ArticleSleep2020
Sex differences in obstructive sleep apnea phenotypes, the multi-ethnic study of atherosclerosis.
Article in Sleep, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
91 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Genome-wide association study of obstructive sleep apnoea in the Million Veteran Program uncovers genetic heterogeneity by sex.EBioMedicine · 2023Pooled it
- The norepinephrine reuptake inhibitor reboxetine alone reduces obstructive sleep apnea severity: a double-blind, placebo-controlled, randomized crossover trial.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Trial
- Physiological Traits and Adherence to Sleep Apnea Therapy in Individuals with Coronary Artery Disease.American journal of respiratory and critical care medicine · 2021Trial
- Sex Differences in Sleep Duration and Quality: Implications for Hypertension Risk.Current hypertension reports · 2026Review
- Sex differences in sleep architecture and nocturnal oxygenation across obstructive sleep apnea severity: an observational hospital-based study.Biology of sex differences · 2026Observational
- Association of Cumulative Smoking Exposure with REM Sleep Alterations in Obstructive Sleep Apnea: A Cross-Sectional Study Supported by Exhaled Carbon Monoxide Measurement.Journal of clinical medicine · 2026Article
- Associations of excessive sleepiness with sleep apnea physiological endo-phenotypes: the multi-ethnic study of atherosclerosis.Annals of the American Thoracic Society · 2026Article
- Obstructive Sleep Apnea and Arrhythmia: A Narrative Review of Arrhythmogenic Mechanisms.Diagnostics (Basel, Switzerland) · 2026Review
- Respiratory and oxygen saturation data for improved modelling and detection of obstructive sleep apnoea.Data in brief · 2026Article
- Sex-specific omics scores of sex hormones and associations with metabolic and sleep disorders.medRxiv : the preprint server for health sciences · 2026Article
- Advances in the Diagnosis and Treatment of Obstructive Sleep Apnea in Women.Pulmonary therapy · 2026Review
- Expert-level probabilistic breathing event detector informs phenotyping of sleep apnea.Nature communications · 2026Article
- Research priorities to improve classification of sleep-wake disorders.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Review
- Self-Reported Precipitating and Priming Factors for Somnambulism in Adult Sleepwalkers.Journal of sleep research · 2026Article
- Intermittent Hypoxia-Induced Inflammation and the Formation of Exhaled Volatile Organic Compound Profiles in Obstructive Sleep Apnea-Hypopnea Syndrome: A Narrative Review.Nature and science of sleep · 2026Review
- Sex, but Not Race, Influences OSA Diagnosis When Applying the 4% Versus 3% Hypopnea Scoring Rule.Journal of clinical medicine · 2025Article
- Article
- A semi-empirical Bayes approach for calibrating weak instrumental bias in sex-specific Mendelian randomization studies.American journal of human genetics · 2025Article
- Research Priorities for Translating Endophenotyping of Adult Obstructive Sleep Apnea to the Clinic: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2025Article
- Obstructive Sleep Apnea Syndrome in women: gender in sleep respiratory medicine is a first step towards personalized medicine.Sleep & breathing = Schlaf & Atmung · 2025Review
31 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
STUDY
objectivesThe bases for sex disparities in obstructive sleep apnea (OSA), is poorly understood. We quantified the influences of event definitions, sleep-state, and body position on apnea-hypopnea indices (AHIs) in men and women, and evaluated sex differences in pathophysiological endotypes.
methodsPolysomnography (PSG) data were analyzed from 2057 participants from the multi-ethnic study of atherosclerosis. Alternative AHIs were compared using various desaturation and arousal criteria. Endotypes (loop gain, airway collapsibility, arousal threshold) were derived using breath-by-breath analysis of PSG signals. Regression models estimated the extent to which endotypes explained sex differences in AHI.
resultsThe sample (mean 68.5 ± 9.2 years) included 54% women. OSA (AHI4P ≥15/h, defined by events with ≥4% desaturations) was found in 41.1% men and 21.8% women. Compared to AHI4P, male/female AHI ratios decreased by 5%-10% when using 3%-desaturation and/or arousal criteria; p < 0.05. REM-OSA (REM-AHI ≥15/h) was similar in men and women regardless of event desaturation criteria. REM-AHI4P ≥15/h was observed in 57% of men and women each. In NREM, AHI4P in men was 2.49 (CI95: 2.25, 2.76) of that in women. Women demonstrated lower loop gain, less airway collapsibility, and lower arousal threshold in NREM (ps < 0.0005). Endotypes explained 30% of the relative sex differences in NREM-AHI4P.
conclusionsThere are significant sex differences in NREM-AHI levels and in physiological endotypes. Physiological endotypes explained a significant portion of the relative sex differences in NREM-AHI. Definitions that use 4%-desaturation criteria under-estimate AHI in women. Combining NREM and REM events obscures OSA prevalence in REM in women.
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Registered trials
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