Obstructive sleep apnea syndrome in elderly patients with chronic kidney disease


DOI: https://dx.doi.org/10.18565/therapy.2021.3.36-42

Efremova E.V., Shutov A.M., Serov V.A.

Ulyanovsk State University
Abstract. The aim of the study was to examine the comorbidity, clinical features and life quality of elderly and senile patients with obstructive sleep apnoea syndrome (OSAS) and chronic renal disease (CRD).
Material and methods. 80 elderly and senile patients with stable cardiovascular pathology were studied. The observation period was 12 months. CRD was diagnosed according to the National guidelines of the Scientific Society of Nephrologists of Russia (2012), OSAS – according to recommendations of the Russian Society of Somnologists (2018). Charlson comorbidity index (CI) was used for comorbidity assessing; comorbidity was considered high at CI ≥6 points. The patients’ quality of life (EQ-5D-5L), the presence of anxiety and depression (HADS Hospital Anxiety and Depression Scale), psychological defense mechanisms were estimated by means of Plutchik–Kellerman–Conte’s «Lifestyle Index» methodic.
Results. CRD took place in 48 (60%) of study participants. OSAS was first diagnosed in 31 (64,5%) of elderly and senile patients having CRD. Elderly and senile patients with CRD and OSAS had a high comorbidity level: Charlson CI consisted of 8 (6; 9) points. When analyzing the personality traits and life quality of the participants of the study, the severity of anxious and depressive reactions, decrease of life quality index and the use of primitive mechanisms of psychological defense in the presence of disturbed sleep quality and daytime sleepiness were observed.
Conclusion. In elderly and senile CRD patients, a high prevalence of previously not diagnosed OSAS was fixed. Elderly and senile patients with CRD and OSAS have a high comorbidity, including cardiovascular comorbidity, which probably determines the prevalence of OSAS. Sleep quality disorder, daytime sleepiness are associated with the severity of anxiety and depression, life quality decrease, and maladjustment.
Keywords: obstructive sleep apnoea syndrome, chronic renal disease, elderly and senile age, comorbidity
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About the Autors

Elena V. Efremova, PhD, associate professor of the Department of therapy and occupational diseases of T.Z. Biktimirov Faculty of medicine, Institute of medicine, ecology and physical culture of Ulyanovsk State University. Address: 432017, Ulyanovsk, 42 Lva Tolstogo Str. Tel.: +7 (8422) 55-27-08, +7 (902) 128-39-68; fax: +7 (8422) 55-27-08. E-mail: lena_1953@mail.ru. ORCID: 0000-0002-7579-4824
Alexander M. Shutov, MD, professor, head of the Department of therapy and occupational diseases of T.Z. Biktimirov Faculty of medicine. Institute of medicine, ecology and physical culture of Ulyanovsk State University. Address: 432017, Ulyanovsk, 42 Lva Tolstogo Str. Tel.: +7 (8422) 55-27-08; +7 (903) 320-57-27; fax: +7 (8422) 55-27-08. E-mail: amshu@mail.ru. ORCID: 0000-0002-1213-8600
Valery A. Serov, MD, professor of the Department of therapy and occupational diseases of T.Z. Biktimirov Faculty of medicine, Institute of medicine, ecology and physical culture of Ulyanovsk State University. Address: 432017, Ulyanovsk, 42 Lva Tolstogo Str. Tel.: +7 (8422) 55-27-08; fax: +7 (8422) 55-27-08. E-mail: valery_serov@mail.ru. ORCID: 0000-0003-1815-5599

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