Among sleep disorders obstructive sleep apnea syndrome SAOS
Among sleep disorders, obstructive sleep terbinafine hcl syndrome (SAOS) is very common among the older adult [14,15]. SAOS occurs when there is a repeated obstruction of the upper airway during sleep for 10s or more, accompanied by oxyhemoglobin desaturation, causing micro-arousals and awakenings. SAOS may be followed by daytime sleepiness and fatigue, an increase in naps and increased cardiovascular morbidity and mortality [16,17]. In the older adult, there is still no consensus on the diagnostic criteria for sleep apnea. Some authors consider the values similar to adults, i.e., an index of apnea/hypopnea episodes per hour up to 5 is considered to be normal, from 21 to 50: moderate, over 50 are considered to be high .
However, it is estimated that the diagnosis of SAOS is not made in 82% of men and 93% of women with moderate to severe SAOS. The low frequency of diagnosis may reflect the reduced perception of symptoms of sleep as a problem by the patient and their relatives, the difficult access to associated diagnostics and the possibility of insufficient training in sleep medicine .
The gold standard method for the diagnosis of sleep disorders is polysomnography, which is a study that is performed throughout the night in a laboratory . However, other diagnostic methods can be used for the investigation of sleep disorders and, subjective and objective assessments of sleep parameters may differ due to sleep misperception and measurement effects. While subjective estimates may be biased by a person’s own sleep perception, objective assessment methods (such as PSGs), may be considered distressing, thus changing the quality and quantity of a person’s usual sleep. Exposure to polysomnographic equipment, e.g., head and chest sensors, or sleeping in an unfamiliar setting such as a laboratory, may interfere with the person’s habitual sleep pattern [21,22].
Statistical analysis The sample size was based on the population of older adult at the Center for the Study of Aging who answered the sleep habits questionnaire, with Hypothesis test average, which met the needed amount of participants to produce a reliable statistical analysis. The independent t test was used to compare the presence or absence of symptoms depending on the variables of polysomnography. The older adults were divided in two groups: have “symptoms” and the ones who do not have symptoms. In order to verify the association between the normative values of polysomnography with the presence of symptoms, we used the chi-square test. For meaningful comparisons, the data are represented by bar charts with confidence intervals (95%). A p-value less than 0.05 was considered statistically significant.
Results We compared all of the variables on the polysomnography with the questions on the CGA (sleep habits questionnaire). The results are shown in Tables 1 and 2. The sleep onset latency on the polysomnography showed relation with the sleep habits questionnaire, when the older adults answered difficulty sleeping on the CGA (p=0.015) and, when they reported waking up at night on the CGA (p=0.005) – graphic 1 The awakenings index on the polysomnography indicated association with snoring on the CGA (p=0.012) – graphic 4 and when older adults noticed there was apnea on the polysomnography and reported the feeling of a pause in breathing on the questionnaire (p=0.001) – graphic 5. A new analysis of polysomnography compared with data from CGA, rated Normal/Changed was performed. We used the Chi-Square for Independence test for this analysis (Table 3).
Discussion The major finding of this research was that the older adults have an accurate perception of the time they spend to fall asleep, which is consistent with the findings of O’Donnell et al. . Those authors assessed 24 healthy adults through questionnaires and polysomnography and found correlations in the total sleep time associated with an increase in slow-wave sleep and sleep onset latency. Our findings of the association between increased in the sleep onset latency with difficulty sleeping and waking up at night is similar to other studies [23,24], and so are our results about total sleep time reduced with daytime sleepiness and snoring (TST) [23–25].