Characterization of obstructive sleep apnea in patients with insomnia across gender and age

A large number of clinical observational studies have suggested that women patients with obstructive sleep apnea (OSA) have a higher presence of insomnia symptoms compared to men with OSA. There is no study that has examined the effect of age and gender on the relationship between OSA and chronic insomnia in a large number of patients with insomnia.

We collected data on 860 patients with chronic insomnia and included both sexes and a wide range of ages (mean age 43.0 ± 12.1 (range 18-81) years, 409 men). All participants underwent overnight polysomnography (PSG) in a sleep medicine center.

The prevalence of OSA based on three different apnea-hypopnea index (AHI) categories (events/h >5, >15, and >30) were 42.5, 21.8, and 8.3% in men and 19.1, 6.2, and 1.8% in women, respectively. Across age ranges of <35, 35~<45, 45~<55, and ≥55 years, the prevalence of OSA was remarkably greater in men than in women up to 55 years of age, but not in subjects with ages ≥55 years. AHI was a significant risk factor for hypertension; the odds ratio of hypertension in patients with high AHI (>30) compared to patients in the lowest AHI category (<5) was 3.68 (95% confidence interval [CI], 1.47-9.21), after adjusting for all other factors.

Similar to the gender differences reported in general population studies, men had a much greater OSA prevalence than women prior to 55 years of age, but not at ages greater than 55 years.