Abstract
Women with polycystic ovarian syndrome (PCOS) have been shown to have a very high prevalence of obstructive sleep apnea (OSA). Screening for OSA is recommended for PCOS patients. How far this is carried out in actual practice is unknown. To study practice patterns with regard to screening for OSA in physicians—both obstetrician/gynecologists (ObGyn) and endocrinologist—who manage PCOS. A secondary aim of this study was to identify practice differences, if any. Two hundred ObGyn and 140 endocrine academic institutions were contacted and mailed with questionnaires, if willing to participate. Responses were obtained from 50 (29.4%) ObGyn physicians and 29 (26.4%) endocrine physicians. The questionnaire was closed-ended. Physicians reported a high occurrence of obesity—36.7% of the physicians reported that 75–100% of their patients had morbid obesity. However, reported prevalence of symptoms was low—86.1% of the physicians felt their patients snored infrequently (<25% of the time) and 74.7% felt that their patients had excess daytime sleepiness (EDS) infrequently. Of the physicians, 92.4% ordered a sleep study <25% of the time. No significant difference in practice between the specialties was identified. Physicians who manage PCOS patients do not believe that these patients have significant symptoms nor warrant frequent testing for OSA. This may reflect lack of knowledge about the link or may imply that PCOS patients remain largely asymptomatic. Educating specialist physicians managing PCOS about OSA and improved tools for OSA screening may improve detection.
Similar content being viewed by others
References
Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep disordered breathing among middle-aged adults. N Engl J Med 328:1230–1235
Bixler EO, Vgontzas AN, Ten Have T, Tyson K, Kales A (1998) Effects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med 157(1):144–148
Bixler EO, Vgontzas AN, Lin HM, Ten Have T, Rein J, Vela-Bueno A, Kales A (2001) Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med 163(3 Pt 1):608–613
Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO (2004) The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 89:2745–2749
Farah L, Lazenby AJ, Boots LR, Azziz R (1999) Prevalence of polycystic ovary syndrome in women seeking treatment from community electrologists. Alabama Professional Electrology Association Study Group. J Reprod Med 44:870–874
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 81:19–25
Faloia E, Canibus P, Gatti C, Frezza F, Santangelo M, Garrapa GG et al (2004) Body composition, fat distribution and metabolic characteristics in lean and obese women with polycystic ovary syndrome. J Endocrinol Invest 27:424–429
Legro RS (2003) Polycystic ovary syndrome and cardiovascular disease: a premature association? Endocr Rev 24:302–312
Diamanti-Kandarakis E (2006) Insulin resistance in PCOS. Endocrine 30(1):13–17
Punjabi NM, Polotsky VY (2005) Disorders of glucose metabolism in sleep apnea. J Appl Physiol 99(5):1998–2007
Fogel RB, Malhotra A, Pillar G, Pittman SD, Dunaif A, White DP (2001) Increased prevalence of obstructive sleep apnea syndrome in obese women with polycystic ovary syndrome. J Clin Endocrinol Metab 86:1175–1180
Vgontzas AN, Legro R, Bixler EO, Grayev A, Kales A, Chrousos GP (2001) Polycystic ovary syndrome is associated with obstructive sleep apnea and daytime sleepiness: role of insulin resistance. J Clin Endocrinol Metab 86(2):517–520
Gopal M, Duntley S, Uhles M, Attarian H (2002) The role of obesity in the increased prevalence of obstructive sleep apnea syndrome in patients with polycystic ovarian syndrome. Sleep Med 3:401–404
Tasali E, Van Cauter E, Ehrmann DA (2006) Relationships between sleep disordered breathing and glucose metabolism in polycystic ovary syndrome. J Clin Endocrinol Metab 91(1):36–42
Ehrmann DA (2005) Polycystic ovary syndrome. N Engl J Med 352(12):1223–1236
Redline S, Kump K, Tishler PV, Browner I, Ferrette V (1994) Gender differences in sleep disordered breathing in a community-based sample. Am J Respir Crit Care Med 149:722–726
Young T, Evans L, Finn L, Palta M (1997) Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep 20:705–706
Cussons AJ, Stuckey BG, Walsh JP, Burke V, Norman RJ (2005) Polycystic ovarian syndrome: marked differences between endocrinologists and gynaecologists in diagnosis and management. Clin Endocrinol (Oxf) 62(3):289–292
Author information
Authors and Affiliations
Corresponding author
Appendix
Appendix
Survey on patients with polycystic ovarian syndrome
Rights and permissions
About this article
Cite this article
Subramanian, S., Desai, A., Joshipura, M. et al. Practice patterns of screening for sleep apnea in physicians treating PCOS patients. Sleep Breath 11, 233–237 (2007). https://doi.org/10.1007/s11325-007-0120-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11325-007-0120-3