Patiño Marcela Concha, Bueno Florez Silvia Juliana, Gallo Loren, Ortiz Paola Andrea, Payán-Gómez César, Molano-Gonzalez Nicolas, Rodríguez Jesús Hernán
Department of Neurology, Clinica Nueva Rafael, Cali, Valle del Cauca, Colombia.
Department of Neurology, Fundación Cardioinfantil, Bogotá, Cundinamarca, Colombia.
Nat Sci Sleep. 2021 May 7;13:547-556. doi: 10.2147/NSS.S287165. eCollection 2021.
Obstructive sleep apnea (OSA) is a common sleep disorder which prevalence is 22% in men and 17% in women. It is well described that females presented different clinical and polysomnographic characteristics compared with men. Those studies were performed in plain areas. We described the analysis by gender and clinical profiles of a sample of patients with diagnostic of OSA and living at high altitude.
It is an observational study that describes differences between clinical and polysomnographic characteristics by gender in patients with OSA. Additionally, an unsupervised cluster algorithm was used to find groups of patients with similar clinical and polysomnographic characteristics.
We included 709 patients, 51.6% were females and 48.3% were males with mean age of 64 and 62 years old, respectively, in which 90.97% presented OSA. Men presented a higher apnea and hypopnea index than women (p=0.002), besides presented more sleep polysomnographic alterations. Meanwhile, women evidenced better sleep quality based on parameters. Additionally, in the sample of patients, we found four separated clinical profiles characterized mainly by differences in the severity of polysomnographic parameters.
The patients were more obese, older, and had lower SpO values than most of those previously reported. Men had greater severity in most of the parameters measured by polysomnography. Polysomnographic variables were different both in the OSA patient profiles and in the gender comparison. However, the REM sleep apnea hypopnea index did not differ between sexes, indicating the importance of this variable in the evaluation of OSA severity in women. In contrast to previous reports, clinical and demographic characteristics showed few differences in both analyses. This result suggests that the behavior of OSA at high altitudes may have particularities with respect to low altitudes.
阻塞性睡眠呼吸暂停（OSA）是一种常见的睡眠障碍，男性患病率为22%，女性患病率为17%。已有充分描述表明，与男性相比，女性呈现出不同的临床和多导睡眠图特征。这些研究是在平原地区进行的。我们描述了对一组诊断为OSA且生活在高海拔地区的患者按性别和临床特征进行的分析。
这是一项观察性研究，描述了OSA患者按性别在临床和多导睡眠图特征方面的差异。此外，使用无监督聚类算法来找出具有相似临床和多导睡眠图特征的患者组。
我们纳入了709名患者，其中51.6%为女性，48.3%为男性，平均年龄分别为64岁和62岁，其中90.97%患有OSA。男性的呼吸暂停低通气指数高于女性（p = 0.002），此外还存在更多的睡眠多导睡眠图改变。同时，基于各项参数，女性的睡眠质量更好。此外，在患者样本中，我们发现了四个不同的临床特征，主要以多导睡眠图参数严重程度的差异为特征。
这些患者比之前报道的大多数患者更肥胖、年龄更大且血氧饱和度（SpO）值更低。在多导睡眠图测量的大多数参数方面，男性的严重程度更高。多导睡眠图变量在OSA患者特征以及性别比较中均有所不同。然而，快速眼动（REM）睡眠呼吸暂停低通气指数在两性之间没有差异，这表明该变量在评估女性OSA严重程度方面的重要性。与之前的报道相反，在这两项分析中临床和人口统计学特征显示出很少的差异。这一结果表明，OSA在高海拔地区的表现相对于低海拔地区可能具有特殊性。
