This article appears in Senior Care Guide 2018.

Getting a good night’s sleep is hard enough as we age, but a new study finds that older Americans are at a high risk — yet are often underdiagnosed — for a severe type of sleep apnea.

More than half (56 percent) of people 65 and older have a high risk of obstructive sleep apnea, a disorder in which the throat collapses during sleep, causing the repeated stoppage of breathing for periods of 10 seconds or longer throughout the night, according to University of Michigan researchers.

While 56 percent of people tested for obstructive sleep apnea were found to be at high risk, only 8 percent had been tested previously for the disorder. An overnight sleep study is necessary to diagnose obstructive sleep apnea.

“Older adults and their caregivers should realize that sleepiness, tiredness, fatigue and lack of energy — especially when sleep complaints such as loud snoring, observed pauses in breathing or insomnia are also present — are not necessarily expected features of aging,” said Dr. Ronald Chervin, a neurologist and director of the University of Michigan Sleep Disorders Centers. “If you have those symptoms, you should speak with your physician or see a board-certified sleep medicine physician who might be able to help figure out underlying causes and treatments for these symptoms. Obstructive sleep apnea is a common cause and it can be treated effectively.”

Not ‘normal aging’

While older adults who are at risk for obstructive sleep apnea are rarely evaluated, when they are tested nearly all — 94 percent — receive a confirmed diagnosis, the study found.

Researchers can only speculate on the reasons why the high rate of underdiagnosis exists.

“One potential explanation is that some of the symptoms that are associated with obstructive sleep apnea, such as snoring or tiredness, are assumed to be part of ‘normal aging,’ and thus may not be reported by older adults,” said Dr. Tiffany Braley, a neurologist at the University of Michigan Sleep Disorders Centers. “Older adults may also experience other symptoms not traditionally associated with obstructive sleep apnea among middle-aged adults (cognitive impairment or falls, for example), highlighting the need for additional obstructive sleep apnea research in this population.”

Treatment options

The most common treatment for obstructive sleep apnea is the use of a continuous positive airway pressure, or CPAP, machine.

A small machine next to the bed sends pressurized air through a tube to a mask worn over the nose or nose and mouth to the throat, keeping it from collapsing during sleep.

“The increased pressure is transmitted to the throat, where it splints the upper airway open and allows the user to breathe normally without choking repeatedly while asleep,” Chervin said.

Other treatments that can be used in some cases include oral appliances — similar to mouth guards or orthodontic retainers — and some patients may qualify for surgical treatment of obstructive sleep apnea, Chervin said.

“Obstructive sleep apnea is linked to many chronic health problems and symptoms that are often experienced by older adults. If you think you may have obstructive sleep apnea, you should discuss it with your doctor rather than ignoring it and suffering the consequences,” Braley said.