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Gender differences in the application of anthropometric measures for evaluation of obstructive sleep apnea.

ABSTRACT: This study aims to investigate anthropometric measures and their effectiveness as screening method for diagnosing obstructive sleep apnea (OSA) in each gender. We also evaluated which measures were associated with OSA in the adult population of a large metropolitan city, Sao Paulo, Brazil. 552 women and 450 men were submitted to polysomnography (PSG), and the anthropometric measurements as body mass index (BMI), waist-to-height ratio, neck and waist circumference were collected. The measurements were then compared with the OSA classification established by the PSG. In women, waist circumference and waist-to-height ratio were found to be the best predictor, while in men, the factors with great potential for identification varied according to severity of the disease, highlighting waist-to-height ratio, neck circumference and BMI had strongest association. The accuracy of the classification in relation to mild-to-severe OSA based on cut-off values of 92.5cm for waist circumference was greater than 72.9% in men, and 78.9% in women based on cut off values of 95cm. Regarding severe OSA, cut-off values of 116.1cm were greater than 91.3% accurate in the male population, and 95.1% in the female population with a cut-off value of 126.5cm. The study found waist circumference and waist-to-height ratio to be the best measure to assess sleep-disordered breathing in women. Waist-to-height ratio and neck circumferences were the best measures in men with mild OSA, but BMI was more closely associated with severe OSA. The present study identified the anthropometric variables with the highest risk for OSA and their respective cutoff value, according to gender.

SUBMITTER: Polesel DN

PROVIDER: S-EPMC6508944 | biostudies-literature | 2019 Jan-Feb

REPOSITORIES: biostudies-literature

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Gender differences in the application of anthropometric measures for evaluation of obstructive sleep apnea.

Polesel Daniel Ninello DN Nozoe Karen Tieme KT Tufik Sergio Brasil SB Bezerra Andreia Gomes AG Fernandes Maria Teresa Bechere MTB Bittencourt Lia L Tufik Sergio S Andersen Monica Levy ML Hachul Helena H

Sleep science (Sao Paulo, Brazil) 20190101 1

This study aims to investigate anthropometric measures and their effectiveness as screening method for diagnosing obstructive sleep apnea (OSA) in each gender. We also evaluated which measures were associated with OSA in the adult population of a large metropolitan city, Sao Paulo, Brazil. 552 women and 450 men were submitted to polysomnography (PSG), and the anthropometric measurements as body mass index (BMI), waist-to-height ratio, neck and waist circumference were collected. The measurements ...[more]

PMID: 31105888

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Project description:ImportanceHypoglossal nerve stimulation is a treatment option for patients with obstructive sleep apnea unable to tolerate continuous positive airway pressure. This study evaluates demographic factors that may be associated with greater improvements in postoperative outcomes of interest.ObjectiveTo examine the association of hypoglossal nerve stimulation with obstructive sleep apnea severity, daytime sleepiness, and sleep-related quality of life.Design, setting, and participantsPatient-level data were pooled from 3 prospective cohorts and 1 retrospective observational cohort comprising 584 adults with moderate to severe obstructive sleep apnea unable to tolerate or benefit from continuous positive airway pressure. The data were gathered from the Stimulation Therapy for Apnea Reduction Trial; a postmarket approval study conducted in Germany; the multicenter, international Adherence and Outcome of Upper Airway Stimulation for OSA Registry; and a retrospective cohort study from 2 sites in the United States.ExposureHypoglossal nerve stimulation.Main outcomes and measuresSeverity of obstructive sleep apnea was the primary outcome. The apnea-hypopnea index (AHI) (<5, normal; 5-15, mild; 15-30, moderate, and >30, severe) and Epworth Sleepiness Scale (range, 0-24; score >10 indicates pathologic sleepiness) outcomes were available at 2 to 6 months from 2 cohorts (n = 398), at 12 months from 1 cohort (n = 126), and at both times from 1 cohort (n = 60). Sleep-related quality of life and oxygen saturation nadir data were collected where available. Linear mixed-effects models were constructed to examine associations between clinical variables and reported postoperative outcomes at 6 and 12 months with study included as a random effect.ResultsOf the 584 patients included in the study, 472 were men (80.8%); mean (SD) age was 58.5 (11.0) years. Greater improvement in the postoperative AHI was associated with a higher preoperative AHI (-0.74 events/h; 95% CI, -0.82 to -0.67), older patient age (-0.10 events/h; 95% CI, -0.20 to -0.00), and lower body mass index (0.52; 95% CI, 0.22-0.83). After adjusting for these variables and considering all patients in the analysis, the AHI was statistically higher at 12 months than at 6 months (3.24 events/h; 95% CI, 1.67-4.82 events/h).Conclusions and relevanceHypoglossal nerve stimulation demonstrated clinically significant improvements in obstructive sleep apnea severity, daytime sleepiness, and sleep-related quality of life in this pooled cohort of patient-level results. Age, body mass index, and preoperative AHI appeared to be associated with treatment outcomes, and these variables may explain some of the difference between 2- to 6-month and 12-month outcomes.

Dataset Information

Gender differences in the application of anthropometric measures for evaluation of obstructive sleep apnea.

Publications

Gender differences in the application of anthropometric measures for evaluation of obstructive sleep apnea.

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