Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb;53(1):34-39.
doi: 10.5152/eurasianjmed.2021.19233.

Impact of Gender on Symptoms and Comorbidities in Obstructive Sleep Apnea

Ozge Can Bostan  1   2 , Beyza Akcan  3 , Cihan Durmus Saydam  3 , Muhammet Tekin  3 , Omur Dascı  3 , Baran Balcan  2
Affiliations

Impact of Gender on Symptoms and Comorbidities in Obstructive Sleep Apnea

Ozge Can Bostan et al. Eurasian J Med. 2021 Feb.

Abstract

Objective: Obstructive sleep apnea (OSA) is more common in men than in women. In this study, we aimed to address the impact of gender on symptoms and comorbidities in patients with OSA.

Materials and methods: This cross-sectional study was conducted among 1,317 consecutive patients, who were admitted to the Sleep Apnea Clinic of the Marmara University Hospital between November 2015 and October 2018, and who completed questionnaires and a sleep study with cardiorespiratory polygraphy. OSA was defined as Apnea Hypopnea Index (AHI) ≥15/hour.

Results: In all, 1,042 patients (334 women) fulfilled the inclusion criteria. OSA was observed in 589 patients (56.5%). Women were older than men (50.2±12.5 versus 45.6±15.1 years) and had lower AHI (22.1±20.1 versus 26.8±21.9 events/h). In the OSA group, women were older (53.7±11.5 versus 47.8±12.8 years) and more obese (BMI 34.6 versus 31.8 kg/m2). Symptoms were categorized as frequent/very frequent, and women with OSA complained more about daytime fatigue (74.6% versus 63.7%), nocturia (69.7% versus 51.8%), headache in the morning (50.0% versus 28.4%), depressive mood (49.0% versus 19.5%), and restless legs symptoms (43.1% versus 17.2%), than did men (all p values <0.05). Comorbidities were observed more in women than in men (lung disease [25.4% versus 13.7%], hypertension [29.6% versus 15.0%], diabetes [20.3% versus 11.3%], and hypothyroidism [14.0 % versus 4.1%]). In regression analysis, age (OR 1.03, p<0.001), BMI (OR 1.13, p<0.001), and male sex (OR 2.08, p<0.001) were significantly predictive for OSA while history of tonsillectomy was protective (OR 0.48, p=0.033).

Conclusion: Fatigue, nocturia, headache, depressive mood, restless leg, and comorbidities were observed more in women. OSA-related symptoms develop late and/or the referral of women for diagnostic evaluation of OSA is delayed. Symptoms and comorbidities in women should be evaluated more attentively for earlier referral and diagnosis of OSA.

Keywords: Obstructive sleep apnea; comorbidities; gender difference; symptoms.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Flow chart of the participants evaluated in the protocol
See this image and copyright information in PMC

References

    1. Kapur VK, Auckley DH, Chowdhuri S, et al. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017;13:479–504. doi: 10.5664/jcsm.6506. - DOI - PMC - PubMed
    1. Franklin KA, Lindberg E. Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. J Thorac Dis. 2015;7:1311–22. - PMC - PubMed
    1. Barewal RM. Obstructive Sleep Apnea: The Role of Gender in Prevalence, Symptoms, and Treatment Success. Dent Clin North Am. 2019;63:297–308. doi: 10.1016/j.cden.2018.11.009. - DOI - PubMed
    1. Westreich R, Gozlan-Talmor A, Geva-Robinson S, et al. The Presence of Snoring as Well as its Intensity Is Underreported by Women. J Clin Sleep Med. 2019;15:471–6. doi: 10.5664/jcsm.7678. - DOI - PMC - PubMed
    1. Tasbakan MS, Gunduz C, Pirildar S, Basoglu OK. Quality of life in obstructive sleep apnea is related to female gender and comorbid insomnia. Sleep Breath. 2018;22:1013–20. doi: 10.1007/s11325-018-1621-y. - DOI - PubMed

LinkOut - more resources