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23 - Sleep apnea in the elderly

from Part 3 - Sleepdisorders in the elderly

Published online by Cambridge University Press:  04 August 2010

By
Andrea H. S. Loewen ,
Marc J. Poulin  and
Patrick J. Hanly
Edited by
S. R. Pandi-Perumal ,
Jaime M. Monti  and
Andrew A. Monjan
S. R. Pandi-Perumal
Affiliation:
Somnogen Inc, New York
Jaime M. Monti
Affiliation:
Universidad de la República, Uruguay
Andrew A. Monjan
Affiliation:
National Institute on Aging, Bethesda, Maryland
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Summary

This chapter provides some guidance on how to manage sleep apnea in the elderly. It focuses on obstructive and central sleep apnea. Sleep disordered breathing includes obstructive sleep apnea (OSA), central sleep apnea including Cheyne-Stokes respiration (CSR), and sleep hypoventilation. The underlying mechanisms that promote the development of sleep apnea in the elderly can be classified into three broad categories, namely: (1) replication of the pathophysiology of sleep apnea in middle-aged adults; (2) physiological changes that are uniquely associated with aging; and (3) consequences of chronic medical disorders and/or medications. Elderly patients with sleep apnea can present with typical clinical features such as snoring, choking or gasping respirations, witnessed apneas, morning headaches, hypertension, and daytime sleepiness. After the identification and treatment of any underlying medical disorders that contribute to sleep apnea, such as hypothyroidism and acromegaly, weight reduction, and postural therapy can be considered.

Keywords

age-related changescircadian rhythmcognitive impairmentolder adultssleep disordered breathingnocturnal confusioninsomniadifferential diagnosissleep disorders
Type
Chapter
Information
Principles and Practice of Geriatric Sleep Medicine , pp. 248 - 259
Publisher: Cambridge University Press
Print publication year: 2009

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