Eva Lindberg1, Bryndis Benediktsdottir2, Karl A Franklin3, Mathias Holm4, Ane Johannessen5, Rain Jögi6, Thorarinn Gislason2, Francisco Gomez Real7, Vivi Schlünssen8, Christer Janson9. 1. Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Sweden. Electronic address: eva.lindberg@medsci.uu.se. 2. Department of Respiratory Medicine and Sleep, The National University Hospital of Iceland, Reykjavik, Iceland; University of Iceland, Faculty of Medicine, Iceland. 3. Department of Surgical and Perioperative Sciences, Surgery, Umea University, Sweden. 4. Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. 5. Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Norway. 6. Lung Clinic, Tartu University Clinics, Tartu, Estonia. 7. Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway. 8. Department of Public Health, Section for Environment, Occupation and Health, Aarhus University, Aarhus, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark. 9. Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Sweden.
Abstract
BACKGROUND: Women are often underrepresented at sleep clinics evaluating sleep-disordered breathing (SDB). The aim of the present study was to analyze gender differences in sleep apnea diagnosis and treatment in men and women with similar symptoms of SDB. METHODS: Respiratory Health in Northern Europe (RHINE) provided information about snoring, excessive daytime sleepiness (EDS), BMI and somatic diseases at baseline (1999-2001) and follow-up (2010-2012) from 4962 men and 5892 women. At follow-up participants were asked whether they had a diagnosis of and/or treatment for sleep apnea. RESULTS: Among those with symptoms of SDB (snoring and EDS), more men than women had been given the diagnosis of sleep apnea (25% vs. 14%, p < 0.001), any treatment (17% vs. 11%, p = 0.05) and CPAP (6% vs. 3%, p = 0.04) at follow-up. Predictors of receiving treatment were age, BMI, SDB symptoms at baseline and weight gain, while female gender was related to a lower probability of receiving treatment (adj. OR 0.3, 95% CI 0.3-0.5). In both genders, the symptoms of SDB increased the risk of developing hypertension (adj OR, 95% CI: 1.5, 1.2-1.8) and diabetes (1.5, 1.05-2.3), independent of age, BMI, smoking and weight gain. CONCLUSIONS: Snoring females with daytime sleepiness may be under-diagnosed and under-treated for sleep apnea compared with males, despite running a similar risk of developing hypertension and diabetes.
BACKGROUND:Women are often underrepresented at sleep clinics evaluating sleep-disordered breathing (SDB). The aim of the present study was to analyze gender differences in sleep apnea diagnosis and treatment in men and women with similar symptoms of SDB. METHODS: Respiratory Health in Northern Europe (RHINE) provided information about snoring, excessive daytime sleepiness (EDS), BMI and somatic diseases at baseline (1999-2001) and follow-up (2010-2012) from 4962 men and 5892 women. At follow-up participants were asked whether they had a diagnosis of and/or treatment for sleep apnea. RESULTS: Among those with symptoms of SDB (snoring and EDS), more men than women had been given the diagnosis of sleep apnea (25% vs. 14%, p < 0.001), any treatment (17% vs. 11%, p = 0.05) and CPAP (6% vs. 3%, p = 0.04) at follow-up. Predictors of receiving treatment were age, BMI, SDB symptoms at baseline and weight gain, while female gender was related to a lower probability of receiving treatment (adj. OR 0.3, 95% CI 0.3-0.5). In both genders, the symptoms of SDB increased the risk of developing hypertension (adj OR, 95% CI: 1.5, 1.2-1.8) and diabetes (1.5, 1.05-2.3), independent of age, BMI, smoking and weight gain. CONCLUSIONS: Snoring females with daytime sleepiness may be under-diagnosed and under-treated for sleep apnea compared with males, despite running a similar risk of developing hypertension and diabetes.
Authors: Christopher E Kline; Lora E Burke; Susan M Sereika; Christopher C Imes; Bonny Rockette-Wagner; Dara D Mendez; Patrick J Strollo; Yaguang Zheng; Stephen L Rathbun; Eileen R Chasens Journal: Mayo Clin Proc Date: 2018-08-03 Impact factor: 7.616
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