The gender bias in sleep apnea diagnosis. Are women missed because they have different symptoms?
The gender bias in sleep apnea diagnosis. Are women missed because they have different symptoms?
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DOI：
10.1001/archinte.1996.00440200055007
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发表时间：
1996
影响因子：
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通讯作者：
T. Young;R. Hutton;L. Finn;S. Badr;M. Palta
中科院分区：
文献类型：
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作者：
T. Young;R. Hutton;L. Finn;S. Badr;M. Palta
基于人群的背景研究表明，相对于男性，女性的睡眠呼吸暂停不足。这种性别偏见的一个假设是，由于临床指南评估和诊断，主要建立在男性上的临床指南，因此遗漏了睡眠呼吸暂停的女性，这对女性无效。在这项调查中，威斯康星州睡眠队列研究的数据是对睡眠呼吸暂停自然史的一项基于社区的研究，用于确定患有睡眠呼吸暂停的妇女是否具有独特的症状或投诉。方法该样本包括551名男性和388名女性，曾经没有被诊断为睡眠呼吸暂停。通过访谈和调查获得有关典型睡眠呼吸暂停症状和其他因素的数据。睡眠呼吸暂停状态是根据在整个夜晚的多夜间多摄影记录的睡眠期间的呼吸暂停和肾上腺异常事件的频率确定的。计算了每种症状或睡眠呼吸暂停因子在不同严重程度下的灵敏度和相对预测能力，并通过性别进行了比较。结果不管严重程度如何，患有睡眠呼吸暂停的女性没有报告与睡眠呼吸暂停相同的男性的症状明显不同。对于男人和女人来说，打s是睡眠呼吸暂停最敏感，最强的预测指标。结论当前的睡眠呼吸暂停评估临床适应症与男性一样适合女性。睡眠呼吸暂停诊断中性别差异的其他原因，包括应提出医疗保健提供者无视女性典型症状的可能性。
BACKGROUND Population-based studies have shown that sleep apnea is underdiagnosed in women, relative to men. One hypothesis for this gender bias is that women with sleep apnea are missed because clinical guidelines for the evaluation and diagnosis of sleep apnea, established primarily on men, are not valid for women. In this investigation, data from the Wisconsin Sleep Cohort Study, a community-based study of the natural history of sleep apnea, were used to determine whether women with sleep apnea have unique symptoms or complaints. METHODS The sample comprised 551 men and 388 women, none of whom had ever been given a diagnosis of sleep apnea. Data on typical sleep apnea symptoms and other factors were obtained by interview and survey. Sleep apnea status was determined from the frequency of apneic and hypopneic events during sleep as recorded by in-laboratory, whole-night polysomnography. The sensitivity and relative predictive power of each symptom or factor for sleep apnea at different severity levels were calculated and compared by gender. RESULTS Regardless of severity level, women with sleep apnea did not report symptoms that differed significantly from those of men with the same level of sleep apnea. For men and women, snoring was the most sensitive and strongest predictor of sleep apnea. CONCLUSIONS Current clinical indications for sleep apnea evaluation are as appropriate for women as they are for men. Other reasons for the gender disparity in sleep apnea diagnosis, including the possibility that health care providers disregard typical symptoms in women, should be pursued.