Obstructive sleep apnea (OSA) is prevalent among the elderly, with incidence rising due to aging trends. Clinical manifestations in the elderly differ significantly, deviating from conventional risk factors such as male gender and obesity. Postmenopausal women experience a notable surge in OSA prevalence, while traditional features like snoring and high body mass index (BMI) di-minish. Limited evidence exists on elderly OSA progression, but untreated cases elevate stroke, cognitive decline, and heart fail-ure risks. Continuous positive airway pressure (CPAP) emerges as the most effective treatment. CPAP therapy proves effective for elderly OSA patients, enhancing sleep quality, addressing nocturia, and improving neurobehavioral outcomes. Elderly individ-uals often require lower CPAP pressures, with positive effects observed on cardiovascular risk factors and neurobehavioral dis-orders. Overcoming challenges like nocturnal awakenings and comorbidities, age does not significantly impact PAP adherence. Education, troubleshooting, and emphasizing therapy benefits are vital. Addressing adherence factors in the elderly, including depression, is pivotal. Individualized strategies, considering aging-related challenges and comorbidities, are imperative for suc-cessful PAP treatment in this population. Despite potential hurdles, PAP therapy remains a valuable intervention, even for those with dementia.
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