Gender-specific differences in a patient population with obstructive sleep apnea-hypopnea syndrome.
BACKGROUND
Sleep-related breathing disorders are increasingly recognized as an important cause of morbidity and mortality. Women with obstructive sleep apnea-hypopnea syndrome (OSA) are less likely to be assessed or to receive a diagnosis, and they may have poorer survival rates.


OBJECTIVE
This study assessed gender-specific differences in patients with OSA.


METHODS
Data were collected with a prospective, point-of-care, anonymous 25-question survey about basic medical information and therapies for patients undergoing polysomnography at the sleep center of a US tertiary care center from January 1 through March 31, 2005.


RESULTS
Of the 646 consecutive patients who received the survey, 522 (80.8%) patients completed it, and 406 subsequently received a diagnosis of OSA. Of those 406 patients, 267 (65.8%) were men. Overall mean age was 57 years (56.4 years for men; 56.7 years for women). Alcohol use was more common in men (132 [49.4%]) than in women (43 [30.90,6]) (P < 0.001). Women were more likely to have the following associated comorbidities: obesity (body mass index > or =30) (P = 0.047), fibromyalgia (P < 0.001), migraine (P < 0.001), depression (P = 0.01), and irritable bowel syndrome (P = 0.01). The 4 most frequently reported sleep-related symptoms in both sexes were snoring (279 [68.7%]), lack of energy (235 [57.9%]), difficulty staying asleep (206 [50.7%]), and daytime sleepiness (204 [50.2%]). Lack of energy (P = 0.01), difficulty falling asleep (P = 0.02), and night sweats (P = 0.01) were observed more frequently in women than in men. There was no significant gender difference in the recalled duration of sleep-related symptoms. The mean (SD) apnea-hypopnea index (AHI) was 26.6 (26.6) for men and 22.1 (26.5) for women (P = 0.02). Conventional medications (including prescription and over-the-counter medications) for sleep-related problems were used more by women (35 [25.2%]) than by men (29 [10.9%]) (P < 0.001).


CONCLUSIONS
The majority of patients who received a diagnosis of OSA were men (male-female ratio, 2:1), and the mean AHI was higher in men than in women. However, women presented with more nonspecific symptoms than did men, although there was no significant gender-specific difference in the recalled duration of symptoms. In addition, women reported more comorbidities and used significantly more conventional medications for sleep-related problems.
Wahner-Roedler
Dietlind L
DL
Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA. wahnerroedler.dietlind@mayo.edu
Olson
Eric J
EJ
Narayanan
Sujata
S
Sood
Richa
R
Hanson
Andrew C
AC
Loehrer
Laura L
LL
Sood
Amit
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D017286:Polysomnography; D011446:Prospective Studies; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D012913:Snoring / Q000453:epidemiology; D011795:Surveys and Questionnaires