Chest ACCP Education Calendar
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via ISI Web of Science (17)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Dancey, D. R.
Right arrow Articles by Hoffstein, V.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Dancey, D. R.
Right arrow Articles by Hoffstein, V.
(Chest. 2003;123:1544-1550.)
© 2003 American College of Chest Physicians

Gender Differences in Sleep Apnea*

The Role of Neck Circumference

David R. Dancey, MD; Patrick J. Hanly, MD; Christine Soong, BSc; Bert Lee, BSc; John Shepard, Jr, MD, FCCP and Victor Hoffstein, PhD, MD, FCCP

* From the Department of Medicine (Drs. Dancey, Hanly, and Hoffstein, Ms. Soong, and Mr. Lee), St. Michael’s Hospital, University of Toronto, Canada; and Mayo Sleep Disorders Center (Dr. Shepard), Mayo Clinic, Rochester, MN.

Correspondence to: Victor Hoffstein, PhD, MD, FCCP, St. Michael’s Hospital, 30 Bond St, Suite 6-015, Toronto, ON, Canada, M5B 1W8; e-mail: victor.hoffstein{at}utoronto.ca

Study objectives: To determine whether differences in sleep apnea severity between men and women referred to a sleep clinic are related to the differences in neck circumference (NC).

Study Design: Case series.

Setting: University hospital sleep disorders clinic.

Participants: A total of 3,942 patients (2,753 men and 1,189 women) referred to the sleep clinic.

Measurements and results: All patients underwent nocturnal polysomnography. NC was used as a surrogate measure of upper airway obesity. We found that sleep apnea, defined an the apnea/hypopnea index (AHI) > 10/h, was significantly more frequent (60% vs 32%, {chi}2 < 0.0001) and severe (mean ± SE, 25 ± 26/h vs 12 ± 19/h, p < 0.0001) in men than in women. Men had significantly larger NC than women, but the difference became much less pronounced when we normalized NC to body height (0.24 ± 0.02 vs 0.23 ± 0.03, p < 0.0001). Men had significantly higher AHI than women even after controlling for age, body mass index (BMI), and neck/height ratio (NHR); analysis of covariance showed that mean AHI was 24.4 ± 0.4 in men vs 14.8 ± 0.7 in women (p < 0.0001). This difference persisted even when we matched men and women for NHR and BMI. Finally, multiple regression analysis revealed the following: (1) NHR was the most significant predictor of AHI, accounting for 19% of the variability; and (2) the slope of AHI vs NHR was significantly higher in men than in women.

Conclusions: We conclude the following: (1) the frequency and severity of sleep apnea in the sleep clinic population is greater in men than women, and (2) factors other than NC, age, and BMI must contribute to these gender differences.

Key Words: gender • neck circumference • sleep apnea






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2003 by the American College of Chest Physicians.