Gender Differences in Obstructive Sleep Apnea Treatment: A Retrospective Analysis
Smith, Michael PhD
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Introduction: Obstructive Sleep Apnea (OSA) affects four times as many men as women in the United States. However, nearly 5 million women have documented OSA, and there are likely many more due to historically high rates of OSA under-diagnosis. As a result of this documented gender difference, OSA treatment providers may not be sensitive to accommodate female patients undergoing positive airway pressure (PAP) therapy, which is the gold standard for OSA treatment and is notoriously obtrusive and uncomfortable. We hypothesized in a retrospective analysis of OSA patient records that (1) PAP treatment is less effective in women vs. men and (2) that women have lower compliance rates to PAP treatment than men. Methods: The University of North Texas Health Science Center Institutional Review Board approved this study. We studied the records of 619 patients (43% women, 57% men). Diagnosis of OSA was established by full night polysomnography (PSG) according to American Academy of Sleep Medicine (AASM) criteria. For this study, only patients prescribed for PAP machines that provide usage data, estimated apnea-hypopnea indices (AHIs), air leakage rates, recent detailed night-to-night data, and (if automated) mean and range of treatment pressures were considered. PAP data was downloaded from each patient’s machine during their office visit (see below) and was transferred into a database. Chi-square analysis assessed for gender differences in YFU vs. OFU treatment groups. Results: In comparing men and women and effectiveness of PAP treatment, there was a greater reduction in respiratory events in men than in women (P=0.037). Men initially had a greater number of baseline events, (P= Conclusions: The results indicate that PAP usage is substantially less in women compared to men, both in terms of 5 of sleep time and days/week, and women receive slightly less benefit from PAP use versus men. Furthermore, We contend that because women use PAP treatment less than men, they are more likely to receive inadequate treatment for their OSA.