수면정신생리

수면정신생리 (30권2호 36-40)

Continuous Positive Airway Pressure Treatment in Elderly Patients With Obstructive Sleep Apnea

노인 폐쇄성수면무호흡증 환자에서의 양압기 치료 전략

Sei Won Kim

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Obstructive sleep apnea (OSA) is prevalent among the elderly, with incidence rising due to aging trends. Clinical manifestations in the elderly differ significantly, deviating from conventional risk factors such as male gender and obesity. Postmenopausal women experience a notable surge in OSA prevalence, while traditional features like snoring and high body mass index (BMI) diminish. Limited evidence exists on elderly OSA progression, but untreated cases elevate stroke, cognitive decline, and heart failure risks. Continuous positive airway pressure (CPAP) emerges as the most effective treatment. CPAP therapy proves effective for elderly OSA patients, enhancing sleep quality, addressing nocturia, and improving neurobehavioral outcomes. Elderly individuals often require lower CPAP pressures, with positive effects observed on cardiovascular risk factors and neurobehavioral disorders. Overcoming challenges like nocturnal awakenings and comorbidities, age does not significantly impact PAP adherence. Education, troubleshooting, and emphasizing therapy benefits are vital. Addressing adherence factors in the elderly, including depression, is pivotal. Individualized strategies, considering aging-related challenges and comorbidities, are imperative for successful PAP treatment in this population. Despite potential hurdles, PAP therapy remains a valuable intervention, even for those with dementia. Sleep Medicine and Psychophysiology 2023；30(2)：36-40

Keywords

: Aging; Continuous positive airway pressure; Obstructive sleep apnea syndrome; Sleep related breathing disorder