Prevalence of sleep-disordered breathing in women - Effects of gender

The prevalence of sleep-disordered breathing has not been well studied in w omen, especially in terms of the effects of age, body mass index (BMI), and menopause. We evaluated this question using a two-phase random sample from the general population. In Phase I, 12,219 women and 4,364 men ranging in age from 20 to 100 yr were interviewed; and in Phase II, 1,000 women and 74 1 men of the Phase I subjects were selected for one night of sleep laborato ry evaluation. The results of our study indicated that, for clinically defi ned sleep apnea (apnea/hypopnea index greater than or equal to 10 and dayti me symptoms), men had a prevalence of 3.9% and women 1.2% resulting in an o verall ratio of sleep apnea for men to women of 3.3:1 (p = 0.0006). The pre valence of steep apnea was quite low in premenopausal women (0.6%) as well as postmenopausal women with hormone replacement therapy (HRT) (0.5%). Furt her, in these women the presence of sleep apnea appeared to be associated e xclusively with obesity(BMI greater than or equal to 32.3 kg/m(2)). Postmen opausal women without HRT had a prevalence of sleep apnea that was signific antly higher than the prevalence in premenopausal women with HRT (2.7 versu s 0.6% p = 0.02) and was more similar to the prevalence in men (3.9%), alth ough it remained significantly less when controlling for age and BMI (p = 0 .001). These data combined indicate that menopause is a significant risk fa ctor for sleep apnea in women and that hormone replacement appears to be as sociated with reduced risk.