title: Waist circumference and postmenopause stages as the main associated factors for sleep apnea in women: a cross-sectional population-based study.
abstract: OBJECTIVE
  The current study aimed to investigate stages of reproductive aging as an associated factor for obstructive sleep apnea syndrome (OSAS) among women in a representative sample of Sao Paulo, Brazil.
  
  
  METHODS
  Four hundred seven women underwent clinical evaluation, polysomnography, and biochemical analysis. Stages of reproductive aging were defined as premenopause, early postmenopause, and late postmenopause.
  
  
  RESULTS
  OSAS was more frequent in the postmenopausal groups, with 68.4% of women affected by severe OSAS belonging to the late postmenopause group. After adjustment for potential confounding factors, associated factors for OSAS, regardless of its severity, were waist circumference, modified Mallampati score IV, and both postmenopause stages. For moderate to severe OSAS and severe OSAS, we found waist circumference and both postmenopause stages to be the main factors. We carried out a receiver operating characteristic curve analysis, which demonstrated that the cutoff value for waist circumference was 87.5 cm, with a maximum of 75.7% accuracy for the classification of women as OSAS or non-OSAS.
  
  
  CONCLUSIONS
  OSAS is prevalent in postmenopausal women, especially in late postmenopause. This study highlights the association between waist circumference, early postmenopause and late postmenopause, and severity of OSAS. Our findings suggest that postmenopause stages may potentially exacerbate the presence of sleep disturbance and that reducing waist circumference may be an important strategy for managing OSAS in women.
authors: From the 1Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil; 2Department of Gynecology, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil; and 3Department of Gynecology, Casa de Saude Santa Marcelina, Sao Paulo, SP, Brazil.
authors: Daniel N
authors: DN
authors: Polesel
authors: Camila
authors: C
authors: Hirotsu
authors: Karen T
authors: KT
authors: Nozoe
authors: Andre C
authors: AC
authors: Boin
authors: Lia
authors: L
authors: Bittencourt
authors: Sergio
authors: S
authors: Tufik
authors: Monica L
authors: ML
authors: Andersen
authors: Helena
authors: H
authors: Hachul
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D055105:Waist Circumference; D055815:Young Adult