Department of Neurology, Duke University Medical Center 3824, Durham, NC, 27710, USA.
Department of Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.
Sleep Breath. 2019 Dec;23(4):1151-1158. doi: 10.1007/s11325-019-01790-x. Epub 2019 Feb 4.
Home sleep apnea tests are recommended only for patients at high risk of moderate to severe obstructive sleep apnea (OSA, apnea-hypopnea index [AHI] ≥ 15/h). We evaluated 14 factors known to be associated with OSA and identified sex differences in predictors of moderate to severe OSA.
Retrospective analysis was done on 545 subjects who completed sleep questionnaires and underwent diagnostic polysomnogram at a tertiary sleep center. Univariate and multivariate analysis was conducted separately in males and females to determine which variables were independent predictors of moderate to severe OSA.
Overall, physical traits were stronger predictors in both males and females. For each sex, only 3 variables were found to be independently predictive of moderate to severe OSA. In order of predictive strength, this included body mass index (BMI) ≥ 38 kg/m (aOR 5.80, p < 0.001), neck circumference (NC) ≥ 17 in. (aOR 2.52, p = 0.002), and Epworth sleepiness scale (ESS) ≥ 13 (aOR 2.22, p = 0.015) for males and age ≥ 50 years (aOR 4.19, p < 0.001), NC ≥ 14.5 in. (aOR 3.13, p = 0.003), and report of morning headaches (aOR 2.00, p = 0.039) for females. Applying the Bonferroni correction, BMI and NC remained significant for males, and age and NC remained significant for females.
In a subject population referred for sleep evaluation at a tertiary care center only a few variables are independently predictive of moderate to severe OSA, and these variables differed between males and females. Only BMI, NC, and a high ESS were independently predictive of moderate to severe OSA in males, whereas age, NC, and morning headaches were independently predictive in females.
仅建议对有中重度阻塞性睡眠呼吸暂停（OSA，呼吸暂停低通气指数[AHI]≥15/h）高危风险的患者进行家庭睡眠呼吸暂停测试。我们评估了与 OSA 相关的 14 个已知因素，并确定了中重度 OSA 的预测因素中的性别差异。
对在三级睡眠中心完成睡眠问卷并接受诊断性多导睡眠图检查的 545 名受试者进行回顾性分析。分别对男性和女性进行单变量和多变量分析，以确定哪些变量是中重度 OSA 的独立预测因素。
总体而言，身体特征在男性和女性中都是更强的预测因素。对于每一种性别，只有 3 个变量被发现是中重度 OSA 的独立预测因素。按预测强度排序，这包括身体质量指数（BMI）≥38kg/m（优势比[aOR]5.80，p<0.001）、颈围（NC）≥17 英寸（aOR 2.52，p=0.002）和嗜睡量表（ESS）≥13（aOR 2.22，p=0.015）对于男性和年龄≥50 岁（aOR 4.19，p<0.001）、NC≥14.5 英寸（aOR 3.13，p=0.003）和报告清晨头痛（aOR 2.00，p=0.039）对于女性。应用 Bonferroni 校正后，BMI 和 NC 对男性仍然具有显著性，年龄和 NC 对女性仍然具有显著性。
在三级保健中心接受睡眠评估的受试者人群中，只有少数几个变量可独立预测中重度 OSA，且这些变量在男性和女性之间存在差异。仅 BMI、NC 和高 ESS 可独立预测男性中重度 OSA，而年龄、NC 和清晨头痛可独立预测女性中重度 OSA。
