Preoperative differences between male and female patients with sleep apnea.

OBJECTIVES/HYPOTHESIS: To evaluate the differences between female and male patients with obstructive sleep apnea syndrome (OSAS) in the preoperative period.

STUDY DESIGN

Nonrandomized cross-sectional study.

METHODS

An analysis of 686 patients (111 women and 575 men) with OSAS was completed. Multivariate modeling techniques were employed to correlate gender with the preoperative respiratory disturbance index (RDI), apnea index (AI), hypopnea index (HI), body mass index (BMI), age, and initial symptoms.

RESULTS

At presentation, the male patients were significantly younger and had a lower BMI and a higher RDI and AI than the female patients. For the entire OSAS population studied, the RDI increased as the BMI increased (correlation coefficient [r] = 0.35, P = <.001). For the female patients there was a weaker correlation (r = 0.21, P =.034), and in male patients there was a stronger correlation (r = 0.40, P <.001). For the entire population there was a negative correlation between age and RDI (r = -0.15, P <.001). In female patients there was a nonsignificant correlation (r = -0.09, P =.35), and in male patients the correlation was significant (r = -0.16, P <.001). There was no difference in the reporting of the number of symptoms based on gender (P =.355). Female patients noted headaches on awakening more commonly than male patients (P =.001), and male patients noted snoring (P =.014) and stopping breathing during sleep (P =.001) more often than female patients.

CONCLUSIONS

The analysis demonstrated that within a surgical population sample, gender differences exist. The findings of this series were as follows: 1) Apnea severity in women was less weight-dependent than in men; (2) in men there was a significant negative correlation between age and apnea severity; and (3) female and male patients reported the same number of signs or symptoms on presentation, although certain signs and symptoms were more commonly reported based on gender. Current clinical evaluation practices must take into account this gender disparity.