Severity of individual obstruction events increases with age in patients with obstructive sleep apnea.
BACKGROUND
Age is a risk factor of obstructive sleep apnea (OSA). It has been shown that OSA progresses over time, although conflicting results have been reported. However, the effect of age on the severity of OSA and individual obstruction events has not been investigated within different OSA severity categories by taking the most prominent confounding factors (i.e., body mass index, gender, smoking, daytime sleepiness, snoring, hypertension, heart failure, and proportion of supine sleep) into account.


METHODS
Polygraphic data of 1090 patients with apnea-hypopnea index (AHI) ≥5 were retrospectively reanalyzed. The effect of age on the severity of OSA and obstruction events was investigated in general, within different OSA severity categories, and in different age groups (age <40, 40≤ age <50, 50≤ age <60, and age ≥60 years).


RESULTS
In the whole population, AHI and durations of apneas, hypopneas, and desaturations increased with increasing age (B ≥ 0.108, p ≤ 0.010). In more detailed analysis, AHI increased with age only in the moderate OSA category (B = 0.075, p = 0.022), although durations of apneas increased in mild and severe OSA categories (B ≥ 0.076, p ≤ 0.038). Furthermore, durations of hypopneas increased with age in mild and moderate OSA categories (B ≥ 0.105, p ≤ 0.038), and durations of desaturations (B ≥ 0.120, p ≤ 0.013) in all OSA severity categories. AHI was not statistically significantly different between the age groups, although durations of obstruction events tended to increase towards older age groups.


CONCLUSION
As obstruction event severity was more strongly dependent on the age than it was dependent on AHI, considering the severity of obstruction events could be beneficial while estimating the long-term effects of the treatments and prognosticating the disease progression.
['Leppänen|Timo|T|', 'Töyräs|Juha|J|', 'Mervaala|Esa|E|', 'Penzel|Thomas|T|', 'Kulkas|Antti|A|']
D000328:Adult D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D015992:Body Mass Index D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D012189:Retrospective Studies D012307:Risk Factors D012720:Severity of Illness Index D020181:Sleep Apnea, Obstructive D012907:Smoking D055815:Young Adult
Obstructive sleep apnea Apnea AHI Duration Hypopnea Desaturation