Comorbidity and gender in patients with sleep apnea–hypopnea syndrome requiring performance of autocpap

Abstract

Introduction Beyond hormonal differences and physical characteristics, there is evidence in the literature that relates sleep apnea–hypopnea syndrome (SAHS) with other cardiovascular risk factors. It might be interesting to assess the patients predominant risk factors by gender. Objectives: To analyze the association between gender and comorbidities in SAHS patients, who are treated by nasal continuous positive airway pressure (CPAP) in our hospital and given an overnight home automatic cPAP. Materials and methods We collected the data of 245 patients diagnosed with sleep apnea-hypopnea syndrome with respiratory polygraphy and polysomnography in treatment with CPAP from June 2007 to October 2009. The pressure was adjusted at first according to a formula, performing subsequent titration by autoCPAP in cases in which there was no clinical improvement, tolerance and/or compliance issues. We analyzed the presence or absence of comorbidities (heart disease, hypertension, depression, COPD, DM, stroke and Obesity hypoventilation syndrome). The statistical test used was Mann Whitney. All tests were two tailed and considered significant with a value of p 0.05. Results Of a total of 256 patients analyzed, 199 were men (78%) and 57 women (22%). There were no significant differences among them in terms of apnea–hipoapnea index (AHI), both showing severe SAHS (median 36 vs. 34). When comparing the characteristics it was observed that more women had a higher body mass index (BMI) (median 34.5 vs 30.8). In both groups we observed an average of 5–6h of compliance. Pressure hrs approx 8–9h approx similarly with respect to the prior initial pressure and the obtained formula autoCPAP. When comparing men and women after adjustment with autoCPAP parameters was observed in both groups good tolerance and compliance of hours of use before, however no significant differences in clinical improvement ( p .03). Conclusion In our experience patients with lack of clinical improvement, poor tolerance and/ or poor compliance were more women older when diagnosed, probably related to a lower suspicion of this disease in women or presentation symptoms later in life. They also have a higher BMI, finding differences in other parameters analyzed. Acknowledgements to Eva Manas Baena and the Sleep Unit the Ramon y Cajal Hospital, Madrid.