Symposium 11：Sleep Apnea and Elderly
Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial or complete collapse of the upper airway during sleep, resulting in reduced (hypopnea) or absent (apnea) airflow lasting for at least 10 seconds and associated with either cortical arousal or a fall in blood oxygen saturation. OSA is present in approximately 25% of adults in the US and is a major cause of excessive sleepiness, contributing to reduced quality of life, impaired work performance, and increased motor vehicle crash risk. OSA is associated with an increased incidence of hypertension, type 2 diabetes mellitus, atrial fibrillation, heart failure, coronary heart disease, stroke, and death. OSA can be diagnosed with either home- or laboratory-based sleep testing, and effective treatments are available.Obstructive sleep apnea (OSA)may potentially be a modifiable risk factor for dementia. In this symposium, we will explore the prevalence and mechanism between OSA and Dementia.
| Time (GMT+8) |
Topic | Speaker | Country / Region |
|---|---|---|---|
| 14:50-15:20 | Concomitant obstructive sleep apnea and chronic obstructive pulmonary disease in elderly patients | Dr. Yung-Che Chen | Taiwan |
| 15:20-15:50 | The interrelationship between sleep duration, daytime sleepiness and sleep disordered breathing: role of age | Dr. Pei-Lin Lee | Taiwan |
| 15:50-16:20 | Sleep Apnea and sleep disorders in elderly dwelling community in Taiwan | Dr. Li-Pang Chuang | Taiwan |
Concomitant obstructive sleep apnea and chronic obstructive pulmonary disease in elderly patients
Abstract:
As unveiled by previous studies that obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) happen concomitantly in about 1-3.6% of general population, and are known as overlap syndrome (OS). OS is more prevalent in elderly patients and those with COPD. OSA and COPD interact pathologically, causing severe hypoxemia, oxidative stress, systemic inflammation, and sympathetic hyperactivity. OS is associated with an increased prevalence of mild cognitive impairment and a higher risk of cardiovascular disease compared with either disease alone. The co-occurrence of OSA and COPD also results in a higher mortality rate than is predicted for either disease occurring independently. Additionally, more frequent COPD exacerbations and hospitalizations are observed when OSA is combined with COPD. The American Thoracic Society have underlined the lack of knowledge on OS, stated research priorities for this condition, and recommended a “screening” strategy to identify OSA in COPD patients with chronic stable hypercapnia. This talk will provide a brief overview of the impact of OS on clinical outcomes, illustrate underlying mechanisms, review treatment options, and consider some perspectives related to OSA in COPD patients.
Dr. Yung-Che Chen
Taiwan
The interrelationship between sleep duration, daytime sleepiness and sleep disordered breathing: role of age
Abstract:
Excessive daytime sleepiness (EDS) is a common symptom in patients with sleep-disordered breathing (SDB) with the prevalence as high as 33.4% to 57%. EDS has been associated with motor vehicle accidents, impaired quality of life, increased healthcare utilization, and higher all-cause mortality. Factors affecting EDS in the general population include younger age, male gender, obesity, depression, and sleep apnea, yet the significance of comorbidities and habitual sleep duration are less certain. The recommended sleep duration for adults 18-64 y/o and ≥65 y/o is 7-9 hours and 7-8 hours, respectively. For community cohorts, several large-scale studies have demonstrated a bi-directional relationship between sleep duration and health outcomes, where both short and long self-report sleep durations were associated with incident cardiovascular disease, obesity, metabolic dysregulation, and mortality. This association was more consistent across studies for sleep duration <6 h. Notably, the evidence supporting the association between short sleep duration and incident EDS is scarce compared to other health outcomes. Hence, more and more studies to clarify the intriguing association between sleep duration and EDS in patients with SDB would be needed.
Dr. Pei-Lin Lee
Taiwan
Pei-Lin Lee is Clinical Associate professor in National Taiwan University, College of Medicine and attending physician, Center of Sleep Disorder, National Taiwan University Hospital . Her current academic positions included American Academy of Sleep Medicine Fellow and International Ambassador, International Assembly; Board member and Chairman of Sleep specialty certificate committee, Taiwan Society of Sleep Medicine; and Committee member, Taiwan Society of Pulmonary and Critical Care, Sleep Medicine Assembly. Her editorial positions are Associate Editor, Sleep Disorder, Frontier in Neurology and Frontier in in Psychiatry and Editors for PLOSONE; Sleep and Breath; and Thoracic Medicine. Her experience includes as a Director, Center of Sleep Disorder, National Taiwan University Hospital (2007/7-2023/7), research fellow in Royal Infirmary Hospital, Edinburgh University, UK (2010/1-2010/12). Her research focuses on clinical phenotyping, molecular mechanism, and therapeutic Intervention of obstructive sleep apnea. She is particularly interested in technology and big data in sleep medicine. Her other works include sleep disordered breathing in pediatrics and pregnancy.
Sleep Apnea and sleep disorders in elderly dwelling community in Taiwan
Abstract:
Sleep disturbance is a prevalent health problem that substantially affects older adults. The associations between sleep patterns and adverse health outcomes have been examined with regard to sleep duration, insomnia, and the use of hypnotics. The evidence for a link between sleep duration and adverse health outcomes is consistent and robust among older adults.
Obstructive sleep apnea (OSA) is a disorder of repeated upper airway collapse during sleep, which caused apnea or hypopnea in varying degrees. Intermittent oxygen desaturation, hypercapnia and sleep fragmentation contributed to excessive daytime sleepiness and associated with the development of some clinical comorbidities, including hypertension, cardiovascular disease, cardiac arrhythmia, pulmonary hypertension, stroke, cognitive impairment, and metabolic syndrome.
Although higher proportion of OSA was found in the people age 65 years and older, the trend of OSA prevalence was not only simple positive correlated with age in elder. The etiology of OSA in aged population might be different from those in middle age. Sarcopenia is a skeletal muscle disorder characterized by low muscle strength, low muscle mass and low physical performance, which contribute to recurrent falling, fractures and mortality. Muscle weakness may lead to increased costs of hospitalization and health care. The change of lifestyle, physical activity, nutritional condition, hormonal status and chronic metabolic disease along with aging leads to the development of sarcopenia.
Prevalence and severity of both OSA and sarcopenia increased with the advance of age. One of the pathogenic mechanisms associated with OSA and sarcopenia and sarcopenia is poor upper airway muscle function, which may induce upper airway collapse. Since there have been fewer studies that evaluated the interaction between age, OSA and sarcopenia, this talk aimed to reveal the relationship between OSA, obesity and sarcopenia in aged population.
Dr. Li-Pang Chuang
Taiwan
As a pulmonologist, Dr. Chuang is specialized in pulmonary disease, critical care and sleep disordered breathing. His clinical interests include lung infection disease, critical care and sleep apnea syndrome. He is also board certified in internal medicine by The Society of Internal Medicine, and in pulmonary medicine and critical care medicine by the Taiwan Society of Pulmonary and Critical Care Medicine, and in sleep medicine by the Taiwan Society of Sleep Medicine.
Dr. Chuang devoted himself in the field of sleep disordered breathing for more than 10 years after becoming the attending physician in Taiwan. He also completed his PhD program in the field of sleep disordered breathing in Taiwan, and he ever went to University of Pennsylvania (UPENN) Sleep Center as a visiting scholar in 2013. Right now, he is the council of Taiwan Society of Sleep Medicine since 2016.
Dr. Liang-Wen Hang
Taiwan
Master 1998, China Medical University/Taichung, Taiwan
BS 1990, China Medical University/Taichung, Taiwan
Dr. Chia-Mo Lin
Taiwan
