The Syndrome of Sleep Apnea in the Elderly Suffering from COPD and Live in the County of Attica, Greece
Marianna Diomidous, Nikas Marios, Dimitrios Zikos, Gourgoulianis Konstantinos, Daniil Zoe, Zoe Mpizopoulou, Xatzoglou Xrysi, Roupa Zoe
Mat Soc Med. 2012; 24(4): 227-231
Introduction: Chronic Obstructive Pulmonary Disease (COPD) and obstructive sleep apnea syndrome are two diseases, which often coexist in one person. The sleep apnea is often caused by an interruption to breath when sleeping, due to an obstruction of the upper airway during inhalation, causing chronic snoring, morning headaches, increased body weight, blood pressure and sleepiness during the day. Aim: The purpose of this study is to investigate the extend of this problem among a large group of elderly people living in the Attica Basin. Material and Methods: Material of the study was 500 people aged 70 and above years old, including 274 men and 226 women. Data collection was facilitated with the use of an anonymous questionnaire with the purpose to identify patients with apnea, after a personal interview with the researcher. Data analysis was performed with the use of the statistical package SPSS 17. Results: Based on their responses to the questionnaires, it was found that 98.0% of the participants have abnormal sleepiness during the day. The 35.4% of them show no apnea, while 36.0% of the sample suffer from mild sleep apnea. It is important though, the fact that about one out of three seniors, 28.6%, shows sleep apnea in a high risk level. Conclusions: COPD is a complex disease that occurs in a large proportion of the elderly. Emphasis should be given on early diagnosis and treatment of sleep apnea syndrome, in order to improve the quality of the elderly life.
1. Kontaxakis V, Hristodoulou G. Third Age. Veta Publications; 2000. 167-171,179-184, 211-221, 223-235.
2. Sahini-Kardasi A, Panou M. Pathological & Surgical Nursing-Nursing Procedres. Veta Publications. 1997; 1: 273-284.
3. Ohri M, Steiner C. COPD: the disease and non-drug treatment. Hospital Pharmacist. 2004; 11: 359-364.
4. Pauwels R, Buist A, Calverley P, Jenkins CR, Hurd SS. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine. 2001; 163: 1256-1276.
5. Nazir SA, Erbland ML. Chronic obstructive pulmonary disease: an update on diagnosis and management issues in older adults. Drugs Aging. 2009; 26(10): 813-831.
6. Koutsourelakis I, Vagiakis E. Sleep Apnea Syndrome. Scientific Issues; 2008. 24-28.
7. American Academy of Sleep Medicine Force. Sleep-related breathing disorders in adults: Recommendations for syndrome definition and measurement techniques in clinical research. Sleep. 1999; 22: 667-689.
8. American Thoracic Society: Indications and standards for use of nasal continuous positive airway pressure (CPAP) in sleep apnea syndromes. Am J Respir Crit Care Med. 1994; 150: 1738-1745.
9. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Bard S.The occurrence of sleep-disordered breathing among middle-aged adults. N engl J Med. 1993; 328: 1230-1235.
10. Farsaris N, Athanasiou E, Goumas P. Syndrome of Obstructive Sleep Apnea, modern aspects regarding etiology, clinical features, diagnosis and therapeutic confrontation. Greek Orthodontic Review. 2003; 6: 7-42
11. American Thoracic Society. Indications and standards for cardiopulmonary sleep studies. Am Rev Respir Dis. 1989; 139: 559-568.
12. Bear SE, Priest JH. Sleep Apnea syndrome: correction with surgical advancement of the mandible. J Oral Surg. 1980; 38: 543-549.
13. Boraz RA, Martin HE, Michael JD.Sleep apnea syndrome: report of case.J Dent Child. 1979; 46: 50-52.
14. Chaban R, Cole P, Hoffstein V. Site of upper airway obstruction in patients with idiopathic obstructive sleep apnea. Laryngoscope. 1988; 98: 641-647.
15. Onen F, Onen H. Obstructive sleep apnea and cognitive impairment in the elderly. Psychol Neuropsychiatr Vieil. 2010; 8(3): 163-169.
16. Jelic S. Diagnostic and therapeutic approach to coexistent chronic obstructive pulmonary disease and obstructive sleep apnea. Int J chron Obstruct Pulmon Dis. 2008; 3(2): 269-275.
