Gender differences in clinical manifestations and polysomnographic findings in Chinese patients with obstructive sleep apnea.
Level 4 - case-series / case-control
Retrospective case-paired comparative observational study
PubMed 31646422 · doi:10.1007/s11325-019-01943-y
What was done
This retrospective case-paired study evaluated 580 consecutive Chinese patients (290 males and 290 females) newly diagnosed with obstructive sleep apnea (OSA) via overnight polysomnography at a single sleep disorders center in China. Researchers compared demographic, clinical, and polysomnographic parameters between men and women and conducted ordinal logistic regression to determine risk factors associated with OSA severity.
What was found
Men and women had similar age (57.3 ± 9.2 vs. 58.2 ± 8.9 years, p > 0.05) and BMI (25.4 ± 3.4 vs. 25.5 ± 3.9 kg/m², p > 0.05). Women more frequently reported insomnia (70.3% vs. 40.3%, p < 0.001), poor sleep quality (58.3% vs. 40.7%, p < 0.001), and morning headaches (23.1% vs. 13.8%, p < 0.01), whereas men more often reported habitual snoring (69.0% vs. 52.1%, p < 0.001). Total apnea-hypopnea index (AHI) (25.8 ± 20.4 vs. 19.3 ± 16.8, p < 0.001) and NREM AHI (22.0 ± 18.2 vs. 15.1 ± 15.4, p < 0.001) were higher in men, but REM AHI was higher in women (4.2 ± 3.6 vs. 3.7 ± 4.3, p < 0.01). Women also had lower sleep efficiency (75.4 ± 15.7% vs. 78.1 ± 15.5%, p < 0.05), longer REM latency (128.9 ± 88.6 vs. 107.7 ± 72.4 min, p < 0.01), and greater wakefulness after sleep onset (98.3 ± 70.2 vs. 88.0 ± 70.3 min, p < 0.05). Lowest oxygen saturation and oxygen desaturation index did not differ significantly. Neck circumference was an independent risk factor for OSA severity in both men (OR 1.161, 95% CI 1.020–1.325) and women (OR 1.163, 95% CI 1.013–1.338).
Why it matters
Female OSA patients in this population presented with less severe overall AHI and more atypical symptoms such as insomnia and headaches rather than classic snoring, highlighting symptom patterns that may contribute to underdiagnosis or delayed diagnosis in women.
Limits
The study is retrospective and conducted at a single tertiary sleep center, introducing potential referral and selection biases. Longitudinal outcomes, treatment responses, and detailed matching criteria were not reported in the abstract.
Cited by
- supports Women with obstructive sleep apnea tend to present differently than men, exhibiting less snoring, more frequent awakenings, and a higher prevalence of morning headaches.