Upper airway sleep-disordered breathing in women

Ann Intern Med. 1995 Apr 1;122(7):493-501. doi: 10.7326/0003-4819-122-7-199504010-00003.


Objective: To investigate the various clinical presentations of sleep-disordered breathing in women.

Design: A retrospective case-control study.

Setting: A sleep disorders clinic.

Patients: 334 women, aged 18 years and older, seen between 1988 and 1993, who were diagnosed with upper airway sleep-disordered breathing. Controls were 60 women with insomnia and 100 men with sleep-disordered breathing.

Measurements: Clinical, anatomic, and polygraphic information.

Results: The mean lag time (+/- SD) in women between the appearance of symptoms and a positive diagnosis was 9.7 +/- 3.1 years; among participants 30 to 60 years of age, the duration of untreated symptoms differed (P < 0.001) between women and men. Sleep-disordered breathing was blamed for divorce or social isolation by 40% of the case patients. Abnormal maxillomandibular features were noted in 45% of the women with disordered breathing. Dysmenorrhea and amenorrhea (which disappeared after treatment with nasal continuous positive airway pressure) were reported in 43% of premenopausal women compared with 13% of persons in the control group of women with insomnia. Thirty-eight women (11.4%) with upper airway sleep-disordered breathing had a respiratory disturbance index of less than 5 and were significantly younger, had a smaller neck circumference, and had a lower body mass index than women with a respiratory disturbance index of 5 or more.

Conclusion: Physicians should revise their understanding of upper airway sleep-disordered breathing so that they notice women with certain craniofacial features, a low body mass index, a small neck circumference, and a respiratory disturbance index of less than 5. These revisions may enable more rapid diagnosis and treatment of women with sleep-disordered breathing.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Analysis of Variance
  • Body Mass Index
  • Case-Control Studies
  • Fatigue / etiology
  • Female
  • Humans
  • Linear Models
  • Male
  • Menopause
  • Menstruation Disturbances / etiology
  • Middle Aged
  • Oropharynx / anatomy & histology
  • Positive-Pressure Respiration
  • Retrospective Studies
  • Sleep Apnea Syndromes / diagnosis*
  • Sleep Apnea Syndromes / physiopathology
  • Sleep Apnea Syndromes / psychology
  • Sleep Apnea Syndromes / therapy