17. Zamarron C, Garcia PV, Morete E, Del Campo Matias F. Association of chronic obstructive pulmonary disease and obstructive sleep apnea consequences. Int J Chron Obstruct Pulmon Dis. 2008; 3(4): 671-682.
18. G.S.V.E.E. Training National Strategy Report on Social Protection and Social Inclusion 2008-2010. Posts of Social Protection. 2008.
19. Zhou Y, Wang C, Yao W, Chen P, Kang J, Huang S, Chen B, Wang C, Ni D, Wang X, Wang D, Liu S, Lu J, Zheng J, Zhong N, Ran P.Current status of prevention and management of chronic obstructive pulmonary disease in rural area in China. Zhonghua Nei Ke Za Zhi. 2009; 48(5): 358-361.
20. Nizankowska-Mogilnicka E, Mejza F, Buist A, Voilner W, Skucha W, Harat R, Pajak A, Gasowski J, Frey J, Nastalek P, Twardoska M, Janicka J, Szczeklik A. Pravalence of copd and tobacco smoking in Malopolska region-results from the BOLD study in Poland. Pol Arch Med Wewn .2007; 117(9): 402-410.
21. Bixler E, Vgontzas A, Ten Have T, Tyson K, Kales A. Effects of age on sleep apnea in men. Am J Respir Crit Care Med. 1998; 157: 144–148
22. Bixler E, Vgontzas A, Lin H, Ten Have T, Rein J, Vela-Bueno A, Kales A. Prevalence of sleep-disordered breathing in women. Am J Respir Crit Care Med. 2001;163: 608–613.
23. Durán J, Esnaola S, Rubio R, Iztueta A. Obstructive sleep apnea–hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med. 2001; 163: 685–689.
24. Maltais F, Bourbeau J, Lacasse Y, Shapiro S, Perrault H, Penrod J, Baltzan M, Rouleau M, Julien M, Paradis B, Audet R, Hernandez P, Levy R, Camp P, Lecours R, Picard D, Bernard S. A Canadian multicentre, randomized clinical trial of home-based pulmonary rehabilitation in chronic obstructive pulmonary disease:rationale and methods. Can Respir J. 2005; 12(4): 193-198.
25. Boxall A, Barclay L, Sayers A, Caplan G. Managing chronic obstructive pulmonary disease in the community. A randomized controlled trial of home-based pulmonary rehabilitation housebound patients. J Cardiopulm Rehabi. 2005; 25(6): 378-385.
26. Bowns I, Challis D, Tong M. Case finding in elderly people: validation of a postal questionnaire. Br J Gen Pract. 1991; 41(344): 100-104.
28. Forbes W, Hayward L, Agwani N. Factors associated with the prevalance of various self-reported impairments among older people residing in the community. Can J Public Health. 1991; 82: 240-244.
29. Murphy F.Loneliness: a challengefor nurses caring for older people. Nurs Older People. 2006; 18(5): 22-25.
30. Lang F. Regulation of social relationships in later adulthood. J. Gerontol. B Psychol Sci Soc Sci. 2001; 56(6): 321-326.
31. Tsentelierou S. We need love, company, and your interest. Newspaper Patris. 2005.
32. Chaikovskaia V, Vialyk T. The characteristics of the delivery of hospital care to the ederly, under the current conditions. Lik Sprava .2000; 2: 122-124.
33. Basta N, Matthews F, Chatfield, Brayne C. Community-level socio-economic status and cognitive and functional impairment in the older population. European Journal of Public Health. 2007; 18(1): 48-54.
34. Cantor M, Little V. Aging and Social Care. New York: Handbook of aging and social sciences. 1985; 745-781.
35. Chappell N. Aging and social care, Aging and the social sciences. New York: Binstock& E.Shanas Eds: 450-541.
36. Sissouras A, Ketsetzopoulou A, Bouzas N, Fagadaki E, Papaliou O, Fakoura A.Providing integrated health and social care for older persons in Greece. National Centre for Social Research. 2002; 1-33.
37. Okun M.Predictors of Volunteer Status in a retirement community. International Journal Of Aging and Human Development. 1993; 36(1): 57-74.
38. Penning M. Health, Social Support and the utilisation of Heakth Services among older adults. Journal of Gerontology. 1995; 50(5): 330-339.
39. Kumari R. Socio-economic conditions, morbidity pattern and social support among the elderly women in a rural area. Sreekarym- Panchayat. 2001; 1-78.