Gender differences in the clinical manifestation of obstructive sleep apnea

Ye, Lichuan; Pien, Grace W.; Weaver, Terri E.

doi:10.1016/j.sleep.2009.02.006

Cited by 128 publications

(104 citation statements)

References 111 publications

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“…The gender difference in OSA prevalence is negligible after the age of 60 years 2,47 . The OSA identified by the BQ and suspicion of higher risk for significant coronary artery disease in individuals aged 40-59 years age group suggests that OSA is more important in younger individuals.…”

Section: Controlsmentioning

confidence: 93%

Obstructive sleep apnea, detected by the Berlin Questionnaire: an associated risk factor for coronary artery disease

et al. 2012

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Obstructive sleep apnea (OSA), a risk factor for coronary artery disease, remains under diagnosed. We investigated if OSA identified by the Berlin Questionnaire (BQ) is associated with the risk of coronary artery disease. Cases were patients referred for elective coronariography. The cases were classified with significant coronary lesions (stenosis > 50% in an epicardial coronary) or without significant coronary lesions. Controls were selected from a population-based sample. Positive BQ results were identified in 135 (41.2%) of 328 cases, in contrast with 151 (34.4%) of 439 control subjects (p = 0.03). In a multinomial logistic analysis, the risk for OSA identified by the BQ was independently associated with coronary artery disease in cases with lesions of at least 50% (OR = 1.53; 95%CI: 1.02-2.30; p = 0.04). The risk from OSA identified by the BQ was higher in younger subjects (40-59 years) (OR = 1.76; 95%CI: 1.05-2.97; p = 0.03) and in women (OR = 3.56; 95%CI: 1.64-7.72; p = 0.001). In conclusion, OSA identified by the BQ greatly increases the risks of coronary artery disease in patients having significant coronary artery lesions indicated by anangiogram, particularly in younger individuals and in women.

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Section: Controlsmentioning

confidence: 93%

Obstructive sleep apnea, detected by the Berlin Questionnaire: an associated risk factor for coronary artery disease

et al. 2012

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“…The ratio of males to females attending sleep laboratories has been reported to be between 8:1 and 10:1, despite the ratio of cases being estimated at between 2:1 and 3:1. 3,7 Traditionally, sleep research has predominantly been conducted in male populations, 3 and consequent evaluative, diagnostic, and management guidelines have been formulated based on such research. It is postulated that females present with nonspecific symptoms that differ from classic symptomatology.…”

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confidence: 99%

“…4 This sex bias may account for some of the underdiagnosis and mismanagement of OSA in females. 3 Other explanations include that females may present less frequently because of the social stigma associated with snoring, as it defies the typical feminine stereotype, or that snoring is more severe in males. 4 Prior research has investigated specific pathophysiologic differences between males and females; however, sex differences in functional status and quality of life for patients living with sleep-related health problems have not been well investigated.…”

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confidence: 99%

“…4 Prior research has investigated specific pathophysiologic differences between males and females; however, sex differences in functional status and quality of life for patients living with sleep-related health problems have not been well investigated. 3 Yin and Davidson argue the importance of functional status because it is valued by the patients themselves and is a component of outcome management. 4 It informs management and treatment, and may enable more patient-centered care.…”

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confidence: 99%

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How Do Sleep-Related Health Problems Affect Functional Status According to Sex?

Boccabella

Malouf

2017

Journal of Clinical Sleep Medicine

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Study Objectives: To measure differences in functional status between men and women presenting with sleep-related health problems. Methods: A retrospective clinical audit of 744 Australian patients across 7 private general practices between April 2013 and January 2015 was conducted. Patients completed an electronic survey as part of their routine consultation, which included the Epworth Sleepiness Scale (ESS), the Functional Outcomes of Sleep Questionnaire 10 (FOSQ-10), and other questions relating to the effect of their sleep problem. The proportion of males and females with ESS and FOSQ-10 scores associated with disorders of daytime sleepiness and burden of symptoms due to sleepiness, respectively, were compared, as well as reported differences between the sexes in memory, concentration, issues with relationships, feeling depressed, and trouble sleeping. Results: On presentation, females were more likely to have sleeping disorders associated with daytime sleepiness (median ESS score of 9 for females versus 8 for males, P = .038; proportion ESS > 9 was 49.0% for females versus 36.9% for males, P = .003). Women were also more likely to report an increased burden of symptoms due to sleepiness compared to men, as shown by lower FOSQ-10 scores (P < .001). Secondary outcome measures showed that females were more likely to feel excessively tired and depressed, have difficulties with memory and concentration, and have trouble sleeping at night. Snoring kept partners awake in roughly the same proportion of males and females, and a larger proportion of the partners of males were forced out of the room. Conclusions: Sleep-related health issues both manifest in and affect the lives of males and females differently. Sleep health professionals should recognize these differences on all levels of disease prevention and health promotion from patient education, to diagnosis and management to improve quality of life for those with sleep-related health problems. Keywords: ESS, FOSQ-10, functional outcomes, obstructive sleep apnea, sex differences, sleep health Citation: Boccabella A, Malouf J. How do sleep-related health problems affect functional status according to sex? J Clin Sleep Med. 2017;13(5):685-692.

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“…Additional clinical challenges in the assessment and management of OSAS include the presentation of OSA without sleepiness and the clinical spectrum of OSA in the elderly and in females. Although OSAS has traditionally been regarded as a disease affecting males, there is increasing recognition that the disease is also prevalent in females, particularly after the menopause, and that the clinical manifestations may differ from those in males [10]. OSA is prevalent in the elderly population, but affected patients appear to be relatively less symptomatic, and the disorder may have less severe clinical consequences in this age group [11].…”

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confidence: 99%