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Sex differences in obstructive sleep apnoea.

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Obstructive sleep apnoea (OSA) is often underdiagnosed in females due to differing symptoms. This review highlights key differences in presentation, pathophysiology, and hormonal factors in women with OSA compared to men.

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Area of Science:

  • Sleep Medicine
  • Respiratory Medicine
  • Endocrinology

Background:

  • Obstructive sleep apnoea (OSA) and obstructive sleep apnoea/hypopnoea syndrome (OSAHS) are traditionally viewed as male-prevalent conditions.
  • However, clinical presentation and physiological impact in females differ significantly from males, influenced by factors like age, pregnancy, and menopause.
  • These differences contribute to underdiagnosis and undertreatment in women.

Purpose of the Study:

  • To review the epidemiology, clinical presentation, and pathophysiology of OSA/OSAHS in females.
  • To compare the hormonal and metabolic profiles of females with OSA/OSAHS to those of males.
  • To emphasize the need for improved diagnosis and treatment strategies for sleep-disordered breathing in women.

Main Methods:

  • This is a review article, synthesizing existing literature on OSA/OSAHS in females.
  • It focuses on comparative analysis of clinical presentation, diagnostic indices, and physiological mechanisms between sexes.
  • Hormonal and metabolic factors relevant to female OSA/OSAHS are discussed.

Main Results:

  • Females with OSA/OSAHS often exhibit more pronounced symptoms despite lower apnoea-hypopnoea index scores.
  • They may experience more prolonged partial upper airway obstruction and report insomnia more frequently.
  • Differences in hormonal and metabolic status contribute to unique OSA/OSAHS presentations in women.

Conclusions:

  • The distinct clinical presentation of OSA/OSAHS in females necessitates tailored diagnostic and treatment approaches.
  • Underdiagnosis in women stems from a lack of recognition of sex-specific symptoms and physiological differences.
  • Further research into female-specific pathophysiology and effective interventions is crucial.