Sleep Disordered Breathing in Elderly: Current Evidence and Future Directions in Clinical Practice

Sleep disordered breathing (SDB) is a common problem in the general population, and its prevalence in the community of middle-aged subjects varies depending on several factors such as age, sex, race, body habitus measures including body mass index, etc [1-6]. Most common treatment of SDB in the world that has been widely used is continuous positive airway pressure (CPAP) through CPAP device, surgery, dental device, and so on [7]. When practicing sleep medicine in clinics, we often find out there are still uncharted areas that are yet to be discovered and need further elucidations. Due to lack of scientific evidences, there might be confusion in making decisions and diagnosing patients with declining compliance of CPAP machine due to older age, individual variation of upper airway anatomy, chronic medical problems in addition to taking medications, and those who experience cumbersome usage of mask on the top of mouth, nose, inside nose like “nasal pillow” type mask, etc. We all have been experiencing the same issue in the clinics without any definite solutions for those issues and reasons why it happens sometimes. And it is demonstrated that patients with moderate-to-severe obstructive sleep apnea syndrome (apnea-hypopnea index > 15 and/or Epworth Sleepiness Scale score > 10) mostly have poor compliance to CPAP device [8]. In our