Gender differences in the psychosocial and functional impact of obstructive sleep apnea: findings from the SHINE patient survey

Abstract

Purpose: Obstructive sleep apnea (OSA) affects nearly 1 billion people worldwide and is associated with significant cardiometabolic, neurocognitive, and psychosocial consequences. Gender differences in symptom presentation may contribute to underdiagnosis and unmet needs, particularly among women. This study aimed to assess gender-specific differences in the psychosocial burden of OSA using the Sleep Health Inquiries on Needs and Emotions (SHINE) survey. Methods: The SHINE survey was conducted in 2024 among 1,500 U.S. adults with self-reported OSA. Participants completed validated items across five domains: work productivity, daily non-work activities, OSA symptoms, relationships, and negative feelings. Gender differences were examined using descriptive statistics, chi-square tests, and multivariable generalized linear models adjusted for demographics, comorbidities, and OSA severity. Results: Respondents included 755 men (50.3%) and 745 women (49.7%). Women were younger, had higher rates of psychological comorbidities (e.g., anxiety: 64.6% vs. 43.2%, p<0.001), and reported more non-classic OSA symptoms, while men more frequently reported cardiometabolic conditions. In adjusted analyses, women were 46% more likely to report OSA impacting daily non-work activities (p=0.01) and 52% more likely to experience ≥2 OSA symptoms in the prior 30 days (p=0.04). No significant gender differences were observed in work productivity impairment after adjustment, although greater symptom burden and negative feelings were associated with work limitations across both sexes. Conclusions: Women with OSA reported broader symptom profiles, more daily activity limitations, and greater emotional burden than men. These findings highlight the need for gender-sensitive screening and personalized treatment approaches to improve diagnosis and management of OSA.