When Mr. Sharma* retired, his hope was for peaceful mornings and peaceful nights. On the contrary, his nights were now filled with the sound of snoring, sudden sleep breaks and his wife waking up in panic. His wife would wake up again and again out of fear. She asked fearfully whether his breathing had stopped? It was not due to any bad dream or poor sleep. This was happening due to obstructive sleep apnea (OSA). This condition increases rapidly in the elderly due to weakening of throat muscles with increasing age.1.
The elderly population in India is increasing almost three times faster than the general population.² Along with this, many serious health problems are also increasing. This also includes OSA. Many people recognize its symptoms: feeling suffocated during sleep, frequent trips to the bathroom at night, feeling tired in the morning, feeling sleepy or lethargic during the day¹ Many people have been living with this problem for years. Some people understand their problem and get it treated. There are many people who still cannot identify it and keep struggling with it.
Why might therapy seem difficult at first?
Dr. Indranil Haldar is an experienced doctor from West Bengal and is an expert in respiratory and lung related diseases (chest, TB and other diseases). He said that starting treatment immediately when symptoms appear and talking to the patient during therapy gives good results. It diagnoses long standing diseases of elderly patients. He said, ‘The rate of taking CPAP therapy in my clinic is more than 50%, whereas globally it is around 40%. This is because we constantly monitor the patient’s condition and our team remains active. Mr Sharma was also given CPAP after diagnosis, but it was not easy for him to adjust to the process. He found it strange to wear a mask. Sometimes the tubes would get entangled in the bed and the constant air pressure felt like a machine. He said, ‘I feel as if I am fighting a machine.’ He is not alone in feeling this way. Many patients in India are uncomfortable with machines. The mask comes off and they find it difficult to continue the therapy due to problems like dry mouth. Research also shows that older patients are less likely to accept therapy.¹ Additionally, it can be challenging for their family or staff to care for them (caregivers). Reduction in snoring brings relief, but seeing loved ones struggling with therapy is frustrating on both sides.⁵ Tamil Nadu’s famous critical care sleep specialist and obesity medicine expert Dr N. Ramakrishnan has over 20 years of clinical and academic experience in this field. He says, ‘About 20–30% of elderly patients are not able to take the therapy properly. However, after some time they understand its importance and start feeling improvement in their symptoms. After this, about 70% of the patients accept the therapy well.
It has a deep impact on the family
Doctor Ramakrishnan says, ‘Families are often very worried in this situation. Especially when the elderly live alone or only the husband/wife lives together and the children live far away or abroad. In most cases the entire family tries to convince the patient to continue the therapy. It is a collective effort.’Doctors say that therapy should not be stopped due to initial difficulties. Another clinician says, ‘Often we see that elderly patients and their families give up very quickly. We should understand that there are many benefits of better sleep. This is important for energy throughout the day. Improves mood and is great for health in the long run.”⁶ According to Dr. Indranil, ‘It is important for both the patient and the family to understand what is being treated and why it is important. This clarity is vital in treating the disease from its roots.’ For the family, good sleep for the elderly is not just important for the patient. It also brings mental peace for the spouse and new energy for the loved ones. This improves the atmosphere of the entire house and brings peace in the lives of the members.
Smart CPAP Solution for the Elderly
Now the good thing is that CPAP machines are equipped with modern technology and their use has also become very easy. Newer machines gradually increase air pressure with technologies like EZStart and Smart Ramp. Due to this, the patients do not panic in the beginning and accept the therapy comfortably. These machines also make the process of breathing easier. This does not cause discomfort and also tracks the progress of the patient. Doctors are able to tailor therapy based on real data.⁷ For Mr Sharma, knowing about the existence of such options was like feeling a new ray of hope. He said, ‘Maybe it’s not about me adjusting to the machine. It seems as if the machine itself can adapt to me. Because in the golden years of life, every peaceful night is worth sleeping peacefully.
*Disclaimer: The name Mr. Sharma has been used as an example only. This is a fictional presentation based on the experiences of people suffering from sleep apnea. The views and statements given by doctors are their personal views. They do not necessarily represent the views, policies or viewpoints of the organization.
For medical advice, please consult a qualified health professional.
Reference:
- Osorio RS, Martínez-García MÁ, Rapoport DM. Sleep apnea in the elderly: a great challenge for the future. Eur Respir J. 2022;59:2101649.
- Banerjee, S. Determinants of rural-urban differential in healthcare utilization among the elderly population in India. BMC Public Health. 2021;21(1):939.
- Kundu S, Sarkar S, Roy D, et al. CPAP acceptance and adherence among patients diagnosed with obstructive sleep apnea: A long-term study from eastern India. Indian J Sleep Med 2014; 9(4):172-178. Published online 2018.
- Goyal A, Agarwal N, Pakhare A. Barriers to CPAP use in India: an exploratory study. J Clin Sleep Med. 2017;13(12):1385-94.
- Khan NN, Olomu AB, Bottu S, et al. Semistructured motivational interviews of patients and caregivers to improve CPAP adherence: a qualitative analysis. J Clin Sleep Med. 2019;15(12):1721-30.
- NIH. News in Health. Good sleep for good health. Available from: https://newsinhealth.nih.gov/2021/04/good-sleep-good-health. Accessed on 17th Sep 2025.
- Philips. Available from https://www.philips.co.in/healthcare/product/HCNOCTN447/dreamstation-cpap-bipap-cpap-bi-level-therapy-systems. Accessed on 20thAug 2025.
