Gender Effects in obstructive sleep apnea syndrome (OSAS): risk factors, symptoms and co-morbidity.

Aim To assess potential gender-related differences in the clinical presentation of a cohort of OSAS patients. Material and Methods 120 consecutive patients, diagnosed by means of ambulatory nocturnal cardiorespiratory monitoring for OSAS, were evaluated as for as: neck and waist circumference, BMI and Mallampati Index, main presenting symptoms (snoring, excessive daytime sleepiness, dry mouth, headache upon awakening, lack of energy, nicturia, attention and memory deficits), (Epworth Sleepiness Scale), quality of life(SF-362v), depressive mood(Beck Depression Inventory), anxiety(Hamilton Anxiety Scale), quality of sleep(Pittsburgh Quality Index); medical co-morbidities (hypertension, diabetes, dislipidemia, hypothyroidism) Results 34/120 patients were females (mean age 57.06): 26 in the post-menopausal, 8 in the pre-menopausal period; 86/121 males (mean age 52.74) were not significantly younger than females(p>0.05). Both gender presented non severe EDS (p>0.5). Females had significantly higher BMI (mean 35.65) than males (mean 31,8) (p<0.002), whereas neck circumference was larger in males (p<0.005) with no significant difference as for waist circumference. Snoring history was 11,41 years for female and 12.67 for male, symptom of presentation in women was perceptually more frequent headache upon awakening, lack of energy, attention and memory deficits without significant difference. Apnoea/hypopnoea Index as well was similar in both genders (p>0.5). Diabetes was significantly overrepresented in the female gender(p<0.05), which was also more affected by hypertension, hypothyroidism and GERD even if this difference did not reach statistical significance; at the same time. On SF-362v women showed a worse quality of life than men(p<0.05); on BDI only women presented moderate mood disturbance(p=0.05). Conclusions Our results suggest that BMI was less in males than in females. In terms of co-morbidities females more affected by diabetes but had a similar rate of hypertension, dislipidemia, hypothyroidism, GERD when compared to males. Finally, females had a worse quality of life and a tendency toward depressive mood in comparison with their male counterparts.