Cyclical nocturnal oxygen desaturation and impact on activities of daily living in elderly patients

Abstract

It is well known, that sleep disordered breathing (SDB) is associated with functional impairment in stroke patients. In elderly non-stroke subjects this relation is unclear. We evaluated 539 elderly patients (median age was 81 years, range 41 to 100 years). We measured activities of daily living (ADL) with the Barthel-Index (BI, 0-100) on admission and discharge, excessive daytime sleepiness (EDS), and the nocturnal oxygen desaturation index (ODI). BI on admission was 54 ±33 in men and 55 ±31 in women (n.s.). More than 50% of the subjects had an ODI above 10/h. The mean BI on discharge was 65 ±31 in men and 67 ±29 in women (n.s.). With increasing SDB severity (quartiles of ODI), BI on admission decreased from 58 ±33 to 46 ±31 (P< 0.001) and BI on discharge decreased from 70 ±31 to 59 ±29 (P< 0.001). The frequency of EDS increased with increasing severity of SDB from 14.1% (first quartile of ODI) to 40.3% (forth quartile of ODI) (P< 0.001). In 330 subjects without EDS, BI on admission did not differ regarding ODI. BI on discharge decreased from 78 ±22 (first quartile of ODI) to 66 ±25 (forth quartile of ODI) (P<0.04). SDB and EDS have a negative and independent impact on activities of daily living in elderly non-stroke subjects. Regarding the high frequency of SDB in the elderly and the effect size on ADL further interventional studies are warranted.