1
|
Canever JB, Zurman G, Vogel F, Sutil DV, Diz JBM, Danielewicz AL, Moreira BDS, Cimarosti HI, de Avelar NCP. Worldwide prevalence of sleep problems in community-dwelling older adults: A systematic review and meta-analysis. Sleep Med 2024; 119:118-134. [PMID: 38669835 DOI: 10.1016/j.sleep.2024.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/09/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024]
Abstract
The understanding of the prevalence of sleep problems in older adults can provide a broad and reliable perspective into the occurrence of such issues among older adults. This systematic review and meta-analysis aimed to estimate the worldwide prevalence of sleep problems in community-dwelling older adults. Studies that provide information on the prevalence of sleep problems in community-dwelling older adults (≥60 years) were screened between December 2022 and March 2023. A total of 20,379 studies were identified in database searches, from which 252 were included in this review. These studies covered the last 35 years (from 1988 to 2023) and pooled a sample of 995,544 participants from 36 countries. The most frequent sleep problem worldwide was obstructive sleep apnea (46.0%), followed by poor sleep quality (40.0%), other sleep problems (37.0%), insomnia (29.0%), and excessive daytime sleepiness (19.0%). No significant difference in the prevalence estimates of all sleep problems was observed between the sexes. This systematic review and meta-analysis showed a high prevalence of some sleep problems, mainly obstructive sleep apnea, poor sleep quality, and other sleep problems. Our estimates can be useful for managers and policymakers in planning healthcare strategies for sleep problems aimed at the older population.
Collapse
Affiliation(s)
- Jaquelini Betta Canever
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Araranguá, Santa Catarina, Urussanguinha, 320188906-072, Brazil; Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Gabriela Zurman
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Felipe Vogel
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Daiana Vieira Sutil
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - Ana Lúcia Danielewicz
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Bruno de Souza Moreira
- Center for Studies in Public Health and Aging, Federal University of Minas Gerais and Oswaldo Cruz Foundation - Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Helena Iturvides Cimarosti
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Araranguá, Santa Catarina, Urussanguinha, 320188906-072, Brazil
| | - Núbia Carelli Pereira de Avelar
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| |
Collapse
|
2
|
Riha RL, Celmina M, Cooper B, Hamutcu-Ersu R, Kaditis A, Morley A, Pataka A, Penzel T, Roberti L, Ruehland W, Testelmans D, van Eyck A, Grundström G, Verbraecken J, Randerath W. ERS technical standards for using type III devices (limited channel studies) in the diagnosis of sleep disordered breathing in adults and children. Eur Respir J 2023; 61:13993003.00422-2022. [PMID: 36609518 DOI: 10.1183/13993003.00422-2022] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 07/27/2022] [Indexed: 02/01/2023]
Abstract
For more than three decades, type III devices have been used in the diagnosis of sleep disordered breathing in supervised as well as unsupervised settings. They have satisfactory positive and negative predictive values for detecting obstructive and central sleep apnoea in populations with moderately high pre-test probability of symptoms associated with these events. However, standardisation of commercially available type III devices has never been undertaken and the technical specifications can vary widely. None have been subjected to the same rigorous processes as most other diagnostic modalities in the medical field. Although type III devices do not include acquisition of electroencephalographic signals overnight, the minimum number of physical sensors required to allow for respiratory event scoring using standards outlined by the American Academy of Sleep Medicine remains debatable. This technical standard summarises data on type III studies published since 2007 from multiple perspectives in both adult and paediatric sleep practice. Most importantly, it aims to provide a framework for considering current type III device limitations in the diagnosis of sleep disordered breathing while raising research- and practice-related questions aimed at improving our use of these devices in the present and future.
