Gender Differences in the Polysomnographic Features of Obstructive Sleep Apnea

O'Connor, C.; Thornley, Kristine S.; Hanly, Patrick J.

doi:10.1164/ajrccm.161.5.9904121

Cited by 354 publications

(286 citation statements)

References 22 publications

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“…In the case of AHT, despite the existence of epidemiological studies that point to SAHS as a causal factor of diurnal AHT [4,5], study of the adverse effect of blood pressure in these patients may require analysis of its nocturnal behaviour [3,30]. Finally, although particular characteristics of SAHS have been described in females [31] and a preliminary study pointed to a possible increase in mortality [32], no differences were found according to sex.…”

Section: Discussionmentioning

confidence: 99%

Mortality in severe sleep apnoea/hypopnoea syndrome patients: impact of treatment

Martí¹,

Sampol²,

Muñoz³

et al. 2002

Eur Respir J

220

121

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The aim of this study was to determine mortality in patients with sleep apnoea/hypopnoea syndrome (SAHS) according to the treatments employed and comorbidity.An historical cohort of patients with SAHS diagnosed at a university hospital between 1982 and 1992 and followed until 1996 was studied. From a total of 475 SAHS patients, 444 (94%), with a mean±sd apnoea/hypopnoea index at diagnosis of 55±27, were located and included in the study. SAHS treatments employed were: surgery (88), weight loss (134), continuous positive airway pressure (124) and 98 patients were not treated.By the end of follow-up, 49 patients had died. According to Cox regression analysis, mortality in treated patients was lower than in those not treated, but higher in those with a history of severe chronic obstructive pulmonary disease. Mortality in nontreated patients compared with that of the general population, adjusted for age and sex, showed excessive mortality, which decreased in treated patients. Stratification by age showed a greater mortality rate ratio in patients <50 yrs. These findings were maintained when mortality from cardiovascular causes was compared.In conclusion, a rise in mortality was found in nontreated sleep apnoea/hypopnoea syndrome patients compared with the general population, whereas mortality in those treated for sleep apnoea/hypopnoea syndrome did not differ significantly from that of the general population.

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Section: Discussionmentioning

confidence: 99%

Mortality in severe sleep apnoea/hypopnoea syndrome patients: impact of treatment

Martí¹,

Sampol²,

Muñoz³

et al. 2002

Eur Respir J

220

121

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“…Its effect is suggested by studies demonstrating improvements in critical pressure and sleep apnea after weight loss (25,116). Central adiposity may lead to disturbances in neuromuscular control because men have a greater severity of sleep apnea in clinical and community-based cohorts than do women (1), and even lean men demonstrate subtle defects in upper airway neuromuscular responses to mechanical loads compared with lean women (87,(117)(118)(119)(120). These findings are consistent with the notion that central obesity is associated with a marked blunting of upper airway neuromuscular responses (Figure 1), although the mechanisms linking regional adiposity and neural responses have not been delineated.…”

Section: Neuromuscular Effects Of Obesitymentioning

confidence: 99%

Obesity and Obstructive Sleep Apnea: Pathogenic Mechanisms and Therapeutic Approaches

Schwartz

Patil²,

Laffan

et al. 2008

Proceedings of the American Thoracic Society

584

416

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Obstructive sleep apnea is a common disorder whose prevalence is linked to an epidemic of obesity in Western society. Sleep apnea is due to recurrent episodes of upper airway obstruction during sleep that are caused by elevations in upper airway collapsibility during sleep. Collapsibility can be increased by underlying anatomic alterations and/or disturbances in upper airway neuromuscular control, both of which play key roles in the pathogenesis of obstructive sleep apnea. Obesity and particularly central adiposity are potent risk factors for sleep apnea. They can increase pharyngeal collapsibility through mechanical effects on pharyngeal soft tissues and lung volume, and through central nervous system-acting signaling proteins (adipokines) that may affect airway neuromuscular control. Specific molecular signaling pathways encode differences in the distribution and metabolic activity of adipose tissue. These differences can produce alterations in the mechanical and neural control of upper airway collapsibility, which determine sleep apnea susceptibility. Although weight loss reduces upper airway collapsibility during sleep, it is not known whether its effects are mediated primarily by improvement in upper airway mechanical properties or neuromuscular control. A variety of behavioral, pharmacologic, and surgical approaches to weight loss may be of benefit to patients with sleep apnea, through distinct effects on the mass and activity of regional adipose stores. Examining responses to specific weight loss strategies will provide critical insight into mechanisms linking obesity and sleep apnea, and will help to elucidate the humoral and molecular predictors of weight loss responses.

