Obstructive Sleep Apnea in Women

Obstructive sleep apnea (OSA) is a common disease with a large public health burden. Due to several anatomical and physiological differences, OSA has traditionally thought to be much less common in women than in men. These differences include variations in craniofacial anatomy, sex hormone differences, greater peripheral fat distribution, as well as women having shorter and less collapsible airways and less respiratory drive instability. However the recruitment bias from clinical samples in early studies has fostered this sex difference to an exaggerated degree. One large community-based sample of adults aged 21–80 indicated a point prevalence of OSA with clinically significant sleepiness of 3–7% in males and 2–5% of females. Another much larger worldwide community study indicated a lifetime prevalence of OSA of 27.3% in men and 22.5% in women in a narrower population aged 30–69. Both studies show an approximate 1:5–1 ratio which is much lower than that of previous studies showing a ratio of 9 or 10:1. In pediatric and elderly populations, the male to female prevalence ratio is close to equal.