Collapse
Affiliation(s)
- Renata L Riha
- Department of Sleep Medicine, The Royal Infirmary Edinburgh, Edinburgh, UK
| | - Marta Celmina
- Epilepsy and Sleep Medicine Centre, Children's Clinical University Hospital, Riga, Latvia
| | - Brendan Cooper
- Lung Function and Sleep, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, UK
| | | | - Athanasios Kaditis
- Division of Paediatric Pulmonology and Sleep Disorders Laboratory, First Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine and Agia Sofia Children's Hospital, Athens, Greece
| | | | - Athanasia Pataka
- Respiratory Failure Unit, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Thomas Penzel
- Department of Cardiology and Angiology, Interdisciplinary Center of Sleep Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - Warren Ruehland
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
| | - Dries Testelmans
- Department of Pneumology, University Hospitals Leuven, Leuven, Belgium
| | - Annelies van Eyck
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp (Edegem), Belgium
- Department of Pediatrics, Antwerp University Hospital, Antwerp (Edegem), Belgium
| | | | - Johan Verbraecken
- Antwerp University Hospital and University of Antwerp, Edegem (Antwerp), Belgium
| | - Winfried Randerath
- Bethanien Hospital, Clinic of Pneumology and Allergology, Center for Sleep Medicine and Respiratory Care, Institute of Pneumology at the University of Cologne, Solingen, Germany
| |
Collapse
|
3
|
Kalantari E, Kalantari F, Edalatifard M, Rahimi B. Evaluating changes in pulse transit time drop index in patients with obstructive sleep apnea before and during CPAP therapy. THE CLINICAL RESPIRATORY JOURNAL 2022; 16:611-617. [PMID: 35941748 PMCID: PMC9436903 DOI: 10.1111/crj.13532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 11/29/2022]
Abstract
Airflow limitation in patients with obstructive sleep apnea (OSA) leads to arousal, increased sympathetic nervous system activity, and elevated blood pressure, which causes a decrease in pulse transit time (PTT). The present study aims to evaluate the effect of CPAP therapy on PTT in patients with moderate to severe OSA. This was a cross‐sectional study. Split‐night polysomnography (PSG) study was performed for each participant with apnea‐hypopnea index (AHI) ≥ 15 before and during CPAP therapy. The PTT was calculated as the time interval between the R wave of the electrocardiogram and the following arrival point in fingertip photoplethysmography. PTT drop was defined as a fall in the PTT curve of ≥15 ms lasting at least for 3 s and at most for 30 s. PTT drop index was defined as the number of drops in PTT that occur per hour of sleep. A total of 30 patients were included. PTT significantly increased, and PTT drop index significantly decreased during CPAP therapy (P < 0.001). PTT was significantly correlated to sleep efficiency (rs = −0.376, P = 0.049) and oxygen desaturation index (ODI) (rs = −0.428, P = 0.018). PTT drop index was strongly correlated to AHI (rs = 0.802, P < 0.001), respiratory disturbance index (RDI) (rs = 0.807, P < 0.001), ODI (rs = 0.693, P < 0.001), arousal index (rs = 0.807, P < 0.001), and periodic leg movement (PLM) index (rs = 0.400, P = 0.035). Overall, the findings from this study indicated that the PTT drop index is a non‐invasive and useful marker for evaluating the severity of OSA and the effectiveness of treatment in patients with moderate to severe OSA.
