Scientific Investigations
Obstructive Sleep Apnea During Rapid Eye Movement Sleep, Daytime Sleepiness, and Quality of Life in Older Men in Osteoporotic Fractures in Men (MrOS) Sleep Study
http://dx.doi.org/10.5664/jcsm.2474
Akram Khan, M.D.1; Stephanie L. Harrison, M.P.H.2; Eric J. Kezirian, M.D., M.P.H.3; Sonia Ancoli-Israel, Ph.D., F.A.A.S.M.4; Daniel O'Hearn, M.D., F.A.A.S.M.1; Eric Orwoll, M.D.1; Susan Redline, M.D., M.P.H.5; Kristine Ensrud, M.D.6; Katie L. Stone, Ph.D.2
1Oregon Health & Science University, Portland, OR; 2California Pacific Medical Center Research Institute, San Francisco, CA; 3Department of Otolaryngology—Head and Neck Surgery, University of California, San Francisco, San Francisco, CA; 4Department of Psychiatry, University of California, San Diego, San Diego, CA; 5Dept. of Medicine, Harvard Medical School, Boston, MA; 6Departments of Medicine and Epidemiology & Community Health, University of Minnesota Medical School, Minneapolis, MN, and Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MN
Study Objectives:
Assess the association between REM predominant obstructive sleep apnea (OSA), sleepiness, and quality of life in a community-based cohort of men ≥ 65 years-old.
Design, Intervention and Measurements:
A cross-sectional analysis of 2,765 subjects from the Outcomes of Sleep Disorders in Older Men (MrOS Sleep) Study was performed to identify subjects with an apnea hypopnea index (AHI) < 15 (n = 2,044). Subjects were divided into groups based on the AHI in REM sleep (< 5 [referent group], 5 to < 15, 15 to < 30, and ≥ 30). Daytime somnolence, sleep-related quality of life, sleep disturbance, general quality of life, depressive symptoms, and health status were quantified using Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Pittsburgh Sleep Quality Index (PSQI), Short Form-12 (SF-12), Geriatric Depression Scale-15 (GDS), and self-perceived health status, respectively.
Results:
Prevalence of REM-predominant OSA (AHI-REM ≥ 5) was 42.8% if OSA was defined as AHI ≥ 15 and 14.4% if OSA was defined as AHI ≥ 5. Higher AHI-REM was associated with polysomnographic indices of poorer sleep architecture (reduced total sleep time, sleep efficiency, REM sleep duration and proportion). Adjusting for age, BMI, and study site, higher AHI-REM was not associated with subjective sleep measures (ESS, FOSQ, PSQI), lower quality of life (SF-12), or greater depressive symptoms (GDS).
Conclusions:
In a community-based sample of older adult men ≥ 65 years-old, REM-predominant OSA was highly prevalent and was associated with objective indices of poorer sleep quality on polysomnography but not with subjective measures of daytime sleepiness or quality of life.
Citation:
Khan A; Harrison SL; Kezirian EJ; Ancoli-Israel S; O'Hearn D; Orwoll E; Redline S; Ensrud K; Stone KL. Obstructive sleep apnea during rapid eye movement sleep, daytime sleepiness, and quality of life in older men in osteoporotic fractures in men (MrOS) sleep study. J Clin Sleep Med 2013;9(3):191-198.
Please login to continue reading the full article
Subscribers to JCSM get full access to current and past issues of the JCSM.
Login to JCSM
Not a subscriber?
Join the American Academy of Sleep Medicine and receive a subscription to JCSM with your membership