BODY-FAT DISTRIBUTION AND SLEEP-APNEA SEVERITY IN WOMEN

The contribution of body fat distribution to sleep-disordered breathin g in women has not been examined in detail (to our knowledge). Fifty w omen under 65 years of age were diagnosed as having obstructive sleep apnea (OSA) by all-night polysomnography in a 6-month period. Twenty-f ive women under-went body fat measurements of skin folds and circumfer ences. The 12 premenopausal and 13 postmenopausal women did not differ in regard to apnea hypopnea index (AHI), SaO(2) nadir, body mass inde x (BMI), or anthropometric measurements. The AHI for these 25 patients was related to the severity of obesity assessed by triceps and subsca pular skin folds, the sum of the skin folds, waist circumference, and BMI. The SaO(2) nadir correlated with triceps and subscapular skin fol ds, the sum of the skin folds, and neck skin fold. Clinical features o f this same group of 25 women were then compared with those of 45 men with OSA previously described by our laboratory. The women, despite si milar age, had less severe OSA than the men (AHI of 34.4 +/- 5.4 vs 51 .1 +/- 4.9, p < 0.05). Despite similar BMIs and waist circumference, t he men had evidence of a greater degree of upper body obesity with a l arger subscapular skin fold thickness, waist-hip ratio, and neck circu mference, In addition, for a given degree of upper-body obesity, men h ad more severe sleep apnea, These findings may explain, at least in pa rt, the greater severity of OSA in the men.