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Differences between men and women with moderate -serenobstrictive sleep apnea-hypopnea syndrome (Master thesis)

Κακάβας, Σωτήριος/ Kakavas, Sotirios/ Ιατρική του Ύπνου

Obstructive sleep apnea-hypopnea syndrome (OSAHS) exhibits differences between men and women regarding prevalence, symptomatology, polysomnographic parameters, and treatment. The aim of this study is to evaluate gender-related differences in clinical presentation, polysomnographic findings, and adherence to continuous positive airway pressure (CPAP) therapy among patients with moderate to severe OSAHS. The study included 861 newly diagnosed patients with moderate to severe OSAHS. During their initial visit to the sleep clinic, a comprehensive medical history was recorded, followed by physical examination and anthropometric measurements. All participants were diagnosed with moderate to severe OSAHS via overnight polysomnography and were referred for CPAP therapy. During follow-up, adherence to and effectiveness of CPAP therapy were assessed, along with genderbased differencesAccording to the study findings, male patients reported greater daytime sleepiness and were characterized by more severe sleep-disordered breathing. In contrast, female patients had higher body mass index (BMI). A distinct comorbidity profile was observed between the two sexes. Regarding sleep architecture, male participants exhibited a higher percentage of N2 sleep stage, while females had a higher proportion of N3 sleep stage. A strong positive correlation between the apneahypopnea index (AHI) and the oxygen desaturation index (ODI) was observed in both sexes. The severity of the syndrome was associated with anthropometric parameters in both groups. However, in males only, smoking status, neck circumference, and BMI were identified as independent predictors of OSAHS severity. The Epworth Sleepiness Scale (ESS) score was also found to be an independent predictor of severity in both men and women. CPAP therapy proved to be effective, with no significant differences in treatment outcomes between the sexes. In conclusion, this study revealed both common features and significant differences between men and women with moderate to severe OSAHS, supporting the existence of gender-specific clinical and functional profiles. A better nderstanding of these gender differences may facilitate gender-specific assessment for diagnosis, prognosis, and management of OSAHS, aiming toward a personalized therapeutic approach.