Sleep-related breathing disorders and gait variability: a cross-sectional preliminary study

Sébastien Celle, Cédric Annweiler, Richard Camicioli, Jean-Claude Barthélémy, Frédéric Roche, Olivier Beauchet, Sébastien Celle, Cédric Annweiler, Richard Camicioli, Jean-Claude Barthélémy, Frédéric Roche, Olivier Beauchet

Abstract

Background: Sleep-related breathing disorders (SRBDs) provoke cognitive and structural brain disorders. Because these disorders have been associated with unsafe gait characterized by an increase in stride-to-stride variability of stride time (STV), we hypothesised that SRBDs could be associated with an increased STV. The aim of this study was to examine the association between SRBDs and STV in French healthy older community-dwellers.

Methods: A total of 49 participants (mean age 69.6 ± 0.8 years; 65.2% female) were included in this cross-sectional study. All participants, who were free of clinically diagnosed SRBDs before their inclusion, had a nocturnal unattended home-sleep assessment. There were separated in three group based on apnea + hypopnea index (AHI): AHI <15 defining the absence of SRBD, AHI between 15-30 defining mild SRBD, and AHI >30 defining moderate-to-severe SRBD. Coefficient of variation of stride time, which is a measure of STV, was recorded while usual walking using SMTEC® footswitches system. Digit span score was used as a measure of executive performance. Age, gender, body mass index (BMI), number of drugs daily taken, vision, proprioception, history of falls, depression symptoms, global cognitive functioning were also recorded.

Results: STV and BMI were higher in participants with mild SRBDs (P = 0.031 and P = 0.020) and moderate-to-severe SRBDs (P = 0.004 and P = 0.002) compared to non-SRBDs. STV positively correlated with AHI (P = 0.036). Lower (i.e., better) STV was associated with the absence of SRBDs (P = 0.021), while greater (i.e., worse) STV was associated with moderate-to-severe SRBD (P < 0.045) but not with mild SRBD (P > 0.06).

Conclusion: Our results show a positive association between STV and SRBDs, with moderate-to-severe SRBD being associated with greater gait variability. This association opens new perspectives for understanding gait disorders in older adults with SRBDs and opens the door to treatments options since SRBDs are potential treatable factors.

