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Obstructive Sleep Apnea May Be Underdiagnosed in Women

About six in 10 women experience obstructive sleep apnea during dream sleep, similar to men

THURSDAY, Dec. 5, 2019 (HealthDay News) — Men and women experience obstructive sleep apnea (OSA) during REM sleep at similar rates, according to a study published online Nov. 5 in SLEEP.

Christine H.J. Won, M.D., from the Yale University School of Medicine in New Haven, Connecticut, and colleagues used polysomnography data from 2,057 participants in the Multi-Ethnic Study of Atherosclerosis to assess sex disparities in OSA.

The researchers found that OSA (apnea-hypopnea indices [AHI] 4P ≥15/hour, defined by events with ≥4 percent desaturations) was found in 41.1 percent of men and 21.8 percent of women. Male:female AHI ratios decreased by 5 to 10 percent when using 3 percent desaturation and/or arousal criteria compared with AHI4P. In both men and women, REM-OSA (REM-AHI ≥15/hour) was similar, regardless of event desaturation criteria. REM-AHI4P ≥15/hour was seen in 57 percent of both men and women. AHI4P in men was 2.49 of that in women for non-REM (NREM). Women showed lower loop gain, less airway collapsibility, and a lower arousal threshold in NREM. Thirty percent of the relative sex differences in NREM-AHI4P was explained by endotypes.

“We are more and more appreciating that sleep apnea is a heterogeneous disease,” Won said in a statement. “It’s important to understand how it affects men and women differently. Understanding sex-specific mechanisms allows us to target therapy and is expected to lead to better outcomes.”

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