Women and Sleep Apnea

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of these conditions are more or less vague (that is, no hard physical or lab finding, with the exception of anemia), we may have to make a decision and offer treatment too soon. Many female patients would rather leave my office with a prescription for a pill than with an order for a sleep study. Men are less likely to have anemia or more than one job, full care of children and the home. There are a lot of depressed men, in my experience, but they would rather have a sleep study than a prescription for antidepressants. (Unfortunately, the males are also less likely, in my experience, to comply with CPAP (continuous positive airway pressure)).

Dr. Collop : Studies have shown that women tend to have different types of complaints than their male OSA

Nancy A. Collop

Nancy A. Collop, MD

counterparts with more insomnia, disrupted sleep, chronic fatigue and depression. Since these aren't the classic symptoms of sleep apnea - these symptoms are often put off to being something else. Also, I think women are more "vigilant" sleepers and are more likely to worry about their bed-partners sleep, whereas men are more sound sleepers and may be less likely to note abnormal sleep in their bed-partner.

Dr. Phillips : Another problem is that women with sleep apnea have more subtle breathing disturbances and are more likely to have REM-related apneas, so they may be tougher to diagnose. And physicians do not have as high an index of suspicion for sleep apnea in women as they do in men.

Dr. Phillips: Does the relationship between OSA and hypertension differ between men and women?

Dr. Baker : Obstructive sleep apnea is a significant risk factor for heart disease . The prevalence of hypertension in people with sleep apnea ranges between 30-70 percent and is similar in men and women. However, when taking body mass index (BMI) into consideration, some gender differences emerge: men with OSA who are markedly obese (BMI > 37 kg.m-2) have a two-fold higher risk of hypertension than obese women with OSA.

Dr. Phillips: Does the relationship between OSA and diabetes differ between men and women?

Dr. Collop : Women with OSA tend to be more obese and have lower AHI (Apnea-Hyponea Index, an index used

Fiona C. Baker, PhD

Fiona C. Baker, PhD

to assess the severity of sleep apnea) than males; however, studies have also suggested that women may have a higher mortality.

Dr. Baker : OSA is associated with an increased risk for the development of type 2 diabetes independent of obesity. There is limited research about the modifying effect of gender on this relationship; however, it appears that habitual snoring and self-reported apneic events are associated with increased risk for