Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, San Antonio, Texas.
Research and Development Service, South Texas Veterans Health Care System, San Antonio, Texas.
J Clin Sleep Med. 2024 Jan 1;20(1):17-30. doi: 10.5664/jcsm.10774.
The aim of this study was to evaluate sex-related differences in symptoms of sleep disorders, sleep-related impairment, psychiatric symptoms, traumatic brain injury, and polysomnographic variables in treatment-seeking military personnel diagnosed with insomnia, obstructive sleep apnea (OSA), or comorbid insomnia and OSA (COMISA).
Participants were 372 military personnel (46.2% women, 53.8% men) with an average age of 37.7 (standard deviation = 7.46) years and median body mass index of 28.4 (5.50) kg/m. Based on clinical evaluation and video-polysomnography, participants were diagnosed with insomnia (n = 118), OSA (n = 118), or COMISA (n = 136). Insomnia severity, excessive daytime sleepiness, sleep quality, nightmare disorder, sleep impairment, fatigue, posttraumatic stress disorder, anxiety, depression symptoms, and traumatic brain injury were evaluated with validated self-report questionnaires. Descriptive statistics, parametric and nonparametric -tests, and effect sizes were used to assess sex differences between men and women.
There were no significant differences between women and men with insomnia or OSA in sleep-related symptoms, impairment, or polysomnography-based apnea-hypopnea index. Military men with COMISA had a significantly greater apnea-hypopnea index as compared to military women with COMISA, but women had greater symptoms of nightmare disorder, posttraumatic stress disorder, and anxiety.
In contrast to civilian studies, minimal differences were observed in self-reported sleep symptoms, impairment, and polysomnography metrics between men and women diagnosed with the most frequent sleep disorders in military personnel (ie, insomnia, OSA, or COMISA) except in those with COMISA. Military service may result in distinct sleep disorder phenotypes that differ negligibly by sex.
Mysliwiec V, Pruiksma KE, Matsangas P, et al. Sex differences in US military personnel with insomnia, obstructive sleep apnea, or comorbid insomnia and obstructive sleep apnea. . 2024;20(1):17-30.
本研究旨在评估睡眠障碍症状、睡眠相关损害、精神症状、创伤性脑损伤和多导睡眠图变量在寻求治疗的失眠、阻塞性睡眠呼吸暂停（OSA）或共病失眠和 OSA（COMISA）的军人中的性别差异。
参与者为 372 名军人（46.2%为女性，53.8%为男性），平均年龄为 37.7（标准差=7.46）岁，中位数体重指数为 28.4（5.50）kg/m。基于临床评估和视频多导睡眠图，参与者被诊断为失眠（n=118）、OSA（n=118）或 COMISA（n=136）。使用经过验证的自我报告问卷评估失眠严重程度、日间嗜睡、睡眠质量、噩梦障碍、睡眠障碍、疲劳、创伤后应激障碍、焦虑、抑郁症状和创伤性脑损伤。使用描述性统计、参数和非参数检验以及效应大小来评估男性和女性之间的性别差异。
在睡眠相关症状、损害或多导睡眠图基于的呼吸暂停低通气指数方面，失眠或 OSA 的女性和男性之间没有显著差异。与 COMISA 的女性军人相比，COMISA 的男性军人的呼吸暂停低通气指数显著更高，但女性的噩梦障碍、创伤后应激障碍和焦虑症状更严重。
与平民研究相比，在自我报告的睡眠症状、损害和多导睡眠图指标方面，除了 COMISA 患者外，诊断为最常见的军人睡眠障碍（即失眠、OSA 或 COMISA）的男性和女性之间观察到的差异很小。军事服务可能导致睡眠障碍表型明显不同，而性别差异可以忽略不计。
Mysliwiec V、Pruiksma KE、Matsangas P 等人。美国军人失眠、阻塞性睡眠呼吸暂停或共病失眠和阻塞性睡眠呼吸暂停的性别差异。睡眠医学。2024；20（1）：17-30。
