Resta O, Caratozzolo G, Pannacciulli N, Stefàno A, Giliberti T, Carpagnano G E, De Pergola G
University of Bari, Bari, Italy.
Eur J Clin Invest. 2003 Dec;33(12):1084-9. doi: 10.1111/j.1365-2362.2003.01278.x.
In the 1970s and 80s it was believed that obstructive sleep apnea (OSA) was primarily a disease of men. The present study was addressed to evaluate the effect of gender and menopause on the prevalence and the characteristics of OSA and on anthropometric, clinical, respiratory and polysomnographic data in a population of obese individuals.
A total of 230 obese subjects (BMI >/= 30 kg m-2), 148 women and 82 men, aged 16-75 years, were recruited and evaluated for general and anthropometric parameters, respiratory function, sleep-related symptoms and sleep disorders of breathing.
Respiratory disturbance index (RDI) and the prevalence of OSA were lower in women than in men (P < 0.001 and P < 0.001, respectively). Among subjects < 55 years, neck circumference, percentage of predicted normal neck circumference (PPNC), waist-to-hip ratio (WHR), PaCO2, RDI and the prevalence of OSA were lower in female subjects (P = 0.05, P < 0.05, P < 0.001, P < 0.01 and P < 0.01, respectively). BMI, neck circumference, PPNC, WHR, RDI and the prevalence of OSA were higher in postmenopausal compared with premenopausal women (P < 0.01, P < 0.01, P < 0.01, P < 0.01 and P < 0.01, respectively).
Our study demonstrates that (i) the male dominance regarding the prevalence and the severity of OSA disappears in men older than 55 years, and (ii) menopause seems to play a pivotal role in modulating both the presence and the degree of sleep disorder.
在20世纪70年代和80年代，人们认为阻塞性睡眠呼吸暂停（OSA）主要是一种男性疾病。本研究旨在评估性别和绝经对肥胖人群中OSA的患病率、特征以及人体测量学、临床、呼吸和多导睡眠图数据的影响。
共招募了230名肥胖受试者（体重指数≥30kg/m²），其中148名女性和82名男性，年龄在16至75岁之间，对其进行了一般和人体测量参数、呼吸功能、睡眠相关症状及睡眠呼吸障碍的评估。
女性的呼吸紊乱指数（RDI）和OSA患病率低于男性（分别为P<0.001和P<0.001）。在年龄小于55岁的受试者中，女性的颈围、预测正常颈围百分比（PPNC）、腰臀比（WHR）、动脉血二氧化碳分压（PaCO₂）、RDI和OSA患病率较低（分别为P = 0.05、P<0.05、P<0.001、P<0.01和P<0.01）。与绝经前女性相比，绝经后女性的BMI、颈围、PPNC、WHR、RDI和OSA患病率更高（分别为P<0.01、P<0.01、P<0.01、P<0.01和P<0.01）。
我们的研究表明，（i）55岁以上男性中OSA患病率和严重程度方面的男性主导地位消失，（ii）绝经似乎在调节睡眠障碍的存在和程度方面起关键作用。
