Gender differences in sleep disordered breathing: Implications for therapy

Expert Review of Respiratory Medicine

Volumn 9, Issue 2, 2015, Pages 221-231

  Won, Christine ^a   Guilleminault, Christian ^b  

^a YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b STANFORD UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

gender; positive airway pressure; sleep apnea; sleep disordered breathing; women

Indexed keywords

ESTRADIOL; ESTROGEN; HORMONE; PROGESTERONE;

AGING; AIRWAY PRESSURE; ALTERNATIVE MEDICINE; ANXIETY; BARIATRIC SURGERY; DEPRESSION; ENDOTHELIAL DYSFUNCTION; HORMONE SUBSTITUTION; HUMAN; HYPERTENSION; LIFESTYLE MODIFICATION; LUNG FUNCTION; MORTALITY; PATHOPHYSIOLOGY; POLYSOMNOGRAPHY; PREGNANCY; PREVALENCE; REVIEW; RISK; SEX DIFFERENCE; SLEEP DISORDERED BREATHING; SNORING; UPPER RESPIRATORY TRACT; WEIGHT REDUCTION; COMORBIDITY; FEMALE; HEALTH DISPARITY; LUNG; MALE; PROGNOSIS; RISK ASSESSMENT; RISK FACTOR; SEVERITY OF ILLNESS INDEX; SEXUAL DEVELOPMENT; SLEEP; SLEEP APNEA SYNDROMES;

COMORBIDITY; FEMALE; HEALTH STATUS DISPARITIES; HUMANS; LUNG; MALE; PREGNANCY; PREVALENCE; PROGNOSIS; RISK ASSESSMENT; RISK FACTORS; SEVERITY OF ILLNESS INDEX; SEX CHARACTERISTICS; SEX FACTORS; SLEEP; SLEEP APNEA SYNDROMES;

EID: 84924931528     PISSN: 17476348     EISSN: 17476356     Source Type: Journal    
DOI: 10.1586/17476348.2015.1019478     Document Type: Review

References (81)

