Morphological features of elderly patients with obstructive sleep apnoea syndrome: a prospective controlled, comparative cohort study
Objectives: To investigate the pharyngeal morphologic features and its pathogenic role on obstructive sleep apnoea syndrome in the elderly population.
Participants: We enrolled 320 consecutive patients with complaints of snoring who visited Nagoya University Hospital from January 2004 to December 2007. We also collected 26 control subjects aged over 60 years from community-dwelling people.
Main outcome measures: We underwent a morphological evaluation, measurement of nasal resistance, assessment of daytime sleepiness and nocturnal polysomnography.
Results and conclusions: 292 patients were analyzed. The constitution ratio of men, the body mass index and Epworth sleepiness scale were decreased with aging. Tonsil size was reduced progressively with aging. Retroglossal space was wider and soft palate was lower in 60yr≤ group than in <40yr group. Retroglossal space was wide in elderly patients with sleep apnoea compared with control subjects. Tonsil size was not correlated to apnoea/hypopnoea index in 60yr≤ group unlike the other generations. Modified Mallampati Score and tongue size were significantly but mildly correlated only in 60yr≤ group. Width of fauces was correlated in all the groups. Multiple regression analysis showed that body mass index, age, gender, tonsil size and width of fauces were independent factors for apnoea/hypopnoea index.
Conclusions: Morphologically, the tonsil could play a minor role but the width of fauces could play relatively a major role. Additionally, wide retroglossal space, low positional soft palate and large tongue size may be characteristic for elderly patients of obstructive sleep apnoea syndrome.