Upper airway sleep-disordered breathing in women.
OBJECTIVE
To investigate the various clinical presentations of sleep-disordered breathing in women.


METHODS
A retrospective case-control study.


METHODS
A sleep disorders clinic.


METHODS
334 women, aged 18 years and older, seen between 1988 and 1993, who were diagnosed with upper airway sleep-disordered breathing. Controls were 60 women with insomnia and 100 men with sleep-disordered breathing.


METHODS
Clinical, anatomic, and polygraphic information.


RESULTS
The mean lag time (+/- SD) in women between the appearance of symptoms and a positive diagnosis was 9.7 +/- 3.1 years; among participants 30 to 60 years of age, the duration of untreated symptoms differed (P < 0.001) between women and men. Sleep-disordered breathing was blamed for divorce or social isolation by 40% of the case patients. Abnormal maxillomandibular features were noted in 45% of the women with disordered breathing. Dysmenorrhea and amenorrhea (which disappeared after treatment with nasal continuous positive airway pressure) were reported in 43% of premenopausal women compared with 13% of persons in the control group of women with insomnia. Thirty-eight women (11.4%) with upper airway sleep-disordered breathing had a respiratory disturbance index of less than 5 and were significantly younger, had a smaller neck circumference, and had a lower body mass index than women with a respiratory disturbance index of 5 or more.


CONCLUSIONS
Physicians should revise their understanding of upper airway sleep-disordered breathing so that they notice women with certain craniofacial features, a low body mass index, a small neck circumference, and a respiratory disturbance index of less than 5. These revisions may enable more rapid diagnosis and treatment of women with sleep-disordered breathing.
Guilleminault
C
C
Stanford Sleep Disorders Clinic and Research Center, Palo Alto, California.
Stoohs
R
R
Kim
Y D
YD
Chervin
R
R
Black
J
J
Clerk
A
A
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D015992:Body Mass Index; D016022:Case-Control Studies; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008593:Menopause; D008599:Menstruation Disturbances / Q000209:etiology; D008875:Middle Aged; D009960:Oropharynx / Q000033:anatomy & histology; D011175:Positive-Pressure Respiration; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy