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Review
. 2024 Nov 1;30(6):593-599.
doi: 10.1097/MCP.0000000000001116. Epub 2024 Aug 26.

Sex differences in sleep and sleep-disordered breathing

Esther I Schwarz  1   2 , Sophia Schiza  3
Affiliations
Review

Sex differences in sleep and sleep-disordered breathing

Esther I Schwarz et al. Curr Opin Pulm Med. .

Abstract

Purpose of review: There is increasing evidence for relevant sex differences in pathophysiology, symptom presentation and outcomes in obstructive sleep apnoea (OSA). However, research on sex differences and sex-specific phenotypes in sleep-disordered breathing (SDB) is still in its infancy and data on sex differences in other SDB is still very scarce.

Recent findings: While OSA is more common in men than in premenopausal women, the prevalence of OSA doubles postmenopausally and becomes comparable to that of men. Women have a lower collapsibility of the upper airway and a lower arousal threshold. In addition, the rapid eye movement (REM)-apnoea-hypopnoea index (AHI) is typically higher in women than in men, but the non-REM-AHI and thus the total AHI is often lower. Women are often symptomatic at lower AHI and present more frequently with symptoms of sleep fragmentation and poor sleep quality. Both certain forms of OSA (e.g. REM-OSA) and certain phenotypes (e.g. COMISA) are more common in women. Men have a higher risk of high loop gain central sleep apnoea.

Summary: For a better understanding of sex-typical phenotypes with the aim of a more targeted treatment approach of SDB, adequately powered studies on sex differences in SDB should be conducted.

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Conflict of interest statement

There are no conflicts of interest.

Figures

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Box 1
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FIGURE 1
FIGURE 1
Overview on endotypic traits and sleep study characteristics in premenopausal women and in men and changes in women postmenopause.
See this image and copyright information in PMC

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References

    1. Redline S, Kirchner HL, Quan SF, et al. . The effects of age, sex, ethnicity, and sleep-disordered breathing on sleep architecture. Arch Intern Med 2004; 164:406–418. - PubMed
    1. Gaillard JM, Blois R. Spindle density in sleep of normal subjects. Sleep 1981; 4:385–391. - PubMed
    1. Vitiello MV, Larsen LH, Moe KE. Age-related sleep change: gender and estrogen effects on the subjective-objective sleep quality relationships of healthy, noncomplaining older men and women. J Psychosom Res 2004; 56:503–510. - PubMed
    1. Cain SW, Dennison CF, Zeitzer JM, et al. . Sex differences in phase angle of entrainment and melatonin amplitude in humans. J Biol Rhythms 2010; 25:288–296. - PMC - PubMed
    1. Zhang B, Wing YK. Sex differences in insomnia: a meta-analysis. Sleep 2006; 29:85–93. - PubMed