Obstructive sleep apnea, depression, and oral status in elderly occupants of residential homes

Obstructive sleep apnea syndrome (OSAS) is a sleep disorder characterized by repetitive episodes of upper airway obstruction. Recently, it has been suggested that edentulism worsens sleep apnea; sleeping without dentures is associated with a significant increase in the apnea-hypopnea index. OSAS is also related to depression. The aim of this study was to assess, in a group of elderly occupants in residential homes in the Turin district of Italy, (1) the prevalence of key symptoms and indicators of OSAS and the prevalence of depressive feelings; (2) how the reduction of vertical dimension of occlusion (VDO) influenced the onset of OSAS; and (3) whether a relationship between OSAS and depression was present.

The sample population consisted of 403 people (77% men, 23% women; age range, 65 to 90 years). The subjects underwent the Italian version of the Mini Mental State Examination (MMSE) to assess their mental condition. The remaining collaborating subjects completed 2 questionnaires to assess the risk of OSAS (Berlin Questionnaire) and depressive feelings (Beck Depression Inventory).

Of the 403 elderly residents initially evaluated with the MMSE, 97 were excluded from the study, reducing the sample size to 306 subjects (75% women, 25% men; mean age +/- standard deviation, 83.12 +/- 11.10 years). The analysis of these data revealed a statistically significant association between the risk for sleep apnea and the VDO (P < .0001), and between sleep apnea and depressive feelings (P < .05).

This study revealed that inadequate VDO is closely associated with the risk of OSAS, and that depressive feelings are more present if there is a high risk for OSAS.