Collapse
Affiliation(s)
- Elham Kalantari
- Department of Pulmonology Isfahan University of Medical Sciences Isfahan Iran
| | - Forough Kalantari
- Department of Nuclear Medicine, Rasoul Akram Hospital Iran University of Medical Sciences Tehran Iran
| | - Maryam Edalatifard
- Advanced Thoracic Research Center Tehran University of Medical Sciences Tehran Iran
| | - Besharat Rahimi
- Advanced Thoracic Research Center Tehran University of Medical Sciences Tehran Iran
| |
Collapse
|
4
|
Clinical impact of sleep-disordered breathing on very short-term blood pressure variability determined by pulse transit time. J Hypertens 2020; 38:1703-1711. [DOI: 10.1097/hjh.0000000000002445] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
5
|
Sforza E, Martin MS, Barthélémy JC, Roche F. Is there an association between altered baroreceptor sensitivity and obstructive sleep apnoea in the healthy elderly? ERJ Open Res 2016; 2:00072-2016. [PMID: 27957483 PMCID: PMC5140016 DOI: 10.1183/23120541.00072-2016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 07/24/2016] [Indexed: 11/05/2022] Open
Abstract
Obstructive sleep apnoea (OSA) is associated with a rise in cardiovascular risk in which increased sympathetic activity and depressed baroreceptor reflex sensitivity (BRS) have been proposed. We examined this association in a sample of healthy elderly subjects with unrecognised OSA. 801 healthy elderly (aged ≥65 years) subjects undergoing clinical, respiratory polygraphy and vascular assessment were examined. According to the apnoea-hypopnoea index (AHI), the subjects were stratified into no OSA, mild-moderate OSA and severe OSA cases. OSA was present in 62% of the sample, 62% being mild-moderate and 38% severe. No differences were found for BRS value according to sex and OSA severity. 54% of the group had normal BRS value, 36% mild impairment and 10% severe dysfunction. BRS was negatively associated with body mass index (p=0.006), 24-h systolic (p=0.001) and diastolic pressure (p=0.001), and oxygen desaturation index (ODI) (p=0.03). Regression analyses revealed that subjects with lower BRS were those with hypertension (OR 0.41, 95% CI 0.24-0.81; p=0.002) and overweight (OR 0.42, 95% CI 0.25-0.81; p=0.008), without the effect of AHI and ODI. In the healthy elderly, the presence of a severe BRS dysfunction affects a small amount of severe cases without effect on snorers and mild OSA. Hypertension and obesity seem to play a great role in BRS impairment.
Collapse
Affiliation(s)
- Emilia Sforza
- Service de Physiologie Clinique et de l'Exercice, Pole NOL, CHU, EA SNA-EPIS, Faculté de Médecine J. Lisfranc, UJM Saint-Etienne, PRES Université de Lyon, Saint-Etienne, France
| | - Magali Saint Martin
- Service de Physiologie Clinique et de l'Exercice, Pole NOL, CHU, EA SNA-EPIS, Faculté de Médecine J. Lisfranc, UJM Saint-Etienne, PRES Université de Lyon, Saint-Etienne, France; Centre Hélio Marin de la Côte D'Azur, Hyeres, France
| | - Jean Claude Barthélémy
- Service de Physiologie Clinique et de l'Exercice, Pole NOL, CHU, EA SNA-EPIS, Faculté de Médecine J. Lisfranc, UJM Saint-Etienne, PRES Université de Lyon, Saint-Etienne, France
| | - Frédéric Roche
- Service de Physiologie Clinique et de l'Exercice, Pole NOL, CHU, EA SNA-EPIS, Faculté de Médecine J. Lisfranc, UJM Saint-Etienne, PRES Université de Lyon, Saint-Etienne, France
| |
Collapse
|
6
|
|
7
|
Saint Martin M, Sforza E, Roche F, Barthélémy JC, Thomas-Anterion C. Sleep breathing disorders and cognitive function in the elderly: an 8-year follow-up study. the proof-synapse cohort. Sleep 2015; 38:179-87. [PMID: 25325480 PMCID: PMC4288598 DOI: 10.5665/sleep.4392] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 08/12/2014] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Sleep breathing disorder (SBD) may be an important factor in age-related cognitive decline. In a cohort of healthy elderly subjects, we performed an 8-y longitudinal study to assess whether changes in cognitive function occur in untreated elderly patients with SBD and without dementia and the factors implicated in these changes. DESIGN A population-based longitudinal study. SETTING Clinical research settings. PARTICIPANTS A total of 559 participants of the PROOF study aged 67 y at the study entry and free from neurological disorders were examined. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Abnormal breathing events were defined by an apnea-hypopnea index (AHI) > 15. The raw cognitive data and averaged Z-scores for the attentional, executive, and memory functions were collected at the baseline and follow-up. At baseline, AHI > 15 was found in 54% of subjects with 18% having an AHI > 30. At follow-up, the presence of abnormal breathing events was associated with a slight but significant decline in the attentional domain (P = 0.01), which was more evident in the subjects with an AHI > 30 (P = 0.004). No significant changes over time were observed in the executive and memory functions. Several indices of chronic hypoxemia, defined either as a cumulative peripheral oxygen saturation (SpO2) < 90% or a minimal SpO2, accounted for portions of the variance in the decline in attention. All observed effects were small, accounting for 4-7% of variance in multivariate models. CONCLUSION In healthy elderly subjects, various components of sleep breathing disorder at baseline were associated with small changes in selected cognitive functions specific to the attention domain after controlling for multiple comorbidities, such as sleepiness, hypertension, diabetes, anxiety, and depression. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifiers NCT 00759304 and NCT 00766584.
