Introduction

Many older adults complain of poor sleep. Foley reported that sleep disruption becomes a common problem in aging adults, with reports of 50% of adults over the age of 65 complaining of poor sleep (1). A variety of factors contribute to sleep disruption in the elderly, including underlying medical and psychiatric illness, medication use, circadian rhythm disturbances, and specific sleep disorders (2). One type of sleep disorder most commonly diagnosed in the elderly, with prevalence reports of 20% to 81%, is sleep-disordered breathing (SDB) (3-5). In general, SDB encompasses a variety of sleep-related breathing disorders ranging from benign snoring to obstructive sleep apnea (OSA); however, the term is often used to refer to OSA. In this chapter, we will use the terms SDB and OSA interchangeably, except when explicitly stated otherwise.

OSA is a condition characterized by cessation of regular breathing during sleep. Apneas refer to complete cessation of respiration and hypopneas refer to partial or reduced respiration. For the diagnosis of sleep apnea, each apneic or hypop-neic event must last a minimum of 10 seconds and recur throughout the night. Each respiratory event generally results in repeated arousals from sleep as well as nocturnal hypoxemia. The apnea index (AI) is the number of apneas per hour of sleep and the total number of apneas plus hypopneas per hour of sleep is called the apnea-hypopnea index (AHI) or respiratory disturbance index (RDI).

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