1. Young T, Evans L, Finn L, et al. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep 1997;20:705-6
2. Redline S, Kump K, Tishler PV, et al. Gender differences in sleep disordered breathing in a community-based sample. Am J Respir Crit Care Med 1994;149:722-6
3. Baldwin CM, Kapur VK, Holberg CJ, et al. Associations between gender and measures of daytime somnolence in the sleep heart health study. Sleep 2004;27:305-11
4. Young T, Finn L. Epidemiological insights into the public health burden of sleep disordered breathing: sex differences in survival among sleep clinic patients. Thorax 1998;53:S16-19
5. Valipour A, Lothaller H, Rauscher H, et al. Gender-related differences in symptoms of patients with suspected breathing disorders in sleep: A clinical population study using the sleep disorders questionnaire. Sleep 2007;30:312-19
6. Tantrakul V, Park CS, Guilleminault C. Sleep-disordered breathing in premenopausal women: differences between younger (less than 30 years old) and older women. Sleep Med 2012;13:656-62
7. Macey PM. Is brain injury in obstructive sleep apnea reversible? Sleep 2012;35:9-10
8. Shepertycky MR, Banno K, Kryger MH. Differences between men and women in the clinical presentation of patients diagnosed with obstructive sleep apnea syndrome. Sleep 2005;28:309-14
9. Quintana-Gallego E, Carmona-Bernal C, Capote F, et al. Gender differences in obstructive sleep apnea syndrome: A clinical study of 1166 patients. Respir Med 2004;98:984-9
10. O'Connor C, Thornley KS, Hanly PJ. Gender differences in the polysomnographic features of obstructive sleep apnea. Am J Respir Crit Care Med 2000;161:1465-72
11. Subramanian S, Hesselbacher S, Mattewal A, et al. Gender and age influence the effects of slow-wave sleep on respiration in patients with obstructive sleep apnea. Sleep Breath 2013;17:51-6
12. Ware JC, McBrayer RH, Scott JA. Influence of sex and age on duration and frequency of sleep apnea events. Sleep 2000;23:165-70
13. Anttalainen U, Polo O, Vahlberg T, et al. Women with partial upper airway obstruction are not less sleepy than those with obstructive sleep apnea. Sleep Breath 2013;17:873-6
14. Young T, Hutton R, Finn L, et al. The gender bias in sleep apnea diagnosis. Are women missed because they have different symptoms? Arch Intern Med 1996;156: 2445-51
15. Mohsenin V. Gender differences in the expression of sleep-disordered breathing: role of upper airway dimensions. Chest 2001;120:1442-7
16. Iber C, Ancoli-Israel S, Chesson AL, Jr, et al. The AASM manual for the scoring of sleep and associated events: Rules, terminology and technical specifications. Version 2.0. American Academy of Sleep Medicine, Darian Ill; 2012. Available from: www.aasmnet.org
17. Thurnheer R, Wraith PK, Douglas NJ. Influence of age and gender on upper airway resistance in NREM and REM sleep. J Appl Physiol (1985) 2001;90:981-8
18. Mohsenin V. Effects of gender on upper airway collapsibility and severity of obstructive sleep apnea. Sleep Med 2003;4: 523-9
19. Popovic V, Spremovic S. The effect of sodium valproate on luteinizing hormone secretion in women with polycystic ovary disease. J Endocrinol Invest 1995;18:104-8
20. Jordan AS, Catcheside PG, O'Donoghue FJ, et al. Genioglossus muscle activity at rest and in response to brief hypoxia in healthy men and women. J Appl Physiol (1985) 2002;92: 410-17
21. Trinder J, Kay A, Kleiman J, et al. Gender differences in airway resistance during sleep. J Appl Physiol (1985) 1997;83:1986-97
22. Sforza E, Petiau C, Weiss T, et al. Pharyngeal critical pressure in patients with obstructive sleep apnea syndrome. Clinical implications. Am J Respir Crit Care Med 1999;159:149-57
23. Pillar G, Malhotra A, Fogel RB, et al. Upper airway muscle responsiveness to rising PCO(2) during NREM sleep. J Appl Physiol (1985) 2000;89:1275-82
24. Jordan AS, Wellman A, Edwards JK, et al. Respiratory control stability and upper airway collapsibility in men and women with obstructive sleep apnea. J Appl Physiol (1985) 2005;99:2020-7
25. White DP, Douglas NJ, Pickett CK, et al. Sexual influence on the control of breathing. J Appl Physiol Respir Environ Exerc Physiol 1983;54:874-9
26. White DP, Douglas NJ, Pickett CK, et al. Hypoxic ventilatory response during sleep in normal premenopausal women. Am Rev Respir Dis 1982;126:530-3
27. Bixler EO, Vgontzas AN, Lin HM, et al. Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med 2001;163:608-13
