OSA: cardiovascular consequences worse for women

  • Kendzerska T & al.
  • Sleep Med
  • 11 Sep 2019

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Women with obstructive sleep apnea (OSA) are more likely than men to experience a cardiovascular composite outcome (all-cause mortality or hospitalization from a cardiac event).

Why this matters

  • Women with sleep risk factors identified here may warrant more frequent cardiac monitoring.

Study design

  • A historical cohort of 10,149 patients with OSA (1994-2010), 38% of whom were women.
  • Primary outcome was a composite cardiovascular event leading to death or hospitalization (myocardial infarction, stroke, heart failure, or atrial fibrillation) controlling for cardiac risk factors.
  • Funding: Ontario Ministry of Health and Long-term Care.

Key results

  • Over a median follow-up of 9.3 years, women with OSA were more likely than men to experience the primary outcome:
    • Women: aHR for interquartile range (IQR), 1.30 (1.19-1.42).
    • Men: aHR for IQR, 1.13 (1.06-1.21; P for interaction=.01).
  • Risk factors for primary outcome:
    • No difference in outcome between men and women for oxygen desaturations and heart rate in sleep.
    • Primary outcome was more likely (HRs; 95% CIs) in women (vs men) with presence of:
      • Daytime sleepiness (via Epworth Sleepiness Score): 1.23 (1.07-1.42).
      • Poor sleep efficiency: 1.16 (1.02-1.31).
      • Periodic leg movements in sleep: 1.18 (1.00-1.41).

Limitations

  • Retrospective observational design.
  • Single-center study.
  • Composite outcome may be overly broad.