Abstract
Due in part to overall improvements in health, the population of elderly individuals is increasing rapidly. Similarly, obstructive sleep apnoea (OSA) is both gaining increased recognition and also increasing due to the worldwide obesity epidemic. The overlap of OSA and ageing is large, but there is strong plausibility for causation in both directions: OSA is associated with pathological processes that may accelerate ageing and ageing-related processes; ageing may cause physical and neurological changes that predispose to obstructive (and central) apnoea. In addition, the common symptoms (e.g. excessive daytime sleepiness, and defects in memory and cognition), possible physiological consequences of OSA (e.g. accelerated cardiovascular and cerebrovascular atherosclerosis), and changes in metabolic and inflammatory markers overlap with the symptoms and associated conditions seen in ageing. There is also the possibility of synergy in the effects of these symptoms and conditions on quality of life, as well as a need to separate treatable consequences of OSA from age-related complaints. Taken together, the aforementioned considerations make it essential to review the interaction of OSA and ageing, both proven and suspected. The present review examines some aspects of what is known and points to the need for further investigation of the relationships, given the large number of potentially affected subjects.
Abstract
Evidence that obstructive sleep apnoea in the elderly is a separate clinical entity is insufficient. Older patients should be diagnosed and treated in the same manner as their younger counterparts, with particular focus on cognition and multimorbidity. https://bit.ly/3jFXI9v
Footnotes
Conflict of interest: R.S. Osorio declares no competing interests. M.A. Martínez-García declares no competing interests. D.M. Rapoport declares grant funding from Fisher & Paykel Healthcare in the 36 months prior to manuscript submission; and that he is the holder of patents.
Support statement: R.S. Osorio is supported by National Institutes of Health grants R01AG056531, R01AG056031 and P30AG066512. Funding information for this article has been deposited with the Crossref Funder Registry.
This article has an editorial commentary: https://doi.org/10.1183/13993003.01627-2021
Number 1 in the series “Challenges in sleep apnoea” Edited by P. Lévy and M.A. Martínez-García
- Received June 11, 2021.
- Accepted August 25, 2021.
- Copyright ©The authors 2022. For reproduction rights and permissions contact permissions{at}ersnet.org