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Published in: Sleep and Breathing 4/2021

01-12-2021 | Sleep Apnea | Sleep Breathing Physiology and Disorders • Original Article

Gender differences in the sleep variables contributing to excessive daytime sleepiness among patients with obstructive sleep apnea

Authors: Eliya Honig, Amit Green, Yaron Dagan

Published in: Sleep and Breathing | Issue 4/2021

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Abstract

Purpose

Excessive daytime sleepiness (EDS) is a main symptom in patients with obstructive sleep apnea (OSA); however, patients with OSA have significant variability in their reported EDS which cannot be fully explained by the apnea-hypopnea index (AHI). The purpose of this study was to investigate gender differences regarding the sleep test variables contributing to excessive daytime sleepiness.

Methods

Retrospective study of 578 men and 270 women with suspected OSA who underwent home overnight sleep test. We assessed the correlation between sleep test variables and EDS, using the Epworth Sleepiness Scale (ESS).

Results

Among the group of men, correlation was found between ESS to BMI (r = .107, p = .010), AHI (r = .158, < .001), number of apneas (r = .129, p = .002), number of hypopneas (r = .115, p = .006), number of blood oxygen desaturations (r = .145,  < .001), and percent of time the blood oxygen saturation was under 90% (r = .130, p = .002). However, among the group of women, no significant correlation was found between any of the sleep test parameters or BMI to ESS. Among the group of women, a negative correlation was found between age and EDS (r = − .208, p < .001).

