Diagnostic indicators of sleep apnea in older women and men: a prospective study

The purpose of the present prospective study of older adults was to (1) explore the nature and frequency of sleep disorder in a sample of self-identified, sleepy/tired individuals and (2) compare symptom presentation of women and men who were subsequently diagnosed with sleep apnea/hypopnea.

Participants were 112 community-based older adults self-identified with daytime sleepiness, fatigue, or insomnia. They underwent medical examination and overnight polysomnographic recording. Sleep quality, daytime sleepiness, fatigue, psychological adjustment, and perceived health were evaluated by self-report measures.

Results indicated (1) a very high rate of sleep disorder identified by the self-selection process, (2) a male-to-female ratio of 1.2 to 1 for diagnosed apnea/hypopnea syndrome, (3) similar severe apnea signs and symptoms reported by both men and women, and (4) virtually no differences in psychological adjustment and few perceived differences in health limitations between men and women. (5) Female participants with sleep apnea/hypopnea could not be distinguished from participants with insomnia only on the basis of reported symptom presentation alone.

Our findings suggest a strategy for identifying individuals for referral to a sleep laboratory. The findings also underline the diagnostic importance of medically unexplained complaints of daytime fatigue or sleepiness in older adults for the diagnosis and, ultimately, the effective management of sleep apnea and its attendant health risks.