Influence of gender on associations of obstructive sleep apnea symptoms with chronic conditions and quality of life

Sarah Appleton, Tiffany Gill, Anne Taylor, Douglas McEvoy, Zumin Shi, Catherine Hill, Amy Reynolds, Robert Adams

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    Women are less likely than men to be diagnosed with obstructive sleep apnea (OSA). We examined contemporary gender differences in symptoms, health status, and quality of life associated with diagnosed OSA and OSA symptoms in a population-based sample. A 2015 postal/on-line questionnaire of 2889 active participants of The North West Adelaide Health Study (response rate = 54%, male n = 704; female n = 856; age 30–100 years) assessed previously diagnosed OSA, OSA symptoms, insomnia, doctor-diagnosed medical conditions, and the SF-36. In weighted analyses, self-reported diagnosed OSA (men: 12.6%, n = 95; women: 3.3%, n = 27) and OSA symptoms (men: 17.1%; women: 9.7%) were more common in men. Diagnosed OSA showed stronger adjusted associations with typical OSA features in women, including obesity (women-odds ratio (OR), 95% CI: 5.7, 1.9–17.1, men: 2.2, 1.2–4.0), daytime sleepiness (women: 6.4, 2.7–15.6, men: 3.3, 2.1–5.4), and loud snoring (women: 25.4, 9.4–69.1, men: 8.7, 5.2–14.4). Diagnosed OSA was independently associated with cardiovascular disease (CVD) in men, and in women with high cholesterol, respiratory disease, insomnia, and reduced SF-36 Physical Component Summary score. In both sexes, OSA symptoms were significantly associated with depression, insomnia, and moderate to severe impairments in SF-36 physical and mental component summary scores. Diagnosed women showed clinical characteristics overtly related to OSA. A higher index of clinical suspicion of OSA may be required in women for a condition regarded as male-predominant to increase equity in health outcomes.

    Original languageEnglish
    Article number0930
    Pages (from-to)1-12
    Number of pages12
    JournalInternational Journal of Environmental Research and Public Health
    Issue number5
    Publication statusPublished - 7 May 2018

    Bibliographical note

    Open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (


    • obstructive sleep apnea
    • epidemiology
    • gender
    • quality of life
    • health status
    • Health status
    • Gender
    • Epidemiology
    • Obstructive sleep apnea
    • Quality of life


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