Conclusion

Men showed correlations between sleep test variables and EDS, while women did not show such correlations. The results suggest that men’s sleepiness is more influenced by OSA and sleep variables compared to women. To our knowledge, this is the first study which shows difference between genders in the influence of sleep variables and OSA on EDS.
Literature
1.
go back to reference Baldwin CM, Griffith KA, Nieto FJ, O’Connor GT, Walsleben JA, Redline S (2001) The association of sleep-disordered breathing and sleep symptoms with quality of life in the sleep heart health study. Sleep 24(1):96–105CrossRef Baldwin CM, Griffith KA, Nieto FJ, O’Connor GT, Walsleben JA, Redline S (2001) The association of sleep-disordered breathing and sleep symptoms with quality of life in the sleep heart health study. Sleep 24(1):96–105CrossRef
2.
go back to reference Baldwin CM, Kapur VK, Holberg CJ, Rosen C, Nieto FJ (2004) Associations between gender and measures of daytime somnolence in the Sleep Heart Health Study. Sleep 27(2):305–311CrossRef Baldwin CM, Kapur VK, Holberg CJ, Rosen C, Nieto FJ (2004) Associations between gender and measures of daytime somnolence in the Sleep Heart Health Study. Sleep 27(2):305–311CrossRef
4.
go back to reference Briones B, Adams N, Strauss M, Rosenberg C, Whalen C, Carskadon M, Roebuck T, Winters M, Redline S (1996) Relationship between sleepiness and general health status. Sleep 19(7):583–588CrossRef Briones B, Adams N, Strauss M, Rosenberg C, Whalen C, Carskadon M, Roebuck T, Winters M, Redline S (1996) Relationship between sleepiness and general health status. Sleep 19(7):583–588CrossRef
5.
go back to reference Durán J, Esnaola S, Rubio R, Iztueta Á (2001) Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med 163(3 I):685–689CrossRef Durán J, Esnaola S, Rubio R, Iztueta Á (2001) Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med 163(3 I):685–689CrossRef
6.
go back to reference Gonçalves MA, Paiva T, Ramos E, Guilleminault C (2004) Obstructive sleep apnea syndrome, sleepiness, and quality of life. Chest 125(6):2091–2096CrossRef Gonçalves MA, Paiva T, Ramos E, Guilleminault C (2004) Obstructive sleep apnea syndrome, sleepiness, and quality of life. Chest 125(6):2091–2096CrossRef
7.
go back to reference Guilleminault C, Partinen M, Quera-Salva MA, Hayes B, Dement WC, Nino-Murcia G (1998) Determinants of daytime sleepiness in obstructive sleep apnea. Chest 94(1):32–37CrossRef Guilleminault C, Partinen M, Quera-Salva MA, Hayes B, Dement WC, Nino-Murcia G (1998) Determinants of daytime sleepiness in obstructive sleep apnea. Chest 94(1):32–37CrossRef
9.
go back to reference Bixler EO, Vgontzas AN, Lin HM, Calhoun SL, Vela-Bueno A, Kales A (2005) Excessive daytime sleepiness in a general population sample: the role of sleep apnea, age, obesity, diabetes, and depression. J Clin Endocrinol Metab 90(8):4510–4515CrossRef Bixler EO, Vgontzas AN, Lin HM, Calhoun SL, Vela-Bueno A, Kales A (2005) Excessive daytime sleepiness in a general population sample: the role of sleep apnea, age, obesity, diabetes, and depression. J Clin Endocrinol Metab 90(8):4510–4515CrossRef
10.
go back to reference Young T (1993) Analytic epidemiology studies of sleep disordered breathing—what explains the gender difference in sleep disordered breathing? Sleep 16(suppl_8):S1–S2CrossRef Young T (1993) Analytic epidemiology studies of sleep disordered breathing—what explains the gender difference in sleep disordered breathing? Sleep 16(suppl_8):S1–S2CrossRef
11.
go back to reference Quintana-Gallego E, Carmona-Bernal C, Capote F, Sánchez-Armengol Á, Botebol-Benhamou G, Polo-Padillo J, Castillo-Gómez J (2004) Gender differences in obstructive sleep apnea syndrome: a clinical study of 1166 patients. Respir Med 98(10):984–989CrossRef Quintana-Gallego E, Carmona-Bernal C, Capote F, Sánchez-Armengol Á, Botebol-Benhamou G, Polo-Padillo J, Castillo-Gómez J (2004) Gender differences in obstructive sleep apnea syndrome: a clinical study of 1166 patients. Respir Med 98(10):984–989CrossRef
12.
go back to reference Ambrogetti A, Olson LG, Saunders NA (1991) Differences in the symptoms of men and women with obstructive sleep apnoea. Aust NZ J Med 21(6):863–866CrossRef Ambrogetti A, Olson LG, Saunders NA (1991) Differences in the symptoms of men and women with obstructive sleep apnoea. Aust NZ J Med 21(6):863–866CrossRef
13.
go back to reference Collop NA, Adkins D, Phillips BA (2004) Gender differences in sleep and sleep-disordered breathing. Clin Chest Med 25(2):257–268CrossRef Collop NA, Adkins D, Phillips BA (2004) Gender differences in sleep and sleep-disordered breathing. Clin Chest Med 25(2):257–268CrossRef
14.
go back to reference Valipour A, Lothaller H, Rauscher H, Zwick H, Burghuber OC, Lavie P (2007) Gender-related differences in symptoms of patients with suspected breathing disorders in sleep: a clinical population study using the Sleep Disorders Questionnaire. Sleep 30(3):312–319CrossRef Valipour A, Lothaller H, Rauscher H, Zwick H, Burghuber OC, Lavie P (2007) Gender-related differences in symptoms of patients with suspected breathing disorders in sleep: a clinical population study using the Sleep Disorders Questionnaire. Sleep 30(3):312–319CrossRef
15.
go back to reference Alotair H, BaHammam A (2008) Gender differences in Saudi patients with obstructive sleep apnea. Sleep Breath 12(4):323–329CrossRef Alotair H, BaHammam A (2008) Gender differences in Saudi patients with obstructive sleep apnea. Sleep Breath 12(4):323–329CrossRef
16.
go back to reference Zhang Z, Cheng J, Yang W, Zou H, Su C, Miao J (2019) Gender differences in clinical manifestations and polysomnographic findings in Chinese patients with obstructive sleep apnea. Sleep Breath 24:1019–1026CrossRef Zhang Z, Cheng J, Yang W, Zou H, Su C, Miao J (2019) Gender differences in clinical manifestations and polysomnographic findings in Chinese patients with obstructive sleep apnea. Sleep Breath 24:1019–1026CrossRef
17.
go back to reference Prasad B, Steffen AD, Van Dongen HPA, Pack FM, Strakovsky I, Staley B et al (2018) Determinants of sleepiness in obstructive sleep apnea. Sleep 41(2):1–9CrossRef Prasad B, Steffen AD, Van Dongen HPA, Pack FM, Strakovsky I, Staley B et al (2018) Determinants of sleepiness in obstructive sleep apnea. Sleep 41(2):1–9CrossRef
18.
go back to reference Cai SJ, Chen R, Zhang YL, Xiong KP, Lian YX, Li J, Shen JC, Liu CF (2013) Correlation of Epworth Sleepiness Scale with multiple sleep latency test and its diagnostic accuracy in assessing excessive daytime sleepiness in patients with obstructive sleep apnea hypopnea syndrome. Chin Med J 126(17):3245–3250PubMed Cai SJ, Chen R, Zhang YL, Xiong KP, Lian YX, Li J, Shen JC, Liu CF (2013) Correlation of Epworth Sleepiness Scale with multiple sleep latency test and its diagnostic accuracy in assessing excessive daytime sleepiness in patients with obstructive sleep apnea hypopnea syndrome. Chin Med J 126(17):3245–3250PubMed
19.
go back to reference Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545CrossRef Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545CrossRef
20.
go back to reference Roure N, Gomez S, Mediano O, Duran J, de la Peña M, Capote F et al (2008) Daytime sleepiness and polysomnography in obstructive sleep apnea patients. Sleep Med 9(7):727–731CrossRef Roure N, Gomez S, Mediano O, Duran J, de la Peña M, Capote F et al (2008) Daytime sleepiness and polysomnography in obstructive sleep apnea patients. Sleep Med 9(7):727–731CrossRef
21.
go back to reference Eriş Gülbay B, Acican T, Çiftçi F, Erdemir Işik M, Önen ZP (2014) Comparison of polysomnography variables in obstructive sleep apnea patients with or without excessive daytime sleepiness. Turkiye Klin J Med Sci 34(1):87–92CrossRef Eriş Gülbay B, Acican T, Çiftçi F, Erdemir Işik M, Önen ZP (2014) Comparison of polysomnography variables in obstructive sleep apnea patients with or without excessive daytime sleepiness. Turkiye Klin J Med Sci 34(1):87–92CrossRef
22.
go back to reference Young T, Finn L, Austin D, Peterson A (2003) Menopausal status and sleep-disordered breathing in the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med 167(9):1181–1185CrossRef Young T, Finn L, Austin D, Peterson A (2003) Menopausal status and sleep-disordered breathing in the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med 167(9):1181–1185CrossRef
Metadata
Title
Gender differences in the sleep variables contributing to excessive daytime sleepiness among patients with obstructive sleep apnea
Authors
Eliya Honig
Amit Green
Yaron Dagan
Publication date
01-12-2021
Publisher
Springer International Publishing
Published in
Sleep and Breathing / Issue 4/2021
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-020-02276-x

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