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“…In studies that used diagnostic criteria similar to ours, AHI have ranged between 10% and 13% (16,17 Because of differences in the definition criteria, in cases with REM-related OSAS, clinical characteristics also demonstrate differences. In many studies, a higher incidence of REM-related OSAS has been reported in women (3,6,12,13,19,20). Higher AHI REM relative to AHI NREM in women suggest the protection of women from respiratory events in NREM sleep.…”

Section: Discussionmentioning

confidence: 95%

A Different Clinical Type of OSAS: REM-Related OSAS

Köseoğlu¹,

Kanbay²,

Demir³

2015

Eurasian J Pulmonol

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INTRODUCTIONObstructive sleep apnea syndrome (OSAS) is characterized by repetitive episodes of complete or partial upper airway obstruction during sleep. Repetitive episodes of airway obstruction lead to increasing respiratory efforts, intermittent arterial oxygen desaturation, systemic and pulmonary arterial blood pressure surges, and sleep disorders (1). We sleep occupies for nearly one-third of our life, and it is an essential and vital part of our life. Although it is perceived as a resting period for the body, during some stages of sleep, the brain and many bodily systems are extremely active. Sleep is evaluated in two stages as rapid eye movement (REM) and non-REM. The REM stage is named after REM during this phase. This stage is classified as tonic and phasic REM. During this stage, brain activity with mixed frequency, erection, thermoregulation loss, muscle twitching, cardiorespiratory disorder, respiratory control impairment, and irregular ventilation occur (2, 3). During REM, pharyngeal muscle activity decreases, and upper airway collapsibility increases as a result of the absence of excitatory, noradrenergic, and serotonergic stimuli in upper airway motor neurons (4). Therefore, in patients with OSAS during REM sleep, the number and duration of obstructive respiratory events increase with resultant serious oxygen desaturation. REM as a specific respiratory disorder was first described in 1996. From that day on, different expressions and diagnostic criteria have been used for the presence and definition of REM-related OSAS. Some authors have accepted this disorder as not a separate entity, but rather a component of an OSAS spectrum, and they indicated REM-related OSAS as an essentially early (baseline presentation) phase of classical OSAS, while others defined it as a different clinical type of OSAS (3,5,6). In the present study, we aimed to compare the clinical and polysomnographic findings of REM-related and non-REM-related OSAS patients to test whether REM-related OSAS is a different clinical type OSAS or the manifestation of early stage or the onset of OSAS. Methods:The study had a retrospective design. Patients with an initial diagnosis of sleep-related breathing disorders were later diagnosed to have OSAS based on an apnea-hypopnea index (AHI) of ≥5 and were divided into the following two groups: patients with AHINREM of <5 and AHIREM/AHINREM of >2 whose REM recordings were obtained for at least 30 min were defined as having "REM-related OSAS," and those who did not meet this description were defined as having "non-REM-related OSAS."Results: A total of 329 patients with a mean age of 51±10 years were included in the study. Thirty-five (10.6%) patients with OSAS were REM-related and 294 (89.4%) were non-REM-related. Age, body mass index, smoking status, and concomitant diseases were comparable between groups (p>0.05). In REM-related patients, AHI was lower, REM duration was longer, and mean oxygen saturations were comparatively higher (p<0.05). Conclusion:Similarities between groups in age, body ...

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Gender Differences in the Polysomnographic Features of Obstructive Sleep Apnea

Cited by 354 publications

References 22 publications

Mortality in severe sleep apnoea/hypopnoea syndrome patients: impact of treatment

Mortality in severe sleep apnoea/hypopnoea syndrome patients: impact of treatment

Obesity and Obstructive Sleep Apnea: Pathogenic Mechanisms and Therapeutic Approaches

A Different Clinical Type of OSAS: REM-Related OSAS

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