Faut-il prendre en charge le syndrome d'apnées du sommeil obstructif chez le sujet âgé ?

Because of the high prevalence of obstructive sleep apnea (OSA) after age 65, the growing awareness of sleep disorders and the aging of the population, the number of elderly patients in whom the question of treatment of OSA is relevant is constantly increasing. Arguments for the initiation of effective treatment are based on the patient's symptoms analysis, the impact of SAS on the quality of life, sometimes contradictory data on OSA-associated morbidity and mortality and lastly, data on the effects of treatment. The treatment of OSA with continuous positive airway pressure (CPAP) improves symptoms (nocturia, repeated falls, and cognitive impairment) and appears to have a positive impact on cardiovascular complications. Despite potential barriers to the successful use of CPAP, compliance is good in the elderly. The use of mandibular advancement devices remains to be evaluated in this population. Aggravating factors (sedatives, obesity, tooth loss, supine position) must be taken into account. A thorough geriatric assessment of some patients may be required. In conclusion, the treatment of OSA in the elderly is both feasible and effective.