Prognosis of the middle‐aged and aged patients with obstructive sleep apnea syndrome

The long‐term natural course of obstructive sleep apnea syndrome (OSAS) is studied in order to determine whether severity of nocturnal oxygen desaturation associated with apnea/hypopnea, body mass index (BMI), and hypertension influence survival in young (

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Veröffentlicht in:Psychiatry and clinical neurosciences 1998-02, Vol.52 (1), p.79-85
Hauptverfasser: NODA, AKIKO, OKADA, TAMOTSU, YASUMA, FUMIHIKO, SOBUE, TOSHIKAZU, NAKASHIMA, NOBUO, YOKOTA, MITSUHIRO
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container_issue 1
container_start_page 79
container_title Psychiatry and clinical neurosciences
container_volume 52
creator NODA, AKIKO
OKADA, TAMOTSU
YASUMA, FUMIHIKO
SOBUE, TOSHIKAZU
NAKASHIMA, NOBUO
YOKOTA, MITSUHIRO
description The long‐term natural course of obstructive sleep apnea syndrome (OSAS) is studied in order to determine whether severity of nocturnal oxygen desaturation associated with apnea/hypopnea, body mass index (BMI), and hypertension influence survival in young (
doi_str_mv 10.1111/j.1440-1819.1998.tb00977.x
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One hundred and forty‐eight patients with OSAS aged 17–78 years (136 men, 12 women, mean 52.0±12.3 yean), who were diagnosed by standard polysomnography (PSG) between 1983 and 1993, participated in the study. The survey revealed 15 deaths and 101 survivors; 32 subjects could not be located. The survival rate was 71.4% (95% confidence interval:55.6–87.2%). The survival rate in patients with OSAS was significantly lower than that in the age and sex‐adjusted control Japanese population (87.6%). In the young group, only one death (a 19–year‐old woman) occurred unexpectedly during sleep. The patient showed an apnea/hypopnea index (AHI) of 33 per h and the length of time that the nocturnal oxygen saturation (SaO2) fell below 90% (time of SaO2 &lt; 90%) of 205 min. The survival rate in middle‐aged patients with OSAS was significantly lower than that in the age and sex‐adjusted control Japanese population (79.2 vs 91.0%), but this pattern was not seen among the aged. Time of SaO2 &lt;90% was significantly longer in the middle‐aged patients than in the aged patients, but AHI did not differ between the two groups. Moreover, it was significantly correlated with AHI in middle‐aged patients, but not in the aged patients. The survival rate was significantly lower in patients with hypertension than in the patients without such complications in the middle‐aged group (57.9 vs 90.4%). Cox proportional‐hazard regression model including age, hypertension, BMI, AHI, lowest SaO2, and time of SaO2 &lt;90% showed that hypertension was only significantly associated with lower survival rate in total group and middle‐aged patients, but not in the young or aged patients. The prognosis in patients with OSAS may differ among the generations. The prognosis in the middle‐aged population may depend on the role of OSAS on the complications of hypertension or severity of oxygen desaturation, but not on AHI only.</description><identifier>ISSN: 1323-1316</identifier><identifier>EISSN: 1440-1819</identifier><identifier>DOI: 10.1111/j.1440-1819.1998.tb00977.x</identifier><identifier>PMID: 9682938</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Age Factors ; Aged ; aging ; Biological and medical sciences ; Body Mass Index ; Cause of Death ; Female ; Follow-Up Studies ; Humans ; hypertension ; Hypertension - diagnosis ; Hypertension - mortality ; Hypertension - physiopathology ; Japan ; Male ; Medical sciences ; Middle Aged ; obstructive sleep apnea syndrome ; Oxygen - blood ; oxygen desaturation ; Pneumology ; Polysomnography ; prognosis ; Respiratory system : syndromes and miscellaneous diseases ; Sex Factors ; Sleep Apnea Syndromes - diagnosis ; Sleep Apnea Syndromes - mortality ; Sleep Apnea Syndromes - physiopathology ; Survival Rate</subject><ispartof>Psychiatry and clinical neurosciences, 1998-02, Vol.52 (1), p.79-85</ispartof><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4269-8964edd4fd735926e469bf35c7c6ca31e80ac1fb69b5da1f9fe0ffba13c9a6143</citedby><cites>FETCH-LOGICAL-c4269-8964edd4fd735926e469bf35c7c6ca31e80ac1fb69b5da1f9fe0ffba13c9a6143</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1440-1819.1998.tb00977.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1440-1819.1998.tb00977.