Prevalence of Obstructive Sleep Apnea Syndrome and CPAP Adherence in the Elderly Chinese Population

• Published in: PloS one Vol. 10; no. 3; p. e0119829
• Main Authors: Ng, Susanna S. S., Chan, Tat-On, To, Kin-Wang, Chan, Ken K. P., Ngai, Jenny, Tung, Alvin, Ko, Fanny W. S., Hui, David S. C.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 16.03.2015; Public Library of Science (PLoS)
• Subjects: Aged; Aged, 80 and over; Apnea; Asian Continental Ancestry Group; Body mass; Bus drivers; Cardiovascular diseases; Chan, David; Cognitive ability; Communities; Community centers; Continuous Positive Airway Pressure; Critical care; Elderly; Elderly people; Female; Geriatrics; Health risks; Hong Kong - epidemiology; Hospitals; Humans; Insomnia; Male; Medicine; Mortality; Neck; Older people; Patient Compliance; Population; Population studies; Prevalence studies (Epidemiology); Prospective Studies; Questionnaires; Restless legs syndrome; Risk analysis; Risk factors; Sleep; Sleep and wakefulness; Sleep apnea; Sleep apnea syndromes; Sleep Apnea, Obstructive - epidemiology; Sleep Apnea, Obstructive - therapy; Sleep deprivation; Sleep disorders; Sleepiness; Surveys; Hong Kong; Hong Kong China; United Kingdom > UK; China; Wales
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0119829

This study assessed the prevalence of obstructive sleep apnea syndrome (OSAS) and CPAP adherence in the elderly Chinese in Hong Kong. We conducted a sleep questionnaire survey among the elders aged ≥60 years in the community centres followed by level 3 home sleep study (Embletta). Subjects with an apnea hypopnea index (AHI) ≥ 15/hr alone and those with AHI ≥ 5/hr plus either cardiovascular risk factors or Epworth Sleepiness Score (ESS) ≥ 10 were offered CPAP treatment. Altogether 819 subjects were interviewed with mean (SD) age of 73.9 (7.5) years, BMI 24.2 (3.6) kg/m2, neck circumference 34.9 (3.4) cm and ESS 6.6 (5.2). Daytime sleepiness was reported by 72.4%, snoring loudly 5.1% and witnessed apnea 4%. Among 234 subjects who underwent home sleep study, 156 (66.7%), 102 (43.6%), 70 (29.9%) and 45 (19.2%) had AHI ≥ 5, ≥ 10, ≥ 15 and ≥ 20/hr respectively, with the prevalence increasing with age and BMI. In the sample, 149 subjects (63.7%) were classified as having OSAS, as defined by an AHI ≥ 5/hr with associated symptoms, involving 81 men (74.3%) and 68 women (54.4%). Neck circumference and snoring frequency were the only positive independent factors associated with the AHI and the diagnosis of OSAS. Among 141 subjects who were offered CPAP treatment, 30 accepted CPAP prescription with improvement of ESS and cognitive function over 12 months with CPAP usage of 4.2 (2.2) h/night. This study showed a high prevalence of OSAS among the community elders in Hong Kong. Home CPAP acceptance was low but there was significant improvement of subjective sleepiness and cognitive function among those on CPAP treatment.