Differences between men and women in the clinical presentation of patients diagnosed with obstructive sleep apnea syndrome.
OBJECTIVE
Obstructive sleep apnea syndrome (OSAS) results from recurrent episodes of breathing cessation during sleep. Epidemiologic studies have shown that OSAS is more prevalent in men than women (4% vs 2%). Previous studies have explored gender-related differences in upper airway anatomy and function, hormone physiology, and polysomnographic findings. The aim of this study is to assess differences in clinical presentation between women and men with OSAS.


METHODS
Retrospective chart review analysis.


METHODS
Tertiary university-based medical center


METHODS
130 randomly selected women with OSAS matched individually with 130 men with OSAS for age, body mass index, apnea-hypopnea index, and Epworth Sleepiness Scale score.


METHODS
N/A.


RESULTS
Data were obtained from questionnaires and in-laboratory polysomnographic studies. There were no differences between the genders for age (48.0 +/- 1.1 years [mean +/- SEM] for women vs 47.6 +/- 1.0 years for men), body mass index (40.4 +/- 0.7 kg/m2 for women vs 40.0 +/- 0.6 kg/m2 for men), apnea-hypopnea index (36.8 +/- 3.3/hour for women vs 36.0 +/- 3.0/hour for men), or Epworth Sleepiness Scale score (12.45 +/- 0.53 for women vs 12.84 +/- 0.47 for men). Although snoring and sleepiness were similarly common in women and men, women more often described their main presenting symptoms as insomnia (odds ratio: 4.20; 95% confidence interval: 1.54-14.26) and were much more likely to have a history of depression (odds ratio: 4.60; 95% confidence interval: 1.71-15.49) and hypothyroid disease (odds ratio: 5.60; 95% confidence interval: 2.14-18.57). Women presented less often with a primary complaint of witnessed apnea (odds ratio: 0.66; 95% confidence interval: 0.38-1.12), consumed less caffeine per day (3.3 cups in women vs 5.2 cups in men; P = .0001), and admitted to less alcohol consumption (odds ratio: 0.36; 95% confidence interval: 0.18-0.70).


CONCLUSIONS
At the time of OSAS diagnosis, women with OSAS are more likely to be treated for depression, to have insomnia, and to have hypothyroidism than are men with the same degree of OSAS.
Shepertycky
Marha R
MR
Sleep Disorders Centre, St. Boniface General Hospital Research Centre, Section of Respiratory Diseases and Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Banno
Katsuhisa
K
Kryger
Meir H
MH
D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012189:Retrospective Studies; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D012894:Sleep Stages / Q000502:physiology