Jonna L Morris1, Diego R Mazzotti2, Daniel J Gottlieb3, Martica H Hall4. 1. School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: jlm356@pitt.edu. 2. Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA. 3. Medical Service, VA Boston Healthcare System, USA; Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA. 4. Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
Abstract
OBJECTIVES: Prior studies have identified symptom subtypes of moderate to severe (AHI >15) obstructive sleep apnea (OSA). They have not yet been consistently examined in those with mild OSA (AHI 5-15 events/hour). This is important as women are more likely than men to present with mild OSA and may present with different OSA symptoms. The objectives of this study were to determine 1) symptom subtypes in mild OSA and 2) if there are sex differences in the distribution of subtypes. METHODS: The sample included men (n = 921) and women (n = 797) with mild OSA, aged 39-90 years, evaluated with a single night of in-home polysomnography as part of the Sleep Heart Health Study. Latent class analysis determined symptom subtypes. Testing for sex differences relative to OSA severity and symptom subtype used chi-squared test for independence. Bonferroni corrected z-tests compared column proportions. RESULTS: Symptom subtypes of mild OSA were not significantly different than those identified in prior studies of moderate-severe OSA (p > 0.05): minimally symptomatic (36.4%), disturbed sleep (11.6%), moderately sleepy (37%), and excessively sleepy (15%), p > 0.05. Sex differences within the symptom subtypes were significant [χ2(df = 3) = 30.04, p < 0.001, Cramer's V = 0.132]. Relative to men, women were more likely to be in the disturbed sleep subtype (p < 0.05), and the excessively sleepy subtype (p < 0.05) while less likely to be in the moderately sleep (<0.05) subtype. Women and men were equally represented in the minimal symptoms subtype (p > 0.05). CONCLUSIONS: Results suggest symptom reporting among individuals with mild OSA differs as a function of sex. These data have important clinical implications for screening men and women for OSA.
OBJECTIVES: Prior studies have identified symptom subtypes of moderate to severe (AHI >15) obstructive sleep apnea (OSA). They have not yet been consistently examined in those with mild OSA (AHI 5-15 events/hour). This is important as women are more likely than men to present with mild OSA and may present with different OSA symptoms. The objectives of this study were to determine 1) symptom subtypes in mild OSA and 2) if there are sex differences in the distribution of subtypes. METHODS: The sample included men (n = 921) and women (n = 797) with mild OSA, aged 39-90 years, evaluated with a single night of in-home polysomnography as part of the Sleep Heart Health Study. Latent class analysis determined symptom subtypes. Testing for sex differences relative to OSA severity and symptom subtype used chi-squared test for independence. Bonferroni corrected z-tests compared column proportions. RESULTS: Symptom subtypes of mild OSA were not significantly different than those identified in prior studies of moderate-severe OSA (p > 0.05): minimally symptomatic (36.4%), disturbed sleep (11.6%), moderately sleepy (37%), and excessively sleepy (15%), p > 0.05. Sex differences within the symptom subtypes were significant [χ2(df = 3) = 30.04, p < 0.001, Cramer's V = 0.132]. Relative to men, women were more likely to be in the disturbed sleep subtype (p < 0.05), and the excessively sleepy subtype (p < 0.05) while less likely to be in the moderately sleep (<0.05) subtype. Women and men were equally represented in the minimal symptoms subtype (p > 0.05). CONCLUSIONS: Results suggest symptom reporting among individuals with mild OSA differs as a function of sex. These data have important clinical implications for screening men and women for OSA.
Authors: Dennis A Dean; Ary L Goldberger; Remo Mueller; Matthew Kim; Michael Rueschman; Daniel Mobley; Satya S Sahoo; Catherine P Jayapandian; Licong Cui; Michael G Morrical; Susan Surovec; Guo-Qiang Zhang; Susan Redline Journal: Sleep Date: 2016-05-01 Impact factor: 5.849
Authors: Fadi Seif; Sanjay R Patel; Harneet K Walia; Michael Rueschman; Deepak L Bhatt; Roger S Blumenthal; Stuart F Quan; Daniel J Gottlieb; Eldrin F Lewis; Susheel P Patil; Naresh M Punjabi; Denise C Babineau; Susan Redline; Reena Mehra Journal: J Hypertens Date: 2014-02 Impact factor: 4.844
Authors: S F Quan; B V Howard; C Iber; J P Kiley; F J Nieto; G T O'Connor; D M Rapoport; S Redline; J Robbins; J M Samet; P W Wahl Journal: Sleep Date: 1997-12 Impact factor: 5.849
Authors: Alan R Schwartz; Susheel P Patil; Alison M Laffan; Vsevolod Polotsky; Hartmut Schneider; Philip L Smith Journal: Proc Am Thorac Soc Date: 2008-02-15
Authors: A J Hirsch Allen; Rachel Jen; Diego R Mazzotti; Brendan T Keenan; Sebastian D Goodfellow; Carolyn M Taylor; Patrick Daniele; Bernardo Peres; Yu Liu; Morvarid Mehrtash; Najib T Ayas Journal: J Clin Sleep Med Date: 2022-09-01 Impact factor: 4.324