Gender Differences in Korean Patients with Obstructive Sleep Apnea

Abstract

Background and Objective Our objective in this study was to investigate gender-specific differences in demographic factors, clinical presenting symptoms, medical comorbidities, and sleep-related parameters in patients newly diagnosed with obstructive sleep apnea (OSA). Methods We enrolled patients who were more than 30 years old, had undergone overnight polysomnography, and had filled out the questionnaires, including demographics, medical comorbidities, and sleep-related symptoms. Results From December 2014 to August 2017, 1224 patients (female, n = 277, 22.6%) were newly diagnosed with OSA. Female patients were significantly older than males (59.62 years vs. 52.75 years, p < 0.001). Alcohol consumption and current smoking were more common in males (p < 0.001). Non-specific symptoms of OSA, such as insomnia-related symptoms, loss of energy, and subjective poor sleep, were observed more frequently in females. Females reported more depressive moods (Beck Depression Inventory-II 15.58) than males did (12.17). Males complained about OSA-specific symptoms, such as snoring, witnessed apnea, and daytime sleepiness, more frequently than females did. The mean apnea-hypopnea index (AHI) was much lower in females (26.25 /h vs. 33.36 /h), but AHI during rapid eye movement sleep was similar for the two groups (33.55 /h vs. 32.76 /h). Sleep latency was longer (15.45 min vs. 10.11 min) and spontaneous arousal index (4.48 /h vs. 3.48 /h) was more frequent in females. Conclusions Females have a different OSA phenotype from males in terms of demographics, clinical manifestations, and sleep parameters of polysomnography. Thus, clinicians should comprehend the different clinical phenotype of female OSA and detect earlier unrecognized OSA in females.

Keywords

• obstructive sleep apnea
• sex
• sleep initiation and maintenance disorders
• polysomnography