Experts Urge Age-Tailored Sleep Apnea Strategies for Seniors

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Researchers from Marshall University, the University of Washington, IRCCS Istituto Auxologico Italiano and the University of Milano-Bicocca in Italy, University and Polytechnic La Fe Hospital in Spain have published a comprehensive review highlighting the urgent need for more individualized, age-adapted approaches to diagnosing and treating obstructive sleep apnea (OSA) in older adults. The review examines the rapidly growing prevalence of OSA in aging populations and outlines the clinical challenges of balancing potential risks and benefits of treatment in adults age 65 and older, particularly those older than 80 and those living with frailty or multiple chronic conditions.

Why it matters

OSA affects nearly half of older adults and becomes even more common in the very elderly, yet this population remains significantly underrepresented in randomized clinical trials. As a result, many diagnostic thresholds and treatment recommendations are largely derived from studies of younger or middle-aged populations, which may not be appropriate for older adults who experience distinct physiological changes.

The details

The review synthesizes available evidence showing that aging is associated with distinct physiological changes in upper airway function, ventilatory control and sleep architecture that may alter how OSA develops and responds to therapy. Older adults often present without classic symptoms such as excessive daytime sleepiness, instead experiencing fatigue, insomnia, cognitive changes, falls or mood disturbances. The authors also highlight the close relationship between OSA and frailty, noting that intermittent hypoxia, inflammation and hormonal dysregulation may contribute to declining physical and cognitive reserve.

• The article was published in Sleep Medicine Reviews on March 3, 2026.