Christian Guilleminault, MD; Riccardo Stoohs, MD; Young-do Kim, MD; Ronald Chervin, MD; Jed Black, MD; Alex Clerk, MD
To investigate the various clinical presentations of sleep-disordered breathing in women.
A retrospective case–control study.
A sleep disorders clinic.
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.
Clinical, anatomic, and polygraphic information.
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.
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.
Guilleminault C, Stoohs R, Kim Y, Chervin R, Black J, Clerk A. Upper Airway Sleep-Disordered Breathing in Women. Ann Intern Med. ;122:493–501. doi: 10.7326/0003-4819-122-7-199504010-00003
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Published: Ann Intern Med. 1995;122(7):493-501.
Pulmonary/Critical Care, Sleep Disorders.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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