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Obstructive sleep apnea is a under-recognised systemic disorders affecting sleep and work performance. It is a independent risk factor for hypertension, diabetes mellitus, psychiatric disorder, myocardial infacrtion, cerebrovascular accidents, pulmonary hypertension, RTA. Gender differences exist in clinical profile and polysomnographic profile. Objective: To study gender differences in polysomnographic profile of patients with obstructive sleep apnea. Methodology: This study was conducted at Polysomnography laboratory at Dr S.C.G.M.C Nanded. We examined the influence of gender on the polysomnographic features of obstructive sleep apnea (OSA) in a study of 80 patients with OSA diagnosed by overnight polysomnography (PSG). The severity of OSA was determined from the apnea– hypopnea index (AHI) for total sleep time (AHITST). Differences in OSA during different stages of sleep were assessed by comparing the AHI during non-rapid eye movement (NREM) (AHINREM) and rapid eye movement (REM) (AHIREM) sleep and calculating the “REM difference” (AHIREM− AHINREM). Additionally, each overnight polysomnographic study was classified as showing one of three mutually exclusive types of OSA: (1) mild OSA, which occurred predominantly during REM sleep (REM OSA); (2) OSA of any severity, which occurred predominantly in the supine position (S OSA); or (3) OSA without a predominance in a single sleep stage or body position (A OSA). Results: Polysomnographic profiles of male and female patients with Sleep Disordered Breathing was different. The mean AHITST for male was significantly higher than that for female (31.8 versus 20.2;p<0.05).Female had a lower AHINREM than did male (7.2 versus 16.72;p<0.05), but had a similar AHIREM (14.6 versus 16.17). Female had a significantly higher REM difference than did males (7.3 versus 4.8;p<0.05),While on the other hand male had a significantly higher positional difference ( AHISUP-AHINONSUP) than male patients ( 19.50 versus 8.02;p<0.05).Mean Lowest Nocturnal Saturation(LNS) was significantly much lower in males. REM- Obstructive Sleep Apnea occurred in 60% of female and 20% of male patients with Obstructive Sleep Apnea. SUPINE- Obstructive Sleep Apnea was significantly more common in male patients with Obstructive Sleep Apnea(28%) than female patients with Obstructive Sleep Apnea(8%). Conclusion: We conclude that: (1) OSA is less severe in women because of milder OSA during NREM sleep; (2) women have a greater clustering of respiratory events during REM sleep than do men; (3) REM OSA is disproportionately more common in women than in men; and (4 ) S OSA is disproportionately more common in men than in women.

Keyword: Polysomnography, REM, NREM, OSA.





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