Diagnosis of obstructive sleep apnea in women: Is there any difference?- Experience from a tertiary care hospital of North India.

CONTEXT: Obstructive sleep apnea (OSA) considered classically to be a male-dominant disease, may have significant gender-based differences in clinical presentation and diagnosis.

AIMS: To evaluate gender-based differences in the clinical profile and polysomnographic features of Indian patients with OSA.

SETTINGS AND

DESIGN

A prospective observational study was conducted over a period of 12 months involving adult ambulatory patients, referred for evaluation of OSA.

METHODS AND MATERIALS: Enrolled patients underwent detailed clinical evaluation followed by supervised polysomnography. Sleep studies were manually validated and analyzed.

STATISTICAL ANALYSIS USED: Continuous variables were compared using two-tailed independent- sample t-test. For the univariate analysis, the Chi-square test was used.

RESULTS

Out of 150 enrolled patients, 94 (62.7%) were males (male-to-female: 1.7:1; age: 51.85 ± 12.60 years; BMI: 32.09 ± 5.53 kg/m2). Most common presenting features were excessive daytime somnolence, snoring, and easy fatiguability. Women with OSA were older than men. Insomnia and anxiety were significantly higher among females. Parameters defining sleep architecture were similar in both groups. Although obstructive apneas and hypopneas were similar, mean apnea hypopnea index was significantly higher (P < 0.05) in males compared to females with higher titratable continuous positive airway pressure.

CONCLUSIONS

There are gender-specific differences in the clinical presentation of OSA due to various anatomical, physiological, and psychosocial factors. Their potential influence on the clinical features, natural history, and implications on treatment need further evaluation on a larger scale.