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Impact of age on intermittent hypoxia in obstructive sleep apnea: a propensity-matched analysis

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

To determine independent relationship of aging with chronic intermittent hypoxia, we compared hypoxia-related polysomnographic variables of geriatric patients (aged ≥ 65 years) with an apnea–hypopnea index (AHI)-, gender-, body mass index (BMI)-, and neck circumference-matched cohort of non-geriatric patients.

Methods

The study was conducted using clinical and polysomnographic data of 1280 consecutive patients who underwent complete polysomnographic evaluation for suspected sleep-disordered breathing (SDB) at a single sleep disorder center. A propensity score-matched analysis was performed to obtain matched cohorts of geriatric and non-geriatric patients, which resulted in successful matching of 168 patients from each group.

Results

Study groups were comparable for gender (P = 0.999), BMI (P = 0.940), neck circumference (P = 0.969), AHI (P = 0.935), and severity of SDB (P = 0.089). The oximetric variables representing the duration of chronic intermittent hypoxia such as mean (P = 0.001), the longest (P = 0.001) and total apnea durations (P = 0.003), mean (P = 0.001) and the longest hypopnea durations (P = 0.001), and total sleep time with oxygen saturation below 90% (P = 0.008) were significantly higher in the geriatric patients as compared with younger adults. Geriatric patients had significantly lower minimum (P = 0.013) and mean oxygen saturation (P = 0.001) than non-geriatric patients.

Conclusions

The study provides evidence that elderly patients exhibit more severe and deeper nocturnal intermittent hypoxia than the younger adults, independent of severity of obstructive sleep apnea, BMI, gender, and neck circumference. Hypoxia-related polysomnographic variables in geriatric patients may in fact reflect a physiological aging process rather than the severity of a SDB.

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Funding

No funding was received for this research.

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Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, Akdeniz University School of Medicine, Antalya, Turkey

    Asli Bostanci & Murat Turhan

  2. Akdeniz University Hospital, Dumlupinar Boulevard, H Blok K: 1, Konyaalti, 07058, Antalya, Turkey

    Asli Bostanci

  3. Department of Biostatistics and Medical Informatics, Akdeniz University School of Medicine, Antalya, Turkey

    Selen Bozkurt

Authors
  1. Asli Bostanci
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  2. Selen Bozkurt
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  3. Murat Turhan
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Correspondence to Asli Bostanci.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Bostanci, A., Bozkurt, S. & Turhan, M. Impact of age on intermittent hypoxia in obstructive sleep apnea: a propensity-matched analysis. Sleep Breath 22, 317–322 (2018). https://doi.org/10.1007/s11325-017-1560-z

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  • DOI: https://doi.org/10.1007/s11325-017-1560-z

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