Sleep Apnea and Sleepiness Raises Older Adults’ Death Risk

A study in the latest issue of the journal SLEEP provides further evidence that sleep apnea should never be left untreated. Older adults have twice the death risk when excessive daytime sleepiness is paired with obstructive sleep apnea.

The study involved 289 participants at least 65 years old and with no clear signs of dementia or depression. The average age at the start of the study was about 78 years old. About three-quarters of the patients were female.

An overnight sleep study at the beginning of the study was used to diagnose participants with obstructive sleep apnea. Subjects who indicated that they felt sleepy or struggled to stay awake during the daytime at least three to four times a week had excessive daytime sleepiness.

Social security death index records indicate after 14 years nearly 55 percent of the participants died. Results show that participants with excessive daytime sleepiness combined with sleep apnea were more than twice as likely to have died. Being sleepy in and of itself did not lead to an increased mortality risk.

The lead author of the study says it’s still unclear exactly why sleep apnea and excessive daytime sleepiness increase the risk of death in older adults, but he suspects it may be related to inflammation. Cases of inflammation may increase the risk of other medical problems such as hypertension.

Obstructive sleep apnea affects nearly 20 percent of older adults. It occurs when the soft tissue in the back of the throat collapses and blocks the upper airway during sleep, causing pauses in breathing.

The study was unable to demonstrate whether treatment for sleep apnea reduced the risk of death. The Sleep Education Blog strongly recommends that anyone with moderate to severe sleep apnea seek treatment immediately.

CPAP therapy is the first-line treatment for obstructive sleep apnea, especially in more severe cases. Surgery and oral appliance therapy are also effective options for lesser cases.

If you think you may have sleep apnea, get checked out at one of the more than 2,200 AASM-accredited sleep disorders centers in the United States. Go to http://www.sleepcenters.org/ to find a sleep center near you.

Image by Nick Wilkes

Majority of assisted living residents have “significant sleep disturbances”

It’s no secret people sleep less as they get older, and there’s no better example of this than residents of assisted living facilities.

65 percent have some type of clinical sleep disorder, according to a study published in the American Geriatrics Society.

The authors tracked 121 seniors after they enrolled in one of 18 assisted living facilities in the Los Angeles area.

The subjects took the Pittsburgh Sleep Quality Index, a self-rated questionnaire. Researchers then measured their sleep quality by wrist actigraph. The subjects took both tests at enrollment and after three and six months at the facility.

A majority of people had some type of sleep disturbance. About 60 percent of residents complained of some form of insomnia. Slightly more subjects said they woke up in the middle of the night or early morning than had trouble sleeping.

Physical and mental health tended to decline at a faster rate for residents who complained of sleep disturbances.

The authors of the study were quick to point out that poor sleep is associated with decline in health at a late age. The authors suggest there’s room to examine for a possible causal relationship by seeing if improving sleep would spur better health.

At this point it’s not known what direction therelationship takes. Does health decline for assisted living residents because of poor sleep or are sleep disturbances a symptom of greater health problems?

A study published in the May issue of SLEEP found people who lived to be 100 slept more than most, averaging 7.5 hours of sleep a day. Generally, older adults tend to get less sleep. However, due to the design of the study, its not known whether sleep increased near 100 years old, or if 100-year-olds were better sleepers than most people ages 65 to 99.

Is 100 year olds' secret to longevity sleep?

Is the trick to living out a healthy and productive twilight getting a good night’s sleep? Those who’ve already celebrated their 100th birthday sleep longer and better than the rest of the elderly.

The study, published in the May 1st issue of SLEEP used survey data to look at the sleeping habits of the oldest populations in China.

They discovered Chinese ages 100 or above slept an average of 7.5 hours a day, including naps. Controlling for factors like wealth and health conditions, the extremely elderly were 70 percent more likely to report sleeping well than 65-year-olds to 79-year-olds.

