Sex differences in obstructive sleep apnoea in aging: a retrospective study

Introduction: many studies show an higher prevalence of OSA in males than female in adulthood.Woman show non specific symptoms ( tiredness, initial insomnia, morning headache) with multiple comorbidities. Sleep disorders in women are underdiagnosed. Detecting "atypical" symptons is important for identiphyng OSA.Unrecognized OSA in women can have an important impact on mortality. Aim of the study: to analyze the clinical aspects of OSA with subjective and objective methods in two groups of patients, distinguished by age and sex. Materials and methods: 1160 patients performed basal poloygraphy:961 eligible for the study,580 M, 381 F, dvided into two age group:adults(l65 years),and elderly (g65 years). Parameters subjective (ESS, PSQI,Berlin test) and objective (anthropometric measurements, polygraphy data) was peformed. Exclusion criteria: no informed consent. Results: the statistical analysis shows the presence of gender differences in the presentation and severity of the disease:OSA is more severe in males, who exhibit significant snoring, in women this symptom is less evident.The usual test are insufficient to identify OSA in women. In aging, estrogenic protection due to menopause fails, the AHI increases significantly compared to adulthood.While the circumference of the neck seems more related to the severity of OSA in both sexes in the geriatirc group. Anatomical susceptibiity to OSA appears to worsen whit aging and there appears to be preferential deposition of fat around the pharynx with aging regardless of systemic fat. Conclusion: Female with OSA are older, obese and have different symptoms than male.Specific questionnaires should be created and used to optimize diagnosis.