CPAP may reduce fall risk among elderly patients of sleep apnea

Falls in older people can lead to severe injury and significant societal health and financial burden. Obstructive sleep apnoea (OSA) is associated with impaired gait/balance and may increase fall risk, yet few studies examined whether treating OSA reduces fall risk. This study examined the effect of continuous positive airway pressure (CPAP) on fall risk markers in people over 65yrs diagnosed with OSA. It was a single-arm intervention study conducted at University and tertiary care CPAP clinic. The study included individuals over 65 years diagnosed with OSA and recommended CPAP.

28 participants had a physiological profile assessment (PPA) at baseline and following 3–6 months of CPAP. The PPA examines visual contrast sensitivity, lower limb proprioception, knee extension strength, reaction time and postural sway to generate a fall risk score (FRS). t-tests were used to determine the difference between pre-and post-treatment FRS. Regression was used to examine the associations between CPAP use and daytime sleepiness with FRS.

Results:

• CPAP significantly reduced the FRS contrast sensitivity and lower limb proprioception
• Increased CPAP use was associated with improvement in FRS in unadjusted analysis
• Reduction in Epworth sleepiness score was associated with a decrease in FRS in unadjusted and adjusted analysis

Researchers concluded that CPAP may reduce fall risk in people over 65yrs, possibly related to better CPAP adherence and reduced daytime sleepiness. Future controlled trials and mechanistic studies must elucidate how CPAP may reduce fall risk.

Reference:

David Stevens, Chris Barr, Katherine Bassett, Aaron Oh, Stephen R. Lord, Maria Crotty, Kelsey Bickley, Sutapa Mukherjee, Andrew Vakulin. Reduction in fall risk markers following CPAP treatment of obstructive sleep apnoea in people over 65 years, Sleep Medicine, ISSN 1389-9457, https://doi.org/10.1016/j.sleep.2022.09.019