Collapse
Affiliation(s)
- Magali Saint Martin
- Department of Clinical Physiology and Exercise, Pole NOL, CHU and Faculty of Medicine of Saint-Etienne, UJM and PRES University of Lyon, Saint-Etienne, France
- EMC Laboratory, EA 3880, University of Lyon 2, Lyon, France
| | - Emilia Sforza
- Department of Clinical Physiology and Exercise, Pole NOL, CHU and Faculty of Medicine of Saint-Etienne, UJM and PRES University of Lyon, Saint-Etienne, France
| | - Frédéric Roche
- Department of Clinical Physiology and Exercise, Pole NOL, CHU and Faculty of Medicine of Saint-Etienne, UJM and PRES University of Lyon, Saint-Etienne, France
| | - Jean Claude Barthélémy
- Department of Clinical Physiology and Exercise, Pole NOL, CHU and Faculty of Medicine of Saint-Etienne, UJM and PRES University of Lyon, Saint-Etienne, France
| | | |
Collapse
|
8
|
Crawford-Achour E, Roche F, Pichot V, Celle S, Barthélémy JC, Chouchou F. Sleep-related autonomic overactivity in a general elderly population and its relationship to cardiovascular regulation. Heart Vessels 2014; 31:46-51. [PMID: 25150588 DOI: 10.1007/s00380-014-0573-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 08/15/2014] [Indexed: 11/25/2022]
Abstract
Alteration in cardiac autonomic activity during sleep is a common feature of sleep disorders. Diurnal sympathetic overactivity is a possible consequence and could contribute to future cardiovascular complications. The aim of this study is to assess the relationship between cardiac autonomic activity during sleep and diurnal autonomic cardiovascular control. In a large cohort (n = 1011) of subjects aged 65 years old (± 0.4) free of cardiac and cerebrovascular events and of sleep-related breathing disorders, we evaluated (cross-sectional study) the prevalence of unexpected alteration in sleep-related autonomic overactivity according to the presence of a cyclical nocturnal heart rate variability [quantified using the relative power spectral density of the very low-frequency band of the heart rate increment (VLFi%) from ECG Holter monitoring]. We tested its relationship with diurnal ambulatory blood pressure and spontaneous baroreflex sensitivity (sBRS). An abnormal cardiac autonomic activity during sleep was retained in 34.4% of this population according to a VLFi% >4. Using multiple logistic regression analysis, the severity of the autonomic alteration was mainly correlated after adjustment with lower sBRS (p = 0.01; OR: 0.94; 95% CI: 0.90-0.98). Diurnal baroreflex control alteration is associated with sleep-related autonomic overactivity elderly. Such alteration may contribute to the increased incidence of cardiovascular complications in sleep disorders.
Collapse
Affiliation(s)
- Emilie Crawford-Achour
- Service de Gériatrie et Gérontologie, CHU Saint-Etienne, Université Jean Monnet, Saint-Etienne PRES de Lyon, France
| | - Frédéric Roche
- Faculté de Médecine Jacques Lisfranc, Service de Physiologie et de l'Exercice, EA 4607 SNA EPIS, CHU Nord, Université Jean Monnet, Saint-Etienne PRES de Lyon, France.
