Gender Differences in Comorbidities and Sleep Patterns of Obese Patients with Obstructive Sleep Apnea

Abstract

Objective: The aim of the study was to compare the comorbidities and sleep patterns most commonly associated with each gender in obstructive sleep apnea (OSA). Methods: This was a cross-sectional study of obese individuals with OSA. The polysomnographies were carried out in a sleep laboratory environment, using a 15-channel polysomnography setup. Airflow was measured using a nasal pressure cannula/thermistor combination. A standard handbook was used for interpretation of PSG findings. Results: A total of 284 subjects were included in the study, (147 females). The mean age, body mass index and neck circumference were similar between females and males (p = 0.9579, p {\textless} 0.0001, and p {\textless} 0.0001, respectively). On polysomnography, females exhibited longer latency to REM sleep (146.50 ± 85.93 vs. 122.3 ± 68.28, p = 0.0210) and a higher percentage of delta sleep (10.09 ± 7.48 vs. 7.55 ± 6.57, p = 0.0037); males had more frequent microarousals (38.37 ± 27.44 vs. 28.07 ± 21.23, p = 0.0017) and a higher AHI score (30.56 ± 27.52 vs. 17.31 ± 21.23, p {\textless} 0.0001). The comorbidities most commonly associated with female gender were diabetes (29{\%} vs. 9.49{\%}, p = 0.0132), hypothyroidism (20{\%} vs. 2.19{\%}, p {\textless} 0.0001), and depression (81.63{\%} vs. 51.22{\%}, p {\textless} 0.0001). Male gender was associated with myocardial infarction (6.57{\%} vs. 1.38{\%}, p = 0.0245) and alcohol intake (33.88{\%} vs. 11.34{\%}, p {\textless} 0.0001). Obese males with OSA have a larger neck circumference and higher AHI and arousal indices than females. Conclusions: There are gender differences both in the sleep patterns and in the comorbidities of patients with OSA. Men had a larger neck circumference, higher apnea and sleep fragmentation scores, were more likely to consume alcohol, and were more likely to have a history of myocardial infarction than women.