Sex differences in sleep apnea predictors and outcomes from home sleep apnea testing

Alyssa Cairns,1 Greg Poulos,1 Richard Bogan,1-3 1Research Division, SleepMed, Inc., 2School of Medicine, The University of South Carolina Medical School, Columbia, 3School of Medicine, The Medical University of South Carolina, Charleston, SC, USA Study objectives: To evaluate sex differences in pred...

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Autores principales:	Cairns A, Poulos G, Bogan R
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Keywords: Home sleep test portable monitor OCST sex ARES Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/7889da8bebb04b308a3cdbce2e925e7e
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spelling	oai:doaj.org-article:7889da8bebb04b308a3cdbce2e925e7e2021-12-02T03:44:33ZSex differences in sleep apnea predictors and outcomes from home sleep apnea testing1179-1608https://doaj.org/article/7889da8bebb04b308a3cdbce2e925e7e2016-06-01T00:00:00Zhttps://www.dovepress.com/sex-differences-in-sleep-apnea-predictors-and-outcomes-from-home-sleep-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Alyssa Cairns,1 Greg Poulos,1 Richard Bogan,1-3 1Research Division, SleepMed, Inc., 2School of Medicine, The University of South Carolina Medical School, Columbia, 3School of Medicine, The Medical University of South Carolina, Charleston, SC, USA Study objectives: To evaluate sex differences in predictors of obstructive sleep apnea (OSA) as per outcomes from home sleep apnea testing. Design: This was a retrospective analysis of a large repository of anonymous test results and pretest risk factors for OSA. Setting and patients: A total of 272,705 patients were referred for home sleep apnea testing from a variety of clinical practices for suspected sleep disordered breathing across North America from 2009 to 2013. Interventions: Not applicable. Measurements and results: Predictors of OSA (apnea hypopnea index4%≥5) were evaluated by multiple logistic regression; sex differences were evaluated by interaction effects. Middle age was the single most robust predictor of OSA for both sexes and was particularly foretelling for females (P<0.001) even after controlling for measures of adiposity and medical conditions. Females over the age of 45 years were much more likely to have OSA compared to their younger counterparts (78.7% vs 42.5%, respectively; odds ratio: 5.0) versus males (88.1% vs 68.8%, respectively; odds ratio: 3.4). Snoring, although more frequently reported by males, was similarly predictive of OSA for both sexes. Witnessed apneas and measures of adiposity were better predictors of OSA for males than females. Insomnia, depression, and use of sleep medication, although more commonly reported in females, did not predict OSA. Hypertension, although equally reported by both sexes, performed better as a predictor in females (P<0.001), even after controlling for age, measures of adiposity, and other medical conditions. Diabetes, heart disease, stroke, and sleepiness did not contribute unique variance in OSA in adjusted models. Conclusion: This study found that males and females report different symptoms upon clinical evaluation for suspected sleep apnea, with some of the “classic” OSA features to be more common in and robustly predictive for males. The finding that advancing age uniquely and robustly predicted OSA in females reinforces our understanding that age-related changes in sex hormones play a role in the development and/or manifestation of sleep disordered breathing. Need exists for sex-specific prediction models and quantification of menopausal status in OSA screening tools. Keywords: home sleep test, portable monitor, HSAT, ARESCairns APoulos GBogan RDove Medical PressarticleKeywords: Home sleep testportable monitorOCSTsexARESPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol 2016, Iss Issue 1, Pp 197-205 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Keywords: Home sleep test portable monitor OCST sex ARES Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	Keywords: Home sleep test portable monitor OCST sex ARES Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Cairns A Poulos G Bogan R Sex differences in sleep apnea predictors and outcomes from home sleep apnea testing
description	Alyssa Cairns,1 Greg Poulos,1 Richard Bogan,1-3 1Research Division, SleepMed, Inc., 2School of Medicine, The University of South Carolina Medical School, Columbia, 3School of Medicine, The Medical University of South Carolina, Charleston, SC, USA Study objectives: To evaluate sex differences in predictors of obstructive sleep apnea (OSA) as per outcomes from home sleep apnea testing. Design: This was a retrospective analysis of a large repository of anonymous test results and pretest risk factors for OSA. Setting and patients: A total of 272,705 patients were referred for home sleep apnea testing from a variety of clinical practices for suspected sleep disordered breathing across North America from 2009 to 2013. Interventions: Not applicable. Measurements and results: Predictors of OSA (apnea hypopnea index4%≥5) were evaluated by multiple logistic regression; sex differences were evaluated by interaction effects. Middle age was the single most robust predictor of OSA for both sexes and was particularly foretelling for females (P<0.001) even after controlling for measures of adiposity and medical conditions. Females over the age of 45 years were much more likely to have OSA compared to their younger counterparts (78.7% vs 42.5%, respectively; odds ratio: 5.0) versus males (88.1% vs 68.8%, respectively; odds ratio: 3.4). Snoring, although more frequently reported by males, was similarly predictive of OSA for both sexes. Witnessed apneas and measures of adiposity were better predictors of OSA for males than females. Insomnia, depression, and use of sleep medication, although more commonly reported in females, did not predict OSA. Hypertension, although equally reported by both sexes, performed better as a predictor in females (P<0.001), even after controlling for age, measures of adiposity, and other medical conditions. Diabetes, heart disease, stroke, and sleepiness did not contribute unique variance in OSA in adjusted models. Conclusion: This study found that males and females report different symptoms upon clinical evaluation for suspected sleep apnea, with some of the “classic” OSA features to be more common in and robustly predictive for males. The finding that advancing age uniquely and robustly predicted OSA in females reinforces our understanding that age-related changes in sex hormones play a role in the development and/or manifestation of sleep disordered breathing. Need exists for sex-specific prediction models and quantification of menopausal status in OSA screening tools. Keywords: home sleep test, portable monitor, HSAT, ARES
format	article
author	Cairns A Poulos G Bogan R
author_facet	Cairns A Poulos G Bogan R
author_sort	Cairns A
title	Sex differences in sleep apnea predictors and outcomes from home sleep apnea testing
title_short	Sex differences in sleep apnea predictors and outcomes from home sleep apnea testing
title_full	Sex differences in sleep apnea predictors and outcomes from home sleep apnea testing
title_fullStr	Sex differences in sleep apnea predictors and outcomes from home sleep apnea testing
title_full_unstemmed	Sex differences in sleep apnea predictors and outcomes from home sleep apnea testing
title_sort	sex differences in sleep apnea predictors and outcomes from home sleep apnea testing
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/7889da8bebb04b308a3cdbce2e925e7e
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Sex differences in sleep apnea predictors and outcomes from home sleep apnea testing

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