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Figure 2. Percentual proportion of sleep cycles in controls (panel A) and seniors (panel B) and sleep frag-mentation due to respiratory related arousals (panels C, D) of patients with OSA. Data are matched for apnea/hypopnea index - AHI. Panels A, B: Patients in the elderly group had lowered proportion of slow-wave NREM3 sleep. *p=0,005 NREM3%, controls vs. seniors. Panels C, D: In younger people with OSA, arousal index on diagnostic polysomnography night almost corresponded with their apnea/hypopnea index. With advancing age, the number of spontaneous arousals has an increasing tendency and adds to overall sleep fragmentation of seniors with OSA.

Figure 3. Sleepiness and sleep efficiency in patients with OSA. Subjective perception of sleepiness defined by ESS starts to decrease in older people with OSA, as the AHI and respiratory related arousals de-crease, despite the sleep latency and WASO periods are prolonged and deep sleep efficiency is below 80%. ESS - Epworth sleepiness score pre-polysomnography, WASO - wake after sleep onset, /hTST - events per hour of total sleep time.

Figure 4. Perception of daily sleepiness of patients with OSA versus CPAP compliance. The probability to indicate excessive daily sleepiness based on Epworth sleepiness score is higher than the probability that the older people stay above 4 hours of daily CPAP use, (*p<0,0001). The data clearly shows that with advancing age the probability of elderly people who are able conform to the compliance cri-teria of 4 hours CPAP use per day decreases. Age PSG – age at the time of OSA diagnosis and ini-tiation of CPAP therapy, ESS – Epworth sleepiness score at the time of OSA diagnosis.