- , CHU Nord, Niveau 6, EFCR, 42055, Saint-Etienne Cedex 2, France.
| | - Vincent Pichot
- Faculté de Médecine Jacques Lisfranc, Service de Physiologie et de l'Exercice, EA 4607 SNA EPIS, CHU Nord, Université Jean Monnet, Saint-Etienne PRES de Lyon, France
| | - Sébastien Celle
- Faculté de Médecine Jacques Lisfranc, Service de Physiologie et de l'Exercice, EA 4607 SNA EPIS, CHU Nord, Université Jean Monnet, Saint-Etienne PRES de Lyon, France
| | - Jean-Claude Barthélémy
- Faculté de Médecine Jacques Lisfranc, Service de Physiologie et de l'Exercice, EA 4607 SNA EPIS, CHU Nord, Université Jean Monnet, Saint-Etienne PRES de Lyon, France
| | - Florian Chouchou
- Faculté de Médecine Jacques Lisfranc, Service de Physiologie et de l'Exercice, EA 4607 SNA EPIS, CHU Nord, Université Jean Monnet, Saint-Etienne PRES de Lyon, France
| |
Collapse
|
9
|
Chouchou F, Pichot V, Pépin J, Tamisier R, Celle S, Maudoux D, Garcin A, Lévy P, Barthélémy J, Roche F. Sympathetic overactivity due to sleep fragmentation is associated with elevated diurnal systolic blood pressure in healthy elderly subjects: the PROOF-SYNAPSE study. Eur Heart J 2013; 34:2122-31, 2131a. [DOI: 10.1093/eurheartj/eht208] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
|
10
|
Zong J, Liu Y, Huang Y, Chen J, Gao L, Zhang C, Dong S, Chen X. Serum lipids alterations in adenoid hypertrophy or adenotonsillar hypertrophy children with sleep disordered breathing. Int J Pediatr Otorhinolaryngol 2013; 77:717-20. [PMID: 23434201 DOI: 10.1016/j.ijporl.2013.01.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 01/20/2013] [Accepted: 01/26/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVES We aimed to investigate metabolic parameters in children with adenoid hypertrophy (AH) only or adenotonsillar hypertrophy (ATH) and compare them with healthy controls. METHODS Forty-four prepubertal children aged 6-12 years who were obstructive symptoms and 16 healthy children were recruited in this study. All children underwent a complete otolaryngologic examination and sleep screening. The patients were divided into three groups according to obstruction type: normal, AH (adenoid grade III or IV, tonsil grade 1 or 2), and ATH (adenoid grade III or IV, tonsil grade 3 or 4). All participants underwent hematologic and biochemical tests including fasting blood glucose, insulin, and plasma lipids. RESULTS (1) The children with AH and ATH had lower high-density lipoprotein cholesterol (HDL-C), when compared to normal children. (2) The level of HDL-C was negatively correlated with the sum of adenoid and tonsillar size scores and the apnea-hypopnea index (AHI) (r=-0.477, p<0.001 vs. r=-0.548, p<0.001, respectively). There was a modest association between HDL-C and minimal SpO₂ (r=0.332, p=0.009). (3) Stepwise multiple regression analysis identified the AHI, triglycerides, and fasting insulin as independent predictors for HDL-C. CONCLUSIONS Patients with adenoid and tonsil hypertrophy had low HDL-C. HDL-C levels are inversely related to the sum of adenoid and tonsillar size scores and AHI in SDB children. HDL-C may be a sensitive indicator of serum lipids changes in SDB children.
Collapse
Affiliation(s)
- Jing Zong
- Department of Endocrinology, The Affiliated Hospital of Jiangsu University, China
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Pillar G, Etzioni T, Katz N. Acoustic snoring analysis can provide important information in OSA diagnosis. Sleep 2012; 35:1195-6. [PMID: 22942495 DOI: 10.5665/sleep.2064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|