Gender differences in sleep apnea: a study of the catalan population

To analyse sex differences in the distribution and comorbidity profile of adults with diagnosed obstructive sleep apnoea (OSA) and no prior cardiovascular disease, stratified by body mass index (BMI). We conducted a retrospective cross-sectional study of 3886 adults with diagnosed OSA. Data were obtained from the SIDIAP database and included individuals with OSA recorded between 1 January 2009 and 31 December 2016 and no previous cardiovascular disease. Analyses were stratified by sex. Variables included age, socioeconomic deprivation (MEDEA index), BMI, smoking, alcohol consumption, cardiometabolic comorbidities, and cardiovascular risk estimated with the REGICOR function. Chi-square tests were used to compare variables by sex and across BMI categories within each sex. Of the 3886 individuals included, 28.8% were women. Most participants were older than 40 years (92.6%). Men had higher proportions of alcohol consumption, smoking, hypertriglyceridaemia, hyperuricaemia, and less favourable REGICOR cardiovascular risk categories. Women showed higher proportions of hypertension, diabetes mellitus, and HbA1c ≥ 6.5%. Among those with available BMI data, women were more frequently represented in the highest BMI category, whereas men were more often represented in the lowest BMI category. Relevant sex-related differences were observed in the clinical profile, comorbidities, cardiometabolic risk factors, and health behaviours of adults with diagnosed OSA. These findings support the need for sex-sensitive approaches to the diagnosis and management of OSA, particularly to improve identification and care in women.