References

    1. McNicholas WT, Levy P. Sleep-related breathing disorders: definitions and measurements. Eur Respir J. 2000;15:988–989. doi: 10.1034/j.1399-3003.2000.01502.x.
    1. Adegunsoye A, Ramachandran S. Etiopathogenetic mechanisms of pulmonary hypertension in sleep-related breathing disorders. Pulm Med. 2012;2012:273591.
    1. Sforza E, Gauthier M, Crawford-Achour E, Pichot V, Maudoux D, Barthélémy JC, Roche F. A 3-year longitudinal study of sleep disordered breathing in the elderly. Eur Respir J. 2012;40:665–672. doi: 10.1183/09031936.00133011.
    1. Sforza E, Roche F, Thomas-Anterion C, Kerleroux J, Beauchet O, Celle S, Maudoux D, Pichot V, Laurent B, Barthélémy JC. Cognitive function and sleep related breathing disorders in a healthy elderly population: the SYNAPSE study. Sleep. 2010;33:515–521.
    1. Gozal D, Daniel JM, Dohanich GP. Behavioral and anatomical correlates of chronic episodic hypoxia during sleep in the rat. J Neurosci. 2001;21:2442–2450.
    1. Beauchet O, Allali G, Launay C, Herrmann FR, Annweiler C. Gait variability at fast-pace walking speed: a biomarker of mild cognitive impairment? J Nutr Health Aging. 2013;17:235–239. doi: 10.1007/s12603-012-0394-4.
    1. Beauchet O, Annweiler C, Celle S, Bartha R, Barthélémy JC, Roche F. Higher gait variability is associated with decreased parietal gray matter volume among healthy older adults. Brain Topogr. 2014;27:293–295. doi: 10.1007/s10548-013-0293-y.
    1. Allali G, Perrig S, Cleusix M, Herrmann FR, Adler D, Gex G, Armand S, Janssens JP, Pepin JL, Assal F. Gait abnormalities in obstructive sleep Apnea and impact of continuous positive airway pressure. Respir Physiol Neurobiol. 2014. [Epub ahead of print]
    1. Goldberg D, Bridges K, Duncan-Jones P, Grayson D. Detecting anxiety and depression in general medical settings. BMJ. 1988;297:897–899. doi: 10.1136/bmj.297.6653.897.
    1. Kressig RW, Beauchet O. European GAITRite Network Group. Guidelines for clinical applications of spatio-temporal gait analysis in older adults. Aging Clin Exp Res. 2006;18:174–176. doi: 10.1007/BF03327437.
    1. Beauchet O, Freiberger E, Annweiler C, Kressig RW, Herrmann FR, Allali G. Test-retest reliability of stride time variability while dual tasking in healthy and demented adults with frontotemporal degeneration. J Neuroeng Rehabil. 2011;8:37. doi: 10.1186/1743-0003-8-37.
    1. Lord SR, Ward JA, Williams P, Anstey KJ. Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc. 1994;42:1110–1117.
    1. Beauchet O, Dubost V, Revel Delhom C, Berrut G, Belmin J. French Society of Geriatrics and Gerontology. How to manage recurrent falls in clinical practice: guidelines of the French Society of Geriatrics and Gerontology. J Nutr Health Aging. 2011;15:79–84. doi: 10.1007/s12603-011-0016-6.
    1. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–198. doi: 10.1016/0022-3956(75)90026-6.
    1. Grober E, Buschke H, Crystal H, Bang S, Dresner R. Screening for dementia by memory testing. Neurology. 1988;38:900–903. doi: 10.1212/WNL.38.6.900.
    1. Beauchet O, Annweiler C, Montero-Odasso M, Fantino B, Herrmann FR, Allali G. Gait control: a specific subdomain of executive function? J Neuroeng Rehabil. 2012;9:12. doi: 10.1186/1743-0003-9-12.
    1. Beauchet O, Celle S, Roche F, Bartha R, Montero-Odasso M, Allali G, Annweiler C. Blood pressure levels and brain volume reduction: a systematic review and meta-analysis. J Hypertens. 2013;31:1502–1516. doi: 10.1097/HJH.0b013e32836184b5.
    1. Gunnbjörnsdóttir MI, Omenaas E, Gíslason T, Norrman E, Olin AC, Jõgi R, Jensen EJ, Lindberg E, Björnsson E, Franklin K, Janson C, Gulsvik A, Laerum B, Svanes C, Torén K, Tunsäter A, Lillienberg L, Gíslason D, Blöndal T, Björnsdottir US, Jörundsdóttir KB, Talvik R, Forsberg B, Franklin K, Lundbäck B, Söderberg M, Ledin MC, Boman G, Norbäck D, Wieslander G. et al.RHINE Study Group. Obesity and nocturnal gastro-oesophageal reflux are related to onset of asthma and respiratory symptoms. Eur Respir J. 2004;24:116–121. doi: 10.1183/09031936.04.00042603.
    1. McGraw B, McClenaghan BA, Williams HG, Dickerson J, Ward DS. Gait and postural stability in obese and nonobese prepubertal boys. Arch Phys Med Rehabil. 2000;81:484–489. doi: 10.1053/mr.2000.3782.
    1. Hue O, Simoneau M, Marcotte J, Berrigan F, Dore’ J, Marceau P. Body weight is a strong predictor of postural stability. Gait Posture. 2007;26:32–38. doi: 10.1016/j.gaitpost.2006.07.005.
    1. Marquis S, Moore MM, Howieson DB, Sexton G, Payami H, Kaye JA, Camicioli R. Independent predictors of cognitive decline in healthy elderly persons. Arch Neuro. 2002;59:601–606. doi: 10.1001/archneur.59.4.601.

Source: PubMed

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