28. Young T, Rabago D, Zgierska A, et al. Objective and subjective sleep quality in premenopausal, perimenopausal, and postmenopausal women in the wisconsin sleep cohort study. Sleep 2003;26:667-72
29. Fuentes-Pradera MA, Sanchez-Armengol A, Capote-Gil F, et al. Effects of sex on sleep-disordered breathing in adolescents. Eur Respir J 2004;23:250-4
30. Cook WR, Benich JJ, Wooten SA. Indices of severity of obstructive sleep apnea syndrome do not change during medroxyprogesterone acetate therapy. Chest 1989;96:262-6
31. Rajagopal KR, Abbrecht PH, Jabbari B. Effects of medroxyprogesterone acetate in obstructive sleep apnea. Chest 1986;90: 815-21
32. Manber R, Kuo TF, Cataldo N, et al. The effects of hormone replacement therapy on sleep-disordered breathing in postmenopausal women: A pilot study. Sleep 2003;26:163-8
33. Fogel RB, Malhotra A, Pillar G, et al. Increased prevalence of obstructive sleep apnea syndrome in obese women with polycystic ovary syndrome. J Clin Endocrinol Metab 2001;86:1175-80
34. Liu PY, Yee B, Wishart SM, et al. The short-term effects of high-dose testosterone on sleep, breathing, and function in older men. J Clin Endocrinol Metab 2003;88: 3605-13
35. Chowdhuri S, Bascom A, Mohan D, et al. Testosterone conversion blockade increases breathing stability in healthy men during NREM sleep. Sleep 2013;36:1793-8
36. Bixler EO, Vgontzas AN, Ten Have T, et al. Effects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med 1998;157:144-8
37. Tishler PV, Larkin EK, Schluchter MD, et al. Incidence of sleep-disordered breathing in an urban adult population: the relative importance of risk factors in the development of sleep-disordered breathing. JAMA 2003;289:2230-7
38. Newman AB, Foster G, Givelber R, et al. Progression and regression of sleep-disordered breathing with changes in weight: the Sleep Heart Health Study. Arch Intern Med 2005;165:2408-13
39. Edwards N, Blyton DM, Hennessy A, et al. Severity of sleep-disordered breathing improves following parturition. Sleep 2005;28:737-41
40. Guilleminault C, Querra-Salva M, Chowdhuri S, et al. Normal pregnancy, daytime sleeping, snoring and blood pressure. Sleep Med 2000;1:289-97
41. Izci B, Martin SE, Dundas KC, et al. Sleep complaints: snoring and daytime sleepiness in pregnant and pre-eclamptic women. Sleep Med 2005;6:163-9
42. Edwards N, Middleton PG, Blyton DM, et al. Sleep disordered breathing and pregnancy. Thorax 2002;57:555-8
43. Bobrowski RA. Pulmonary physiology in pregnancy. Clin Obstet Gynecol 2010;53: 285-300
44. Izci B, Riha RL, Martin SE, et al. The upper airway in pregnancy and pre-eclampsia. Am J Respir Crit Care Med 2003;167:137-40
45. Bourjeily G, Raker CA, Chalhoub M, et al. Pregnancy and fetal outcomes of symptoms of sleep-disordered breathing. Eur Respir J 2010;36:849-55
46. Champagne K, Schwartzman K, Opatrny L, et al. Obstructive sleep apnoea and its association with gestational hypertension. Eur Respir J 2009;33:559-65
47. Bourjeily G, Ankner G, Mohsenin V. Sleep-disordered breathing in pregnancy. Clin Chest Med 2011;32:175-89
48. Chen YH, Kang JH, Lin CC, et al. Obstructive sleep apnea and the risk of adverse pregnancy outcomes. Am J Obstet Gynecol 2012;206:136 e1-5
49. Louis JM, Auckley D, Sokol RJ, et al. Maternal and neonatal morbidities associated with obstructive sleep apnea complicating pregnancy. Am J Obstet Gynecol 2010;202:261 e1-5
50. Reid J, Skomro R, Cotton D, et al. Pregnant women with gestational hypertension may have a high frequency of sleep disordered breathing. Sleep 2011;34: 1033-8
51. Banno K, Ramsey C, Walld R, et al. Expenditure on health care in obese women with and without sleep apnea. Sleep 2009;32:247-52
52. Greenberg-Dotan S, Reuveni H, Simon-Tuval T, et al. Gender differences in morbidity and health care utilization among adult obstructive sleep apnea patients. Sleep 2007;30:1173-80
53. Gay P, Weaver T, Loube D, et al. Evaluation of positive airway pressure treatment for sleep related breathing disorders in adults. Sleep 2006;29:381-401
54. Ballester E, Badia JR, Hernandez L, et al. Evidence of the effectiveness of continuous positive airway pressure in the treatment of sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 1999;159:495-501
55. Ye L, Pien GW, Ratcliffe SJ, et al. Gender differences in obstructive sleep apnea and treatment response to continuous positive airway pressure. J Clin Sleep Med 2009;5: 512-18
56. Nieto FJ, Young TB, Lind BK, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 2000;283:1829-36
