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      Calidad de vida en personas mayores con síndrome de apnea obstructiva del sueño. Revisión sistemática Translated title: Quality of life in older people with obstructive sleep apnea syndrome. Systematic review

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          Abstract

          RESUMEN Objetivos: Identificar cómo afecta a la calidad de vida de las personas de edad avanzada padecer apnea obstructiva del sueño. Metodología: Revisión sistemática sobre los diferentes estudios que traten la apnea del sueño en personas de edad avanzada, y cómo afecta esta a su calidad de vida. Esta revisión incluye casos y controles, estudios de cohortes, ensayos clínicos y estudios observacionales publicados desde 2014 hasta 2019. Resultados: Se revisaron cerca de 400 artículos, de los cuales solo 16 formaron parte de la revisión, tras cumplir con exactitud todos los criterios de inclusión establecidos. Existe una gran disparidad entre los resultados encontrados; aun así, la calidad de vida de las personas de edad avanzada con apnea obstructiva del sueño mejora con el uso de la CPAP (presión positiva continua en la vía aérea). Conclusiones: Son necesarias más investigaciones que estudien el síndrome de apnea obstructiva del sueño en personas de edad avanzada; la mayoría de los estudios encontrados se centran en población infantil o adulta. Entre los pocos estudios que se centran en estudiar la calidad de vida de las personas de edad avanzada cuando padecen apnea obstructiva del sueño se encuentra disparidad en sus resultados, no llegando a ninguna conclusión firme. Este es un tema prioritario de salud, debido al envejecimiento de la población y a la cada vez mayor prevalencia de este síndrome.

          Translated abstract

          ABSTRACT Aims: To identify how obstructive sleep apnea affects the quality of life of the elderly. Methods: Systematic review of the different studies that treat sleep apnea in the elderly, and how it affects their quality of life. This review includes cases and controls, cohort studies, clinical trials and observational studies published from 2014 to 2019. Results: Nearly 400 articles were reviewed, of which only 16 were part of the review, after accurately meeting all established inclusion criteria. There is a large disparity between the results found; however, the quality of life of older people with obstructive sleep apnea improves with the use of CPAP (continuous positive air pressure). Conclusions: More research is needed to study obstructive sleep apnea syndrome in the elderly; most of the studies found focus on children or adults. Among the few studies that focus on studying the quality of life of older people with obstructive sleep apnea, there is a disparity in their results, with no firm conclusions. This is a priority health issue, due to the ageing population and the increasing prevalence of this syndrome.

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          Most cited references21

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          Continuous positive airway pressure in older people with obstructive sleep apnoea syndrome (PREDICT): a 12-month, multicentre, randomised trial.

          The therapeutic and economic benefits of continuous positive airway pressure (CPAP) for moderate to severe obstructive sleep apnoea (OSA) syndrome have been established in middle-aged people; however, the benefits in older people are unknown. This trial was designed to address this evidence gap.
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            Efficacy of continuous positive airway pressure treatment on 5-year survival in patients with ischaemic stroke and obstructive sleep apnea: a randomized controlled trial.

            The main purpose of the present analysis is to assess the influence of introducing early nasal continuous positive airway pressure (nCPAP) treatment on cardiovascular recurrences and mortality in patients with a first-ever ischaemic stroke and moderate-severe obstructive sleep apnea (OSA) with an apnea-hypopnea index (AHI) ≥20 events h(-1) during a 5-year follow-up. Patients received conventional treatment for stroke and were assigned randomly to the nCPAP group (n = 71) or the control group (n = 69). Cardiovascular events and mortality were registered for all patients. Survival and cardiovascular event-free survival analysis were performed after 5-year follow-up using the Kaplan-Meier test. Patients in the nCPAP group had significantly higher cardiovascular survival than the control group (100 versus 89.9%, log-rank test 5.887; P = 0.015) However, and also despite a positive tendency, there were no significant differences in the cardiovascular event-free survival at 68 months between the nCPAP and control groups (89.5 versus 75.4%, log-rank test 3.565; P = 0.059). Early nCPAP therapy has a positive effect on long-term survival in ischaemic stroke patients and moderate-severe OSA.
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              Obstructive sleep apnoea in the elderly: role of continuous positive airway pressure treatment.

              Almost all the information about the effect of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnoea (OSA) comes from clinical trials involving only middle-aged patients. The objective of this study was to assess the effect of CPAP treatment in elderly patients with severe OSA on clinical, quality-of-life and neurocognitive spheres. We performed an open-label, randomised, multicentre clinical trial in a consecutive clinical cohort of 224 elderly (≥70 years old) patients with confirmed severe OSA (apnoea-hypopnea index ≥30) randomised to receive CPAP (n=115) or no CPAP (n=109) for 3 months. A sleep study was performed by either full polysomnography or respiratory polygraphy. CPAP titration was performed by an autoCPAP device. The primary endpoint was quality of life (Quebec Sleep Questionnaire) and secondary endpoints included sleep-related symptoms, presence of anxiety/depression, office-based blood pressure and some neurocognitive tests. The mean±sd age was 75.5±3.9 years. The CPAP group achieved a greater improvement in all quality-of-life domains (p<0.001; effect size: 0.41-0.98), sleep-related symptoms (p<0.001; effect size 0.31-0.91) as well as anxiety (p=0.016; effect size 0.51) and depression (p<0.001; effect size: 0.28) indexes and some neurocognitive tests (digit symbol test (p=0.047; effect size: 0.20) and Trail Making Test A (p=0.029; effect size: 0.44)) in an intention-to-treat analysis. In conclusion, CPAP treatment resulted in an improvement in quality of life, sleep-related symptoms, anxiety and depression indexes and some neurocognitive aspects in elderly people with severe OSA.
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                Author and article information

                Journal
                geroko
                Gerokomos
                Gerokomos
                Sociedad Española de Enfermería Geriátrica y Gerontológica (Barcelona, Barcelona, Spain )
                1134-928X
                2021
                : 32
                : 2
                : 105-110
                Affiliations
                [2] Jaén Andalucía orgnameUniversidad de Jaén Spain
                [1] Andalucía orgnameUniversidad de Jaén Spain
                Article
                S1134-928X2021000200105 S1134-928X(21)03200200105
                cc0522bd-2cb0-4e8f-a5c1-48711490d98f

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 10 October 2019
                : 26 August 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 21, Pages: 6
                Product

                SciELO Spain

                Categories
                Revisión

                persona de edad avanzada, 80 años en adelante,Quality of life,aged,aged, 80 and over,sleep, apnea obstructive,Calidad de vida,persona de edad avanzada,apnea obstructiva del sueño

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