As we age, maintaining good health becomes increasingly vital yet more challenging. Seniors often face a range of health issues that can complicate daily life and increase the risk of hospitalizations. And there’s a frequently overlooked factor that could greatly contribute to these hospitalizations. It is a sleep disorder called sleep apnea.

This is characterized by repeated interruptions in breathing during sleep which can have profound effects on physical and mental health. In 2024 recent studies have highlighted a significant link between sleep apnea and increased hospitalizations among seniors. The researcher emphasize the importance of early diagnosis and treatment. Indeed, understanding this connection can help improve health outcomes and quality of life for older adults.

Understanding Sleep Apnea

Sleep apnea, especially obstructive sleep apnea (OSA), is a prevalent disorder where breathing repeatedly stops and starts during sleep. Approximately 39 million U.S. adults have OSA, and an estimated 936 million adults globally suffer from mild to severe OSA. A common symptom of sleep apnea, present in up to 90% of patients, is loud snoring. However, the condition often goes undiagnosed, leading to severe health issues.

OSA occurs when the muscles in the throat relax excessively, causing a temporary blockage of the airway. This interruption in breathing results in reduced oxygen levels in the blood, prompting the brain to wake the person briefly to resume breathing. These interruptions can happen multiple times per hour, severely disrupting sleep quality.

Impact on Physical Health

Untreated sleep apnea can lead to numerous physical health complications. It significantly increases the risk of heart disease, high blood pressure, and stroke due to repeated drops in blood oxygen levels and the strain this places on the cardiovascular system. Additionally, sleep apnea is linked to metabolic disorders including diabetes, as it affects insulin sensitivity and glucose metabolism.

Plus, untreated sleep apnea can lead to kidney problems and exacerbate existing conditions. It’s estimated that  33 million of adults use a CPAP (Continuous Positive Airway Pressure) machine to manage sleep apnea. Including prominent figures like President Joe Biden. CPAP therapy helps keep the airway open, ensuring continuous airflow and reducing the risks associated with sleep apnea. This treatment can also help regulate blood pressure and improve overall quality of life.

Mental Health Concerns

Sleep apnea doesn’t just affect physical health. It also has an effect on mental well-being. Individuals with sleep apnea have an increased risk of developing psychopathological conditions including depression, anxiety and even suicidal ideation. Not to mention the chronic fatigue and sleep disruption caused by sleep apnea could also lead to mood disorders and cognitive impairments.

What Is the Link Between Sleep Apnea and Hospitalizations in Seniors?

As we discussed, sleep apnea significantly impacts seniors’ health. Yet how exactly does it relate to hospitalizations?

A new study titled  “Association Between Sleep Apnea and Health Service Utilization: Results from the Health and Retirement Study” sheds light on this issue.

It was conducted on a nationally representative cohort of approximately 20,000 middle-aged and older adults in the United States. This study aimed to explore the association between sleep apnea and the subsequent use of health services, independent of other health conditions and potential confounders.

The Study’s Methodology

The participants aged are 50 and above. They were surveyed in 2016 and again in 2018 as part of the Health and Retirement Study (HRS). In 2016, they were asked if a doctor had ever diagnosed them with a sleep disorder. Specifically sleep apnea. Two years later, they reported on their use of various health services, including hospitalization, home healthcare, and nursing home use.

Using logistic regression, the researchers analyzed the data to determine if there was an association between having sleep apnea in 2016 and the use of health services in 2018. Also they adjusted for demographics, BMI,  existing health conditions, and depressive symptoms to isolate the effect of sleep apnea.

Key Findings

They examined a sample of 20,115 participants from the HRS study, 11.8% of whom reported having sleep apnea. In 2016, individuals with sleep apnea had a 21% higher likelihood of using any health service in the future compared to those without sleep apnea, with an Adjusted Odds Ratio (AOR) of 1.21 (95% Confidence Interval [CI]=1.02-1.43), after adjusting for confounding variables. Specifically, those with sleep apnea were more likely to be hospitalized (AOR=1.21, 95% CI=1.02-1.44) and had a higher, though not statistically significant, likelihood of using home healthcare services (AOR=1.23, 95% CI=0.99-1.54).

Implications of the Findings

These findings highlight a critical issue. Sleep apnea significantly increases the likelihood of hospitalization and other health service use in seniors. Even so why does this happen?

The answer is that sleep apnea often coexists with other chronic health conditions, such as cardiovascular disease (Heart failure by 140%, stroke by 60%, and heart disease by 30%), diabetes, and hypertension. The intermittent lack of oxygen and the fragmented sleep caused by sleep apnea can exacerbate these conditions, leading to more frequent and severe health crises that require hospitalization.

Added to that the daytime fatigue and cognitive impairments associated with sleep apnea can increase the risk of accidents and falls, particularly in older adults. These incidents often result in injuries that necessitate hospitalization or home healthcare.

The Importance of Addressing Sleep Apnea

Given the clear link between sleep apnea and increased health service utilization. It is a must to address this condition proactively. Early diagnosis and effective management of sleep apnea can potentially reduce hospitalizations and improve overall health outcomes for seniors.

Healthcare providers should routinely screen for sleep apnea in older adults. Epecially those with risk factors such as obesity, hypertension, or a history of cardiovascular disease. With that treatment options like Continuous Positive Airway Pressure (CPAP) therapy, lifestyle changes, and in some cases, surgical interventions can significantly alleviate the symptoms of sleep apnea.

