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