DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20192924

Gender differences in clinical profile and risk factors for obstructive sleep apnea in a public health care setting

Vijay Kapse, Vikas Patel, Dilip Mhaisekar, Mithilesh Kulkarni

Abstract


Background: Obstructive Sleep Apnea Syndrome is an increasingly prevalent chronic condition which is, unfortunately, still underdiagnosed. It is peculiarity of this noisy disease that it announces itself to everyone within earshot-except its victims. The intermittent hypoxemia and sleep fragmentation caused by recurrent episodes of upper airway collapse are chiefly responsible for the pathophysiology associated with this condition.

Methods: The present study was carried out from January 2014 to August 2015 in a tertiary care government hospital. In this comparative hospital based study 94 patients with Sleep Disordered Breathing and >13 years of age were included. There were 58 males and 36 females in the present study. All patients who satisfied inclusion criteria were studied after taking written consent. Collection of data was carried out with predesigned proforma.

Results: Of all the 94 patients who underwent overnight Polysomnographic study,80 patients were diagnosed as Obstructive Sleep Apnea. Risk factor of OSA have gender differences in their distribution. Female patient is older with significantly higher mean age compared to male patients with OSA (52.9 vs 44.7 years). Females are having significantly higher BMI compared to male OSA(38.2 vs 31.5) but neck circumference is higher in males (44.7 Vs 38.1 cm).The prevalence of Smoking and Alcoholism as a risk factor is higher in male patients while endocrine disorder are more common in females. ENT abnormalities are present more or less equally in both the sexes.

Conclusions: In the present study females’ patients with Obstructive Sleep Apnea were mainly Older, Obese, Postmenopausal and endocrine disorder like Hypothyroidism were more prevalent while male patients were Smoker, Alcoholic and had higher neck circumference.


Keywords


Endocrine disorder, Hypothyroidism, Obstructive sleep apnea, Polysomnographic study, Postmenopausal, Sleep disorder, Sleep disordered breathing

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References


Sharma H, Sharma SK. Overview and implications of obstructive sleep apnea. Indian J Chest Dis Allied Sci. 2008;50(1):137-50

Koo BB, Dostal J, Loachimescu O, Budur K. Effect of gender and age on REM-related sleep-disordered breathing, Sleep Breath. 2008;12(3):259-64.

Tishler PV, Larkin EK, Schluchter MD, Redline S. Incidence of sleep disordered breathing in urban adult population: relative importance of risk factor in development of sleep disodered breathing. JAMA. 2003;289(17):2230-7

Quintana-Gallego E, Carmona-Bernal C, Capote F, Sánchez-Armengol Á, Botebol-Benhamou G, Polo-Padillo J, et al. Gender differences in obstructive sleep apnea syndrome: a clinical study of 1166 patients. Respir Med. 2004;98(10):984-9.

Guilleminault C, Quera-Salva MA, Partinen M, Jamieson A. Study on Women and the Obstructive Sleep Apnea Syndrome. Chest. 1988;93(1):104-9.

Onat A, Hergenç G, Yüksel H, Can G, Ayhan E, Kaya Z, et al. Neck circumference as a measure of central obesity: associations with metabolic syndrome and obstructive sleep apnea syndrome beyond waist circumference. Clin Nutrit. 2009;28(1):46-51.

Davies RJ, Ali NJ, Stradling JR. Neck circumference and other clinical features in the diagnosis of the obstructive sleep apnoea syndrome. Thorax. 1992;47(2):101-5.

Millman RP, Carlisle CC, McGarvey ST, Eveloff SE, Levinson PD. Body fat distribution and sleep apnea severity in women. Chest. 1995;107(2):362-6.

Whittle AT, Marshall I, Mortimore IL, Wraith PK, Sellar RJ, Doughlas N. Neck soft tissue and fat distribution: comparison between normal men and women by magnetic resonance imaging. Thorax. 1999;54(4):323-8.

Bixler EO, Vgontzas A, Lin HM, Ten Have T, Rein J, Vela-Bueno A. et al. Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med. 2001;163(3):608-13.

Wetter DW, Young TB, Bidwell TR, Badr MS, Palta M. Smoking as a risk factor for sleep-disordered breathing. Arch Inter Med. 1994;154(19):2219-2.

Kashyap R, Hock LM, Bowman, TJ. Higher Prevalence of Smoking in Patients Diagnosed as Having Obstructive Sleep Apnea. Sleep Breath. 2001;5(4):167-72.

Lam JC, Sharma SK, Lam B. Obstructive sleep apnoea: definitions, epidemiology and natural history. Indian J Med Res. 2010;131(2):165.

Agrawal S, Sharma SK, Sreenivas V, Lakshmy R. Prevalence of metabolic syndrome in a north Indian hospital-based population with obstructive sleep apnoea. Indian J Med Res. 2011;134(5):639.

Mitler MM, Dawson A, Henriksen SJ, Sobers M, Bloom FE. Bedtime ethanol increases resistance of upper airways and produces sleep apneas in asymptomatic snorers. Alcoholism: Clin Expe Res. 1988;12(6):801-5.

Issa FG, Sullivan CE. Alcohol, snoring and sleep apnea. J Neurol Neurosurg Psychiatry. 1982;45(4):353-9.

Valipour A, Lothaller H, Rauscher H, Zwick H, Burghuber OC, Lavie P. Gender-Related Differences in Symptoms of Patients with Suspected Breathing Disorders in Sleep: A Clinical Population Study Using the Sleep Disorders Questionnaire. Sleep. 2007;30(3):312-9.

Meyer TK, Woodson BT. Surgical management of snoring and obstructive sleep apnea. WMJ. 2003;102(1):28-31.

Rappai M, Collop N, Kemp S, deShazo R. The nose and sleep-disordered breathing: what we know and what we do not know. Chest. 2003;124(6):2309-23.

Grunstein RR, Sullivan CE. Sleep apnea and hypothyroidism: mechanism and management, Am J Med. 1988;85(6):775-9.

Punjabi NM. The Epidemiology of Adult Obstructive Sleep Apnea, Proc. Am Thorac Soc. 2008;5(2):136-43.

Shepertycky MR, Banno K, Kryger MH. Differences between men and women in the clinical presentation of patients diagnosed with obstructive sleep apnea syndrome. Sleep. 2005;28(3):309-14.

Fogel RB, Malhotra A, Pillar G, Pittman SD, Dunaif A, White DP. Increased prevalence of Obstructive Sleep Apnea syndrome in obese women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2001;86(3):1175-80.

Gopal M, Duntley S, Uhles M, Attarian H. The role of obesity in the increased prevalence of obstructive sleep apnea syndrome in patients with polycystic ovarian syndrome. Sleep Med. 2002;3(5):401-4.