title: Gender differences in respiratory disturbance, sleep and daytime sleepiness in hypertensive patients with different degrees of obesity.
abstract: BACKGROUND
  Hypertension (HT) and obesity have both been linked to obstructive sleep apnoea (OSA). Difficulties have been described in identifying patients with OSA in primary care, causing low referral rates to sleep clinics. Increased knowledge about gender-specific characteristics and symptoms may help to identify patients.
  
  
  OBJECTIVE
  The aim was to describe gender differences regarding undiagnosed OSA, self-rated sleep, insomnia and daytime sleepiness in middle-aged primary care patients with HT and different degrees of obesity.
  
  
  METHODS
  A cross-sectional design was used and 394 patients (52.5% women), mean age 57.8 years (SD 6.7 years), with HT (BP >140/90 mmHg) were included. Clinical examinations, respiratory recordings and self-rated scales regarding OSA symptoms, sleep, insomnia and daytime sleepiness were used. Body mass index (BMI) was classified according to the criteria from the National Institutes of Health.
  
  
  RESULTS
  Pre-obesity and obesity classes I and II were seen among 53%, 26% and 8% of the men and 37%, 19% and 14% of the women, respectively. Occurrence of mild, moderate and severe OSA increased significantly across the BMI classes for both genders (p<0.01). Ninety percent of the men and 80% of the women in obesity class II had OSA. Insomnia was prevalent in obese patients. Other clinical variables did not differ between BMI classes or genders.
  
  
  CONCLUSIONS
  The occurrence of overweight/obesity and OSA was high among both genders. A high BMI might be a convenient clinical marker for healthcare personnel to identify hypertensive patients with possible OSA in need of further evaluation and treatment.
authors.affiliation: Department of Nursing Science, School of Health Sciences, Jönköping University, Jönköping, Sweden. anders.brostrom@hhj.hj.se
authors.forename: Anders
authors.initials: A
authors.lastname: Broström
authors.forename: Ola
authors.initials: O
authors.lastname: Sunnergren
authors.forename: Per
authors.initials: P
authors.lastname: Nilsen
authors.forename: Bengt
authors.initials: B
authors.lastname: Fridlund
authors.forename: Martin
authors.initials: M
authors.lastname: Ulander
authors.forename: Eva
authors.initials: E
authors.lastname: Svanborg
mesh_terms: D000368:Aged; D001823:Body Composition; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology*; D012120:Respiration Disorders / Q000453:epidemiology*; D012727:Sex Characteristics; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology; D012893:Sleep Wake Disorders / Q000453:epidemiology*