Sleep Apnea in the Elderly

Purpose of Review

The population of the world is aging and increasing age has been associated with increased prevalence of obstructive sleep apnea (OSA). However, OSA in the elderly has not received much attention. The purpose of the present narrative review is to provide a comprehensive overview on what is known about the specific features of OSA, its consequences and treatment in the elderly.

Recent Findings

The number of studies regarding OSA in the elderly is very limited. The clinical presentation of OSA in the elderly differs from the clinical presentation of OSA in middle-aged people. Furthermore, recent studies suggest that the risks caused by untreated OSA in the elderly differ from the risks in middle-aged patients with less focus on sleepiness, hypertension and cardiovascular health and more concerns on cerebrovascular health, cognition and perhaps even the risk of falls. However, the treatment of especially severe symptomatic OSA seems to have many benefits also in the elderly. Several studies suggest that CPAP adherence may also be good among the elderly. There is also emerging evidence of cost effectiveness of CPAP treatment in the elderly. Ongoing studies will reveal the effect of CPAP on cognitive decline and the risk of falls.

Summary

Taking into consideration that the population is aging, there is an urgent need for larger studies especially on the phenotypes of OSA in the elderly and identifying groups benefiting from and adhering to CPAP therapy.