Study On The Clinical Features In Elderly Patients With Obstructive Sleep Apnea Hypopnea Syndrome

BackgroundThe typical characteristics of obstructive sleep apnea hypopnea syndrome?OSAHS? is a repeating upper airway collapse and stenosis during sleep, which leads to partial or complete airway obstruction, apnea and arousal, accompanied by snoring, sleep disorder and and frequently hypoxemia, hypercapnia, and further leads to daytime sleepiness, cognitive dysfunction, high blood pressure,endocrine disease, metabolic disorders,and complications of heart brain lung system and rises the risk of some professional work.And as the growth of age, the incidence of OSAHS increases gradually. But because the elderly are accompanied with fatigue, daytime sleepiness, slow response and various medical diseases, thus the manifestations of elderly patients with OSAHS are not as typical as young and middle-aged OSAHS patients, besides, patients and medical staffs are not well understanding of the disease, which usually lead to missed diagnosis and even the diagnostic errors. At present the study on the clinical features in elderly patients with obstructive sleep hypopnea syndrome is less, the goal of this research is about the clinical features in elderly patients with obstructive sleep hypopnea syndrome and clear the related risk factors. ObjectiveThrough the research in clinical features of elderly patients with obstructive sleep apnea hypopnea syndrome, meanwhile compare with the young and middle-aged patients, to understand the clinical features and the influencing factors, and to provide evidence for clinical intervention measures for its prevention and treatment. Subjects and MethodThis study collected 237 cases of OSAHS from June 2014 to June 2015 in the sleep monitoring center of The First Affiliated Hospital of Zhengzhou University. There are 105 cases? male 73 cases, female 32 cases? in the elderly group, 132 cases? male 120 cases, female 12 cases? in the young and middle-aged group. Questionnaire survey ? physical examination and polysomnography?PSG?were performed for all the patients.Some indicators were monitored and recorded, such as lowest oxygen saturation?mean oxygen saturation?cumulative percentages of time spent at oxygen saturation below 90% and so on. SPSS 17.0 software was used for data analyzing. According to the different variables, the elderly group and the young and middle-aged group were analyzed by using t test?chi-square test. The inspection level is 0.05. ResultIn this research, there are 237 cases with OSAHS, including 105 elderly cases and 132 young and middle aged cases. Statistical analyse the data of two group, height : x ±s in elderly group was?1.664±0.079?cm, young and middle aged group was(1.709±0.067 cm, t value was-4.613, P value was 0.000, it was statistically significant between the two groups; weight: x ±s in elderly group was?76.50± 13.346?Kg, young and middle aged group was?84.71±13.456?Kg, t value was-4.682, P value was 0.000, it was statistically significant between the two groups; body mass index : x ±s in elderly group was?27.58±4.201?Kg/m2, young and middle aged group was?28.96±3.926?Kg/m2, t value was-2.609, P value was 0.010, it was statistically significant between the two groups; neck circumference : x ±s in elderly group was?40.27±4.320?cm, young and middle aged group was?41.57±3.089?cm, t value was-2.597, P value was 0.010, it was statistically significant between the two groups; rate of palate vertical overlength: x ±s in elderly group was 5.7%, young and middle aged group was 15.1%, ?2 value was 5.333, P value was0.021, it was statistically significant between the two groups; rate of alcohol drinking: x ±s in elderly group was 20.0%, young and middle aged group was 47.7%, ?2 value was 19.650, P value was0.000, it was statistically significant between the two groups; total apnea time : x ±s in elderly group was?72.71±71.975?min, young and middle aged group was?97.63±86.645?min, t value was-2.418, P value was 0.016, it was statistically significant between the two groups; rate of I period sleep time of the total sleep time : x ±s in elderly group was?26.37±21.517?%, young and middle aged group was?17.99±14.046?%, t value was 3.449, P value was 0.010, it was statistically significant between the two groups; rate of III period sleep time of the total sleep time : x ±s in elderly group was?23.21±16.438?%, young and middle aged group was?28.21±20.924?%, t value was-2.005, P value was 0.046, it was statistically significant between the two groups; micro-arousal index : x ±s in elderly group was?14.10±13.707?time/h, young and middle aged group was?20.43±25.489?time/h, t value was-2.444, P value was 0.015, it was statistically significant between the two groups; oxygen desturation index: x ±s in elderly group was?33.390± 25.273?%, young and middle aged group was?41.424±27.791?%, t value was-2.300, P value was 0.022, it was statistically significant between the two groups; rate of coronary heart disease incidence : x ±s in elderly group was 7.6%, young and middle aged group was 0%, ?2 value was 10.408, P value was 0.001, it was statistically significant between the two groups;The apnea hyponea index?AHI??blood oxygen saturation percentage is less than 90% of total sleep time?CT90 %??epworth sleeping scale score?ESS score??the percentage of II phase sleep of total sleep time?the percentage of quick eye movement period of total sleep time?mean blood oxygen saturation?MSaO₂??waist circumference?the lowest blood oxygen saturation?LSaO₂??the longest time of sleep apnea, tongue body hypertrophy?palate vertical over width and the incidence of hypertension?hyperlipidemia prevalence and incidence of stroke?diabetes?smoking?presence of mandibular retraction?there was no statistically significant difference between the two groups, all of the P values above were greater than 0.05. Conclusion1.The incidence of obesity in elderly patients is low;2.The old patients with OSAHS results of sleep disorder, phase I sleep tend to be long, and phase III sleep tend to be short;3.The incidence of coronary heart disease in elderly patients with OSAHS is high;4.The manifestations of the elderly patients with OSAHS is not typical, the total sleep apnea time?micro-arousal index?oxygen desturation index and percentage of palate vertical overlength are lower than that of young and middle aged patients with OSAHS.