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Influence of Gender on Associations of Obstructive Sleep Apnea Symptoms with Chronic Conditions and Quality of Life

Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville 5011 SA, Australia
Adelaide Medical School, University of Adelaide, Adelaide 5005 SA, Australia
Adelaide Institute for Sleep Health, A Flinders Centre of Excellence, College of Medicine & Public Health, Flinders University, Bedford Park 5042 SA, Australia
Rheumatology Unit, The Queen Elizabeth Hospital, Woodville 5011 SA, Australia
The Appleton Institute, CQUniversity Australia, 44 Greenhill Rd, Wayville SA 5034, Australia
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(5), 930;
Received: 20 March 2018 / Revised: 26 April 2018 / Accepted: 3 May 2018 / Published: 7 May 2018
(This article belongs to the Collection Health Behavior and Public Health)
PDF [507 KB, uploaded 7 May 2018]


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. View Full-Text
Keywords: obstructive sleep apnea; epidemiology; gender; health status; quality of life obstructive sleep apnea; epidemiology; gender; health status; quality of life

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Appleton, S.; Gill, T.; Taylor, A.; McEvoy, D.; Shi, Z.; Hill, C.; Reynolds, A.; Adams, R. Influence of Gender on Associations of Obstructive Sleep Apnea Symptoms with Chronic Conditions and Quality of Life. Int. J. Environ. Res. Public Health 2018, 15, 930.

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