Men were significantly more likely to report sleeping well than women. Those with health problems were nearly half as likely to report quality sleep.

The study found access to health care and economic status were strongly related to good sleep.

The authors of the study picked China because it has the world’s largest elderly population, with nearly 40.5 million people over age 75. The Chinese Longitudinal Healthy Longevity Survey, completed in 2005, is used by global researchers to study the lifestyle habits of the elderly. The survey was conducted using in-home interviews.

While the study sheds light on the sleeping habits of oldest people in the world, it does not explain why they lived to be so old. The authors say they suspect it may be due in part to sleeping well, but because the research was based on a survey, it’s impossible to prove at the moment.

Do Dentures Affect Sleep Apnea?

Obstructive sleep apnea is common at all ages. But it occurs even more often in the transition from middle-aged to older-aged adults. For older adults with sleep apnea, do dentures affect their breathing during sleep?

A new study from Japan found mixed results. The study involved 34 adults who wear complete dentures. Their average age was 72.5 years. Twenty seven of the participants had at least mild sleep apnea with five or more breathing pauses per hour of sleep.

Sleeping without dentures, participants stopped breathing an average of 17.7 times per hour during one night of sleep. With dentures, breathing pauses during sleep decreased in 19 of the 27 participants. The average number of breathing pauses per hour of sleep with dentures dropped to 13.3. But in eight of the older adults, breathing pauses increased when sleeping with dentures.

Dentures certainly are no cure for sleep apnea in older adults. And the study did not measure how dentures may affect the use of CPAP therapy.

But older adults with sleep apnea should discuss denture use with their sleep doctor.

Get sleep tips for older adults on SleepEducation.com.

More than Insomnia: Other Sleep Disorders Are Common in Older Adults

Many older adults struggle with insomnia. Now a new study shows that in older adults other sleep disorders are common too.

The study involved 892 people between the ages of 70 and 89. Results show that 59 percent had signs of at least one sleep disorder other than insomnia.

Data were gathered by questionnaire. Symptoms were reported by a person who sleeps in the same room as the participant.

Sleep-related leg cramps was the most common sleep disorder. Symptoms were present in 32 percent of participants.



The second and third most common sleep disorders were obstructive sleep apnea and periodic limb movements in sleep. Other common sleep disorders were REM sleep behavior disorder, restless legs syndrome and sleepwalking.

“All of these sleep disorders can disrupt a person’s quality of life, because they affect sleep,” lead researcher Dr. Jennifer Molano said in a Mayo Clinic statement. “But if these problems are recognized, an accurate diagnosis could lead to successful treatment.”

Older adults can get help for sleep problems at an AASM-accredited sleep center. Get sleep tips for older adults on SleepEducation.com.

Is Daytime Sleepiness an Excessive Risk for Older Adults?

Excessive daytime sleepiness is common in older adults. But is it anything to be worried about?

A new study from France may raise a few eyebrows. It links EDS in older adults with an increased risk of death.

The study involved 8,269 adults with an average age of 74 years. All of them were living in the community rather than in a nursing home. None of them had dementia when the study began.

At the start of the study almost 19 percent of participants reported having regular or frequent EDS. The study group was followed for six years.

During this time 762 people died. Of these deaths, 196 were caused by heart disease.

Results show that the older adults with EDS had a much worse survival rate. There was a 33 percent increase in their risk of death. There also was a 49 percent increase in their risk of death from heart disease.

So is EDS a symptom of heart disease? The relationship may not be so simple.

The study measured the resting heart rates of participants. Ultrasound also was used to examine the carotid artery of two-thirds of the study group. There were no differences between those with and without EDS.

Does this mean that EDS in some way triggers heart disease? The authors aren’t sure. But they suggest that EDS in older adults may not be as harmless as some might think.

They recommend that doctors should routinely screen older adults for EDS. Those who have EDS then should undergo a sleep study to look for any underlying sleep problems.

Get Sleep Tips for Older Adults from the AASM.