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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=53316#.VLyl5MnQrzE
Affiliation(s)
1Department of Neurology, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea.
2Department of Neurology, Ajou University School of Medicine, Suwon, Korea.
2Department of Neurology, Ajou University School of Medicine, Suwon, Korea.
ABSTRACT
Sleep
disordered breathing (SDB) is an independent risk factor for
cardiovascular disease. It is known to be associated more frequently
with men than women, particularly in the premenopausal age range. The
goal of this study is to evaluate gender differences among Korean
patients diagnosed with SBD. This study included 309 patients who
visited our Sleep Clinic due to sleep-related symptoms and were
diagnosed with SDB by overnight polysomnography (PSG). We analyzed age,
gender, body mass index, various PSG indices including sleep stages,
apnea-hypopnea index (AHI) and AHI ratio in rapid eye movement (REM)
versus non-REM (NREM) sleep stages (R:N ratio). Of those 309 patients
diagnosed with obstructive sleep apnea, 217 (70.2%) were men (mean age
51.05 ± 12.64 years) and 92 (29.8%) were women (mean age 64.53 ± 10.43
years). The mean AHI during total sleep time was 30.34 ± 21.17 in men
and 21.47 ± 17.14 in women (P < 0.001). The AHI in NREM sleep was higher in men than in women (30.97 ± 22.39 versus 20.19 ± 18.17, P
< 0.001), whereas the AHI in REM sleep was not significantly
different between men and women (25.73 ± 21.61 versus 28.00 ± 21.76, P
= 0.402). REM SDB with R:N ratio higher than 2.0 was more frequently
observed in women than in men, 34.8% (32/92) of women, compared with
11.9% (26/217) in men (P < 0.001). Interestingly, the mean R:N
ratio tended to decrease with increasing age in women, but remained
relatively constant in men. The prevalence of REM SDB was higher in
women than in men, and the gender difference was the most prominent in
women with the age < 60 years old compared to age-matched and older
men or women > 60 years old. These findings suggest the possibility
of different pathophysiologic mechanisms of SDB between genders and also
between NREM versus REM sleep, which can be partly explained by the
influence of female sex hormones.
KEYWORDS
Women, Sleep Disordered Breathing, Obstructive Sleep Apnea, Rapid Eye Movement Sleep, Apnea-Hypopnea Index
Cite this paper
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