57. Hedner J, Bengtsson-Bostrom K, Peker Y, et al. Hypertension prevalence in obstructive sleep apnoea and sex: A population-based case-control study. Eur Respir J 2006;27: 564-70
58. Sforza E, Chouchou F, Collet P, et al. Sex differences in obstructive sleep apnoea in an elderly French population. Eur Respir J 2011;37:1137-43
59. Morrish E, Shneerson JM, Smith IE. Why does gender influence survival in obstructive sleep apnoea? Respir Med 2008;102:1231-6
60. Campos-Rodriguez F, Martinez-Garcia MA, Reyes-Nunez N, et al. Role of sleep apnea and continuous positive airway pressure therapy in the incidence of stroke or coronary heart disease in women. Am J Respir Crit Care Med 2014;189:1544-50
61. Campos-Rodriguez F, Martinez-Garcia MA, de la Cruz-Moron I, et al. Cardiovascular mortality in women with obstructive sleep apnea with or without continuous positive airway pressure treatment: A cohort study. Ann Intern Med 2012;156:115-22
62. Pelletier-Fleury N, Rakotonanahary D, Fleury B. The age and other factors in the evaluation of compliance with nasal continuous positive airway pressure for obstructive sleep apnea syndrome. A Cox's proportional hazard analysis. Sleep Med 2001;2:225-32
63. Sin DD, Mayers I, Man GC, et al. Long-term compliance rates to continuous positive airway pressure in obstructive sleep apnea: A population-based study. Chest 2002;121:430-5
64. Jayaraman G, Majid H, Surani S, et al. Influence of gender on continuous positive airway pressure requirements in patients with obstructive sleep apnea syndrome. Sleep Breath 2011;15:781-4
65. Guilleminault C, Palombini L, Poyares D, et al. Pre-eclampsia and nasal CPAP: part 1. Early intervention with nasal CPAP in pregnant women with risk-factors for preeclampsia: preliminary findings. Sleep Med 2007;9:9-14
66. Poyares D, Guilleminault C, Hachul H, et al. Pre-eclampsia and nasal CPAP: part 2. Hypertension during pregnancy, chronic snoring, and early nasal CPAP intervention. Sleep Med 2007;9:15-21
67. Lim J, Lasserson TJ, Fleetham J, et al. Oral appliances for obstructive sleep apnoea. Cochrane Database Syst Rev 2006(1): CD004435
68. Gotsopoulos H, Chen C, Qian J, et al. Oral appliance therapy improves symptoms in obstructive sleep apnea: A randomized, controlled trial. Am J Respir Crit Care Med 2002;166:743-8
69. Palm E, Franklin KA, Marklund M. Mandibular tori size is related to obstructive sleep apnea and treatment success with an oral appliance. Sleep Breath 2014;18:431-8
70. Ng AT, Darendeliler MA, Petocz P, et al. Cephalometry and prediction of oral appliance treatment outcome. Sleep Breath 2012;16:47-58
71. Lee CH, Kim JW, Lee HJ, et al. Determinants of treatment outcome after use of the mandibular advancement device in patients with obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 2010;136:677-81
72. Mitchell LJ, Davidson ZE, Bonham M, et al. Weight loss from lifestyle interventions and severity of sleep apnoea: A systematic review and meta-analysis. Sleep Med 2014;15:1173-83
73. Thomasouli MA, Brady EM, Davies MJ, et al. The impact of diet and lifestyle management strategies for obstructive sleep apnoea in adults: A systematic review and meta-analysis of randomised controlled trials. Sleep Breath 2013;17:925-35
74. Tuomilehto HP, Seppa JM, Partinen MM, et al. Lifestyle intervention with weight reduction: first-line treatment in mild obstructive sleep apnea. Am J Respir Crit Care Med 2009;179:320-7
75. Sarkhosh K, Switzer NJ, El-Hadi M, et al. The impact of bariatric surgery on obstructive sleep apnea: A systematic review. Obes Surg 2013;23:414-23
76. Foster GD, Borradaile KE, Sanders MH, et al. A randomized study on the effect of weight loss on obstructive sleep apnea among obese patients with type 2 diabetes: the Sleep AHEAD study. Arch Intern Med 2009;169:1619-26
77. Kuna ST, Reboussin DM, Borradaile KE, et al. Long-term effect of weight loss on obstructive sleep apnea severity in obese patients with type 2 diabetes. Sleep 2013;36:641-649A
78. Gilardini L, Lombardi C, Redaelli G, et al. Glucose tolerance and weight loss in obese women with obstructive sleep apnea. PLoS One 2013;8:e61382
79. Guilleminault C, Kirisoglu C, Poyares D, et al. Upper airway resistance syndrome: A long-term outcome study. J Psychiatr Res 2006;40:273-9
80. Salpeter S. Mortality associated with hormone replacement therapy in younger and older women. J Gen Intern Med 2006;21:401
81. Young T, Finn L, Austin D, et al. Menopausal status and sleep-disordered breathing in the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med 2003;167:1181-5