Don't Ignore The Snore, Obstructive Sleep Apnea In The Elderly Can Have Serious Health Consequences

Sleep apnea is common among the elderly, with serious health consequences. Diagnosis is often challenging due to cognitive dysfunction & fatigue but can be done with sleep studies or portable monitors

Obstructive sleep apnea is often under-diagnosed and under-recognised among the elderly.

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By Dr. Jeethan Bendoor

Transitioning into an older age group can be challenging for many individuals. These golden years are a time to relax and enjoy life to the fullest. For them, a good night’s sleep is vital to staying healthy and energetic. However, sleep apnea can disrupt their daily lives, negatively affecting functioning and causing several health problems. This problem often goes undetected because some symptoms are overlooked and attributed to the ageing process. As the elderly population grows across the world and in India, it is vital to take note of this pressing sleep issue. 

Obstructive sleep apnea and its prevalence among the elderly

Obstructive sleep apnea (OSA) is a serious and increasingly prevalent condition among the elderly, marked by frequent interruptions in breathing during sleep because of airway blockage. As age progresses, physiological changes can make older adults more susceptible to OSA, resulting in fragmented sleep that can contribute to various health complications.

Research indicates that the prevalence of OSA in individuals over 60 years of age is alarmingly high, highlighting a critical need for awareness and intervention.

OSA is strongly linked to cardiovascular diseases, diabetes, and dementia, underscoring the importance of timely diagnosis and management. Risk factors such as obesity, smoking, alcohol consumption, and underlying medical conditions (e.g., chronic lung disorders, hormonal imbalances) further elevate the risk of OSA, making the elderly particularly vulnerable.

Symptoms of OSA in older adults

• Gasping for air during sleep
• Loud snoring
• Morning headaches
• Excessive daytime drowsiness
• Mood disturbances

Challenges of diagnosing obstructive sleep apnea in the elderly

OSA is often under-diagnosed and under-recognised among the elderly due to several reasons. Firstly, the elderly often do not report snoring as a source of concern. Secondly, challenges such as cognitive dysfunction, fatigue, and unintentional napping may be attributed to ageing or other disorders. Lastly, as people age, their bodies have a harder time reacting quickly to changes. As a result, they don’t respond as strongly when they can’t breathe, or when their oxygen levels drop. Without timely intervention, OSA (this condition can) will significantly affect quality of life. 

OSA is typically diagnosed with sleep studies (polysomnography). Level 1 or level 2 sleep studies are considered accurate as they are carried out in a sleep clinic. However, those with limited access or who are too old/frail to travel to clinics may be unable to take these tests. In such cases, a level 3 test, which can be carried out at home using portable monitors, is recommended.

With technological advancements, OSA can be diagnosed with comfortable wearables that can be linked to smartphone apps — both are easy to use and understand, as well are convenient while travelling, non-invasive, and importantly provide clinically verifiable reports that are similar to polysomnography. These devices can be easily integrated into the daily routines without requiring technical know-how and are more affordable than traditional study in a clinic.  They can be used over multiple nights to monitor sleep and track improvements. 

Treating obstructive sleep apnea

Data in scientific literature indicates that by 2050, almost 2.1 billion people globally will be above 60 years of age. It is, therefore, imperative that OSA be addressed with urgency. Treatment of OSA in the elderly is similar to that in the young and is based on the severity of the condition. 

With advancements, simpler and more convenient devices are now available for mild-to-moderate OSA. For instance, a mandibular or dental device that repositions the lower jaw while the person sleeps, helps them breathe easily. These devices are compact, portable, fully adjustable, lightweight, and travel friendly. Furthermore, they can be used along with wearable sleep monitors to gauge sleep quality. 

Early diagnosis of OSA in the elderly, and effective management with convenient treatment options that are easily acquirable can improve their well-being, reduce the risk of health complications, and significantly improve quality of life. 

Dr. Jeethan Bendoor is, Consultant to Dormir Bien Private Limited.

[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]