Moreover, raising awareness about the importance of sleep health among seniors and their caregivers can encourage more people to seek diagnosis and treatment. Educating patients about the risks of untreated sleep apnea and the benefits of adhering to treatment plans can lead to better compliance and health outcomes.

How Can Early Diagnosis and Treatment of Sleep Apnea Reduce Hospitalizations?

Untreated sleep apnea in seniors can make things much worse.  Especially for those seniors who also have other health issues. So how can early diagnosis and treatment of sleep apnea help reduce hospitalizations in older adults?

It is important to note that for seniors who are already dealing with these issues, sleep apnea adds more stress to their bodies, increasing the chances of severe health problems that could land them in the hospital.

Early Diagnosis

The first step to managing sleep apnea is early diagnosis. Regular health check-ups for seniors could also include screening for sleep apnea, especially if they have risk factors like obesity, high blood pressure or a history of heart problems. Simple questionnaires could help identify those at high risk. And if needed, further testing like home sleep studies or overnight sleep lab studies can confirm the diagnosis.

Benefits of Early Treatment

Once sleep apnea is diagnosed, starting treatment right away can make a huge difference by:

  1. Improving Heart Health

Sleep apnea puts a lot of strain on the heart. The repeated drops in oxygen levels during sleep can cause high blood pressure. Also it can increase the risk of heart attacks and strokes. Treating sleep apnea early, often with CPAP therapy (a machine that keeps the airway open during sleep), can significantly lower these risks.

  1. Better Control of Chronic Conditions

As mentioned earlier, many seniors deal with chronic conditions like diabetes and hypertension. Sleep apnea can make managing these conditions more challenging. For example, poor sleep can mess with blood sugar levels in diabetics. So when sleep apnea is treated seniors can better manage these conditions, reducing the chances of complications that might require hospitalization.

  1. Reduced Risk of Accidents

Daytime sleepiness and cognitive problems are common in people with sleep apnea, which can lead to accidents and falls. This is particularly dangerous for seniors. Early treatment can help improve alertness and coordination, reducing the risk of such accidents.

  1. Enhanced Quality of Life

Treating sleep apnea also improves overall quality of life. Better sleep means better mood, sharper thinking, and more energy. This helps seniors stay active, maintain social connections, and manage their other health conditions more effectively.

Ongoing Care and Follow-Up

Early treatment is really important. But it’s just the beginning. Continuous monitoring and regular follow-up care can make the treatment remain effective. This might involve adjusting CPAP machine settings or addressing any new health issues that come up. Regular check-ins with healthcare providers can catch problems early before they turn into something serious that requires hospitalization.

Disclaimer: The information provided in this blog post is for educational and informational purposes only. Always consult with a qualified healthcare professional before making any changes to your health regimen.

How Can The Insomnia and Sleep Institute of Arizona Help You?

The Insomnia and Sleep Institute of Arizona understands the profound impact sleep apnea and other sleep disorders can have on your health, especially for seniors. Our ISIA specialists set the standard for sleep medicine practice in Arizona. We offer comprehensive care to improve your sleep quality and overall well-being.

Physician-owned and operated, our institute is home to top-rated sleep medicine leaders. We treat all types of sleep disorders, addressing the neurological-sleep connection, and offering treatment for both adult and pediatric patients as young as one year old.

As your leading sleep clinic, we go beyond just sleep testing. We offer a wide range of clinical services to manage and treat sleep disorders, aiming to reduce related health issues such as headaches, migraines, facial pain, and seizures like epilepsy. Additionally,  we conduct sleep clinical trials to advance the understanding and treatment of sleep conditions.

Our commitment is to provide you with the highest quality care to improve your sleep and overall health. So if you or a loved one is struggling with sleep apnea or any other sleep disorder, we are here to help. Just contact us.

 

References:

 

Bangash, A., Wajid, F., Poolacherla, R., Mim, F. K., & Rutkofsky, I. H. (2020). Obstructive Sleep Apnea and Hypertension: a Review of the Relationship and Pathogenic Association. Cureus, 12(5). https://doi.org/10.7759/cureus.8241

‌Biden Has Begun Using a CPAP Machine for Sleep Apnea (Published 2023). (2024). The New York Times. https://www.nytimes.com/2023/06/28/us/politics/biden-cpap-sleep-apnea.html

Jean-Louis, G., Zizi, F., Clark, L. T., Brown, C. D., & McFarlane, S. I. (2008). Obstructive sleep apnea and cardiovascular disease: role of the metabolic syndrome and its components. Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine, 4(3), 261–272. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2546461/

Pandey, A., Demede, M., Zizi, F., Al Haija’a, O. A., Nwamaghinna, F., Jean-Louis, G., & McFarlane, S. I. (2010). Sleep Apnea and Diabetes: Insights into the Emerging Epidemic. Current Diabetes Reports, 11(1), 35–40. https://doi.org/10.1007/s11892-010-0164-9

Ricks, C. (2024, April 22). WVXU: Find your CPAP annoying? UC researchers are working on a more comfortable device. UC News. https://www.uc.edu/news/articles/2024/04/wvxu–find-your-cpap-annoying-university-of-cincinnati-researchers-may-have-a-solution.html

‌Seniors, in. (2019). Study Shows Link Between Sleep Apnea and Hospitalizations in Seniors. Google Docs. https://docs.google.com/document/d/1W1UHEuPaV_8FcftjEXNFNIMPBDvstwTUilb0bRlGHS4/edit

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