PURPOSE: Obstructive sleep apnea (OSA) results from recurrent episodes of breathing cessation during sleep. The aim of this study is to assess differences in clinical presentation and polysomnographic (PSG) profile between women and men with mild obstructive sleep apnea defined as an apnea hypopnea index (AHI) ≥5-15.
METHODS: We retrospectively reviewed 63 patients with mild OSA to assess for gender differences in baseline clinical and PSG information. Clinical and physiologic data were collected from questionnaires and in-laboratory PSG studies. For statistical comparisons, continuous variables were analyzed by student’s t-test and categorical variables by chi-square. We performed multivariate regression analysis to simultaneously adjust for age and Body Mass Index (BMI).
RESULTS: Women (N=32) and men (N=31) were similar in age (52.6 vs. 51.0 years; p=0.65) and BMI (40.2 vs. 37.8; p=0.34). Women and men with mild OSA differed significantly in three of twelve parameters examined: witnessed apnea, sleep stage 1, and sleep stage 2. Women had less witnessed apnea (31 vs. 75.9%; p= 0.002), spent less time in stage 1 (20.5 vs. 30.9 minutes; p< 0.002), and spent more sleep time in stage 2 (62.5 vs. 54.9 minutes; p < 0.02) compared to men. Results remained significant in multivariate models adjusted for age and BMI. There were no significant differences between women and men with mild obstructive sleep apnea (OSA) in snoring, daytime sleepiness, chocking, sleep onset latency, sleep efficiency, stage 3, stage 4, REM sleep, or REM onset latency.
CONCLUSION: We found in patients with mild OSA that men have more witnessed apneas, more stage 1 sleep, and less stage 2 sleep compared to women. This may result in more sleep fragmentation and more daytime symptoms in men than women for the same degree of OSA.
CLINICAL IMPLICATIONS: Physicians may consider a lower threshold for CPAP therapy in men with mild OSA rather than managing them conservatively. Current clinical evaluation practices must take into account this gender disparity.
DISCLOSURE: Iyad Asaad, None.