Sleep and Breathing

, Volume 22, Issue 1, pp 241–249 | Cite as

Gender differences in clinical and polysomnographic features of obstructive sleep apnea: a clinical study of 2827 patients

  • Ozen K. BasogluEmail author
  • Mehmet Sezai Tasbakan
Epidemiology • Original Article



Obstructive sleep apnea (OSA) is underdiagnosed in females due to different clinical presentation. We aimed to determine the effect of gender on clinical and polysomnographic features and identify predictors of OSA in women.


Differences in demographic, clinical, and polysomnographic parameters between 2052 male and 775 female OSA patients were compared.


In female OSA patients, age (56.1 ± 9.7 vs. 50.4 ± 11.6 years, p < 0.0001) and body mass index (36.3 ± 8.6 vs. 31.8 ± 5.9 kg/m2, p < 0.0001) were increased, whereas men had higher waist-to-hip ratio and neck circumference (p < 0.0001). Hypertension, diabetes mellitus, thyroid disease, and asthma were more common in females (p < 0.0001). Men reported more witnessed apnea (p < 0.0001), but nocturnal choking, morning headache, fatigue, insomnia symptoms, impaired memory, mood disturbance, reflux, nocturia, and enuresis were more frequent in women (p < 0.0001).

The indicators of OSA severity including apnea-hypopnea index (AHI) (p < 0.0001) and oxygen desaturation index (p = 0.007) were lower in women. REM AHI (p < 0.0001) was higher, and supine AHI (p < 0.0001) was lower in females. Besides, women had decreased total sleep time (p = 0.028) and sleep efficiency (p = 0.003) and increased sleep latency (p < 0.0001). In multivariate logistic regression analysis, increased REM AHI, N3 sleep, obesity, age, morning headache, and lower supine AHI were independently associated with female gender.


These data suggest that frequency and severity of sleep apnea is lower in female OSA patients, and they are presenting with female-specific symptoms and increased medical comorbidities. Therefore, female-specific questionnaires should be developed and used for preventing underdiagnosis of OSA.


Obstructive sleep apnea Gender Obesity Polysomnography Symptoms 



apnea-hypopnea index


body mass index


confidence interval


continuous positive airway pressure


Epworth sleepiness score


forced expiratory volume in one second


forced vital capacity


non-rapid eye movement


oxygen desaturation index


odds ratio


obstructive sleep apnea


arterial partial pressure of carbon dioxide


arterial partial pressure of oxygen


rapid eye movement


slow wave sleep


oxygen saturation



The authors thank sleep technicians Bahar Yoruk, Yakup Coskun, and Merve Ozdemir in the Sleep Disorders Laboratory, Department of Chest Diseases, Ege University School of Medicine, for their valuable help in gathering the data related to the health of the patients. The authors also thank Timur Kose from the Department of Biostatistics, Ege University School of Medicine, for statistical assistance.

Compliance with ethical standards


No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study, and no identifying information about participants was available in the article.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of Chest DiseasesEge University School of MedicineIzmirTurkey

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