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27903,27904,45553,45554,46387,46811</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=2258517$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9682938$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>NODA, AKIKO</creatorcontrib><creatorcontrib>OKADA, TAMOTSU</creatorcontrib><creatorcontrib>YASUMA, FUMIHIKO</creatorcontrib><creatorcontrib>SOBUE, TOSHIKAZU</creatorcontrib><creatorcontrib>NAKASHIMA, NOBUO</creatorcontrib><creatorcontrib>YOKOTA, MITSUHIRO</creatorcontrib><title>Prognosis of the middle‐aged and aged patients with obstructive sleep apnea syndrome</title><title>Psychiatry and clinical neurosciences</title><addtitle>Psychiatry Clin Neurosci</addtitle><description>The long‐term natural course of obstructive sleep apnea syndrome (OSAS) is studied in order to determine whether severity of nocturnal oxygen desaturation associated with apnea/hypopnea, body mass index (BMI), and hypertension influence survival in young (&lt;40 years), middle‐aged (40–64 years), and aged (65 years) using a questionnaire survey. One hundred and forty‐eight patients with OSAS aged 17–78 years (136 men, 12 women, mean 52.0±12.3 yean), who were diagnosed by standard polysomnography (PSG) between 1983 and 1993, participated in the study. The survey revealed 15 deaths and 101 survivors; 32 subjects could not be located. The survival rate was 71.4% (95% confidence interval:55.6–87.2%). The survival rate in patients with OSAS was significantly lower than that in the age and sex‐adjusted control Japanese population (87.6%). In the young group, only one death (a 19–year‐old woman) occurred unexpectedly during sleep. The patient showed an apnea/hypopnea index (AHI) of 33 per h and the length of time that the nocturnal oxygen saturation (SaO2) fell below 90% (time of SaO2 &lt; 90%) of 205 min. The survival rate in middle‐aged patients with OSAS was significantly lower than that in the age and sex‐adjusted control Japanese population (79.2 vs 91.0%), but this pattern was not seen among the aged. Time of SaO2 &lt;90% was significantly longer in the middle‐aged patients than in the aged patients, but AHI did not differ between the two groups. Moreover, it was significantly correlated with AHI in middle‐aged patients, but not in the aged patients. The survival rate was significantly lower in patients with hypertension than in the patients without such complications in the middle‐aged group (57.9 vs 90.4%). Cox proportional‐hazard regression model including age, hypertension, BMI, AHI, lowest SaO2, and time of SaO2 &lt;90% showed that hypertension was only significantly associated with lower survival rate in total group and middle‐aged patients, but not in the young or aged patients. The prognosis in patients with OSAS may differ among the generations. 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One hundred and forty‐eight patients with OSAS aged 17–78 years (136 men, 12 women, mean 52.0±12.3 yean), who were diagnosed by standard polysomnography (PSG) between 1983 and 1993, participated in the study. The survey revealed 15 deaths and 101 survivors; 32 subjects could not be located. The survival rate was 71.4% (95% confidence interval:55.6–87.2%). The survival rate in patients with OSAS was significantly lower than that in the age and sex‐adjusted control Japanese population (87.6%). In the young group, only one death (a 19–year‐old woman) occurred unexpectedly during sleep. The patient showed an apnea/hypopnea index (AHI) of 33 per h and the length of time that the nocturnal oxygen saturation (SaO2) fell below 90% (time of SaO2 &lt; 90%) of 205 min. The survival rate in middle‐aged patients with OSAS was significantly lower than that in the age and sex‐adjusted control Japanese population (79.2 vs 91.0%), but this pattern was not seen among the aged. Time of SaO2 &lt;90% was significantly longer in the middle‐aged patients than in the aged patients, but AHI did not differ between the two groups. Moreover, it was significantly correlated with AHI in middle‐aged patients, but not in the aged patients. The survival rate was significantly lower in patients with hypertension than in the patients without such complications in the middle‐aged group (57.9 vs 90.4%). Cox proportional‐hazard regression model including age, hypertension, BMI, AHI, lowest SaO2, and time of SaO2 &lt;90% showed that hypertension was only significantly associated with lower survival rate in total group and middle‐aged patients, but not in the young or aged patients. The prognosis in patients with OSAS may differ among the generations. The prognosis in the middle‐aged population may depend on the role of OSAS on the complications of hypertension or severity of oxygen desaturation, but not on AHI only.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>9682938</pmid><doi>10.1111/j.1440-1819.1998.tb00977.x</doi><tpages>7</tpages></addata></record>
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source MEDLINE; Wiley Online Library Journals Frontfile Complete; Wiley Online Library Free Content; Freely Accessible Japanese Titles; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
subjects Adolescent
Adult
Age Factors
Aged
aging
Biological and medical sciences
Body Mass Index
Cause of Death
Female
Follow-Up Studies
Humans
hypertension
Hypertension - diagnosis
Hypertension - mortality
Hypertension - physiopathology
Japan
Male
Medical sciences
Middle Aged
obstructive sleep apnea syndrome
Oxygen - blood
oxygen desaturation
Pneumology
Polysomnography
prognosis
Respiratory system : syndromes and miscellaneous diseases
Sex Factors
Sleep Apnea Syndromes - diagnosis
Sleep Apnea Syndromes - mortality
Sleep Apnea Syndromes - physiopathology
Survival Rate
title Prognosis of the middle‐aged and aged patients with obstructive sleep apnea syndrome
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