Are Breathing Disturbances in Elderly Equivalent to Sleep Apnea Syndrome?

The prevalence of sleep apnea syndrome (SAS) in middle-aged populations is unknown but is currently estimated to be 4% in women and 9% in men (1).In the elderly, however, the prevalence of repetitive episodes of upper airway obstruction has been estimated to be substantially higher, between 24 and 75% (2).Because of this high prevalence, questions arise as to the significance of sleep-disordered breathing (SDB) in the elderly.Is SDB in the elderly the same phenomena, i.e.SAS, that presents in younger adults?Sleep apnea syndrome is defined as repetitive episodes of upper airway obstruction that occur during sleep, usually associated with a reduction in blood oxygen saturation (3).Some ofthe more common symptoms of SAS include loud snoring, feeling unrefreshed in the morning and excessive sleepiness, particularly when in a relaxed position.Cardiovascular disease is also commonly associated with SAS.SAS can result in profound functional impairment, with life threatening complications and, ultimately, can lead to premature death (3).Although these are the same symptoms found in the elderly, the question is still, what constitutes disease in the elderly, i.e. do these symptoms constitute SAS or SDB?Sleep-disordered breathing is defined as the presence of apneas (complete cessation of respiration) or hypopneas (partial decrease of respiration), but has no added definition of accompanying symptoms.There is no question that SDB is found in the elderly.We will review the literature to determine whether the symp-