title: Roles of gender, age, race/ethnicity, and residential socioeconomics in obstructive sleep apnea syndromes.
abstract: OBJECTIVE
  Review recent research on the roles of gender, race/ethnicity, residential socioeconomics and age in obstructive sleep apnea syndromes (OSA) and their treatment.
  
  
  RESULTS
  Men have a higher prevalence of OSA than women and require higher continuous positive airway pressure (CPAP) pressures for treatment, given similar severity of OSA. When comparing age, women have less severe apnea at all ages. Menopause, pregnancy and polycystic ovarian syndrome increase the risk for OSA in women. Neck fat and BMI influence apnea-hypopnea index (AHI) severity in women; abdominal fat and neck-to-waist ratio do so in men. Obesity, craniofacial structure, lower socioeconomic status and neighborhood disadvantage may better explain ethnic/racial differences in the prevalence and severity of OSA. Ethnicity was no longer significantly associated with OSA severity when WHO criteria for obesity were used.
  
  
  CONCLUSIONS
  OSA has a male predominance; women have a lower AHI than men during certain stages of sleep; women require less CPAP pressure for treatment of similar severity of OSA, and there are ethnic/racial differences in the prevalence and severity of OSA but these may be due to environmental factors, such as living in disadvantaged neighborhoods.
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of New Mexico School of Medicine, University of New Mexico Hospital Sleep Disorders Center, Albuquerque, New Mexico 87102, USA. fralls@salud.unm.edu
authors.forename: Frank M
authors.initials: FM
authors.lastname: Ralls
authors.forename: Madeleine
authors.initials: M
authors.lastname: Grigg-Damberger
mesh_terms: D000367:Age Factors; D015992:Body Mass Index; D045422:Continuous Positive Airway Pressure; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012111:Residence Characteristics; D012307:Risk Factors; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D012959:Socioeconomic Factors