Daytime Sleepiness Linked to Cognitive Impairment in Elderly

Obstructive sleep apnea, the disruption of normal breathing during sleep increases daytime sleepiness and may be associated with cognitive impairment.

Highlights

Older adults tend to fall asleep during the day and the prevalence is 50%.
Recurrent awakenings due to disrupted breathing leads to excessive sleep during the day.
Obstructive Sleep apnea was more common in adults aged over 65 with cognitive impairment.

Sleep-disordered breathing (SDB), a disruption of normal breathing during sleep causes recurrent awakenings and subsequent excessive daytime sleepiness in the elderly.

Compared with younger adults, the elderly spend more time in bed but have deterioration in both the quality and quantity of sleep. A Boston University School of Medicine (BUSM) researcher stresses that it is now time for physicians to consider the association between these sleep conditions and cognitive impairment in the elderly.

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‘Older adults aged 65 and more have sleep-disordered breathing or obstruction during sleep and they were found to have cognitive impairment.’

In the same issue of the journal, researchers of the "HypnoLaus Study" investigated an older population (over the age of 65), with and without cognitive impairment. They performed sleep studies on these groups and found that the group with cognitive impairments had more sleep disturbances attributed to SDB.

"Although this does not necessarily mean that sleep apnea causes cognitive impairment in the elderly, it does highlight the association," explained corresponding author Sanford Auerbach, MD, associate professor of neurology and psychiatry at BUSM and director of the Sleep Disorders Center at Boston Medical Center.

According to Auerbach the causal link between SDB /obstructive sleep apnea (OSA) and cognitive impairment in the elderly is not entirely clear.

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"Nevertheless, it does raise the issue that clinicians evaluating OSA in the elderly should screen for cognitive impairments. Furthermore, clinicians evaluating cognitive impairment in the elderly should also screen their patients for sleep disturbance and OSA."

Even though it is not clear that treatment of OSA will delay or prevent the cognitive impairment and possible development of dementia, Auerbach believes that treatment of OSA will certainly improve the quality of life for these patients.

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Turbulent airflow causes tissues of the nose and throat to vibrate and the noise produced by these vibrations is called snoring.

Reference

Sanford Auerbach and Kristine Yaffe, The link between sleep-disordered breathing and cognition in the elderly, Americal Academy of Neurology (2016), http://dx.doi.org/10.1212/WNL.0000000000003577.
Jana R. Cooke and Sonia Ancoli-Israel, Normal and Abnormal sleep in the Elderly. Handbook of Clinical Neurology (2012) 10.1016/B978-0-444-52006-7.00041-1.

Source-Medindia

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