positive airway pressure is effective at treating sleep apnoea in older people,
a new study has found.
Stopping the throat from closing
sleep apnoea (OSA) is a condition where the walls of the throat relax and
narrow during sleep, interrupting normal breathing and causing profound
sleepiness. For people with moderate or severe OSA, doctors usually recommend
using a continuous positive airway pressure (CPAP) device, which consists of a
small pump that delivers pressurised air into the nose through a mask, stopping
the throat from closing.
studies have established the benefits of CPAP in middle-aged people with OSA,
but until now there has been no research on whether the treatment is useful and
cost-effective for older patients.
research found that CPAP reduces how sleepy patients feel in the daytime and
reduces healthcare costs. The researchers say CPAP should be offered routinely
to older patients with OSA, and more should be done to raise awareness of the
study, published today in Lancet Respiratory Medicine, involved 278
patients aged 65 or over at 14 NHS centres in the UK. It was led by researchers
at Imperial College London and the Royal Infirmary of Edinburgh in
collaboration with the Medical Research Council Clinical Trials Unit at UCL,
and the Universities of Oxford and York. It was funded by the National
Institute for Health Research Health Technology Assessment (NIHR HTA)
20 per cent of the adult population experiences breathing problems during
sleep. In four to five per cent of middle-aged people, these problems lead to
sleepiness in the daytime, classified as obstructive sleep apnoea syndrome.
Read: Sleep apnoea linked to dementia
Obesity a major risk factor
condition is thought to be more common in older people, but the true prevalence
is unknown, in part because patients and their relatives may attribute their
sleepiness to old age, or older people can compensate by napping. The disease
is becoming more common because obesity is a major risk factor.
Read: Sleep apnoea? Lose weight
Mary Morrell, co-principal investigator of the study from the National Heart
and Lung Institute at Imperial College London, said: "Sleep apnoea can be
hugely damaging to patients' quality of life and increase their risk of road
accidents, heart disease and other conditions.
Lots of older people might
benefit from this treatment. Many patients feel rejuvenated after using CPAP
because they're able to sleep much better and it may even improve their brain
with sleep apnoea sometimes stop breathing for 30 seconds or longer at night
before they wake up and start breathing again. In these pauses, their blood
oxygen levels fall.
Changes in the brain
think low oxygen levels at night might accelerate cognitive decline in old people,
and studies have found that sleep apnoea causes changes in the grey matter in
the brain. We're currently researching whether treatment can prevent or reverse
those changes," said Professor Morrell.
investigator Dr. Renata Riha, Consultant and Honorary Reader at the Royal
Infirmary of Edinburgh, added that sleep medicine spans many disciplines and
comprises an important area of research which deserves support and greater
recognition by funding bodies, universities and public policy makers.
disorders, such as sleep apnoea, impact on a wide variety of chronic
conditions, potentially leading to their development or worsening them,
including diabetes, heart attacks, strokes and possibly even cancer. Successful
treatment diminishes this risk but we still have a great deal of work to do in
the area," she said.
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Image: Man with sleep apnoea from Shutterstock
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