Continuous positive airway pressure (CPAP) therapy might be the gold standard for treating obstructive sleep apnea (OSA). But a recent study out of La Fe University and Polytechnic Hospital in Spain says CPAP treatment may not be as effective for patients ages 80 years and older.
For this age range, the study looked at how CPAP therapy affects sleep apnea symptoms and other factors, including brain function. Researchers found that CPAP therapy decreased patients’ snoring and witnessed apneas, which is when a patient gasps for air and wakes from sleep.
They also found that CPAP therapy did not improve the patients’ other sleep-related symptoms, such as frequent nighttime awakenings to use the bathroom, choking, or nightmares. Other factors that did not improve in the group that used CPAP therapy were quality of life, mood, blood pressure, or cognitive functions, such as decision-making, language comprehension, memory, and attention.
Previous research has not focused on this age population, despite the increase in prevalence of sleep apnea in older adults. While OSA affects 2% to 9% of adults in the U.S., a 2020 study found that sleep apnea affects 15% to 20% of people ages 65 and older.
Untreated sleep apnea is linked to a number of health conditions, including heart disease, stroke, and diabetes. A 2020 study found that treating sleep apnea could reduce the risk of a later dementia diagnosis.
“These are preliminary observations that are provocative but should not serve to change current practice.” — Dr. David Gozal, University of Missouri
CPAP treatment may be less effective for sleep apnea patients 80 years and older for multiple reasons, the researchers say. People in this age group may be treating other health issues and also may live a more sedentary lifestyle than younger sleep apnea patients. Both factors can affect older adults’ sleep quality. These factors can lead to the appearance of symptoms that are similar to those of sleep apnea, such as hypersomnia, but are not treatable with CPAP therapy.
The study’s results do not indicate that sleep apnea patients in this age range should immediately stop using CPAP therapy altogether, however. Researcher Dr. David Gozal of University of Missouri School of Medicine’s Department of Child Health says that “these are preliminary observations that are provocative but should not serve to change current practice.” He advises that all sleep apnea patients try CPAP to see if it helps them.
Researchers also note that evaluation of CPAP treatment on this age population is still evolving because patients age 80 years and older usually make up less than 20% of study participants, which limits researchers’ abilities to make beneficial conclusions about this age group. The related 2020 study also determined that, on average, patients in this age group were likely to use CPAP therapy for less than three hours a night, which is less than the recommended four hours of therapy per night to receive the most benefit of the treatment.
The study’s researchers suggest that future investigations can focus on other factors within the 80-and-older population and if other treatments can help these patients treat sleep apnea.
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