Morbidity and Predicted Mortality in Older Adults with Central Sleep Apnea
|Saban-Hakki Onen 1,2*, Virgine Dauphinot3, Nalaka S Gooneratne4,5, Ghislaine Watchueng1, Jian-Sheng Lin2 and Fannie Onen6,7|
|1Hospices Civils de Lyon, Hôpital Antoine Charial, Centre Gériatrique de Médecine du Sommeil, F-69340 Francheville, France|
|2Inserm U1028, Université Lyon1, F-69373 Lyon Cedex 08, France|
|3Hospices Civils de Lyon, CMRR Biostatistiques, Hôpital des Charpennes, F-69100 Villeurbanne, France|
|4Center for Sleep and Circadian Neurobiology and Division of Sleep Medicine, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA|
|5Division of Geriatric Medicine, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA|
|6CHU Bichat Claude Bernard, APHP, Service de Gériatrie, F-75018 Paris, France|
|7INSERM U669, Université Paris Descartes, 75014 Paris, France|
|Corresponding Author :||Saban-Hakki ONEN
Hôpital Antoine Charial 40
avenue de la Table Pierre 69340, FRANCHEVILLE - FRANCE
Tel: +33 4 72 32 34 23
Fax: +33 4 72 32 39 32
E-mail: [email protected]
|Received August 03, 2013; Accepted October 10, 2013; Published October 15, 2013|
|Citation: Saban-Hakki Onen, Dauphinot V, Gooneratne NS, Watchueng G, Lin JS, et al. (2013) Morbidity and Predicted Mortality in Older Adults with Central Sleep Apnea. J Sleep Disord Ther 2:146. doi:10.4172/2167-0277.1000146|
|Copyright: © 2013 Saban-Hakki Onen, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Objectives: To assess cardiovascular morbidity and prognostic mortality risk in older patients with CSA in comparison to those with OSA and without any SDB (apnea-hypopnea index <15/hour).
Background: Sleep-Disordered Breathing (SDB), including both Central Sleep Apnea (CSA) and Obstructive Sleep Apnea (OSA), is a prevalent condition in older adults. In contrast to OSA, the information concerning the morbidity and mortality associated with CSA is scarce and inconsistent.
Methods: We analyzed a prospectively collected database of consecutive patients aged 70 and over referred for suspicion of SDB. All patients underwent an overnight polysomnography and a clinical assessment. Cardiovascular morbidities and prognostic index for 4-year mortality (PIM) were abstracted from patient records.
Results: The data derived from 207 patients (79.7 ± 5.7 years) was divided into three groups according to the apnea classification (20 CSA, 121 OSA, and 66 no-SDB). Stroke (7/20, p= 0.02) and hypertension (19/20, p=0.003) were more frequent in CSA patients than OSA and no-SDB patients. The mean PIM score of patients with CSA (10.7 ± 3.3) was higher than those with OSA (7.8 ± 3.1) and no-SDB (8.4 ± 2.9), even after adjustment for potential confounders including gender and SpO2 (p <0.001).
Conclusion: CSA is associated with stroke and hypertension and an increased prognostic mortality risk compared to OSA and no-SDB in older patients. The knowledge of morbidities and mortality risk associated with CSA may help in planning preventive and therapeutic strategies to improve patients’ global health status and quality of life.