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Objectives <p>To explore the clinical characteristics and sex differences in relevant indicators of obstructive sleep apnea syndrome (OSAS) in elderly patients.</p> Methods <p>A total of 1290 elderly patients diagnosed with OSAS by polysomnography (PSG) from 2015 to 2017 were consecutively collected from multiple medical institutions. Detailed demographic data, laboratory indicators, and sleep breathing parameters were recorded for each patient. All subjects were grouped according to sex, and the differences in each index between groups were statistically analyzed. Furthermore, analyses of the interaction between the influencing factors of nocturnal hypoxia were performed.</p> Results <p>The male to female ratio was 1.62:1 in all subjects. There was no significant difference in age between groups (65 years vs. 66 years). The men had a higher BMI than the women (26.7&#xa0;kg/m<sup>2</sup> vs. 25.8&#xa0;kg/m<sup>2</sup>), but the women had a slightly higher ratio of waistline to height (0.56 vs. 0.53). Hemoglobin, creatinine, and uric acid levels were higher in male patients (all <i>P</i> &lt; 0.001). The prevalence of hypertension was higher in both sexes, but it was greater in men (60.4% vs. 67.4%, <i>P</i> = 0.011). Male patients had a greater apnea-hypopnea index (AHI) (25.5 events/h vs. 30.9 events/h) and a longer apnea time (44&#xa0;s vs. 56&#xa0;s); nonetheless, the percent of total time with an oxygen saturation lower than 90% during sleep (T90) showed no significant difference between the two groups (3.9% vs. 3.6%, <i>P</i> &gt; 0.05). Furthermore, in men, hemoglobin attenuated the effect of apnea duration on the risk of more pronounced nocturnal hypoxemia (<i>P</i><sub>interaction</sub>=0.037). In the subgroup of patients ≥ 70 years, the AHI was consistent in both groups, but T90 was longer in women than in men (7.4% vs. 3.8%, <i>P</i> = 0.001).</p> Conclusions <p>The proportion of severe OSAS in elderly patients was high. It was more severe in men than in women, but women tended to have more pronounced nighttime hypoxia. Therefore, clinical attention should be paid to sex differences in the effects of hypoxia on health in patients with OSAS.</p>

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Female predominance in nocturnal hypoxemia among elderly OSAS patients: hemoglobin mediates sex-specific hypoxic burden in Chinese cohorts

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月7日

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  • Libo Zhao,
  • Wei Zhang,
  • Yinghui Gao,
  • Weimeng Cai,
  • Zhe Zhao,
  • Dong Rui,
  • Zuo Zhang,
  • Junling Lin,
  • Li Fan,
  • Cong Ma,
  • Lin Liu,
  • Kailiang Li

摘要

Objectives

To explore the clinical characteristics and sex differences in relevant indicators of obstructive sleep apnea syndrome (OSAS) in elderly patients.

Methods

A total of 1290 elderly patients diagnosed with OSAS by polysomnography (PSG) from 2015 to 2017 were consecutively collected from multiple medical institutions. Detailed demographic data, laboratory indicators, and sleep breathing parameters were recorded for each patient. All subjects were grouped according to sex, and the differences in each index between groups were statistically analyzed. Furthermore, analyses of the interaction between the influencing factors of nocturnal hypoxia were performed.

Results

The male to female ratio was 1.62:1 in all subjects. There was no significant difference in age between groups (65 years vs. 66 years). The men had a higher BMI than the women (26.7 kg/m2 vs. 25.8 kg/m2), but the women had a slightly higher ratio of waistline to height (0.56 vs. 0.53). Hemoglobin, creatinine, and uric acid levels were higher in male patients (all P < 0.001). The prevalence of hypertension was higher in both sexes, but it was greater in men (60.4% vs. 67.4%, P = 0.011). Male patients had a greater apnea-hypopnea index (AHI) (25.5 events/h vs. 30.9 events/h) and a longer apnea time (44 s vs. 56 s); nonetheless, the percent of total time with an oxygen saturation lower than 90% during sleep (T90) showed no significant difference between the two groups (3.9% vs. 3.6%, P > 0.05). Furthermore, in men, hemoglobin attenuated the effect of apnea duration on the risk of more pronounced nocturnal hypoxemia (Pinteraction=0.037). In the subgroup of patients ≥ 70 years, the AHI was consistent in both groups, but T90 was longer in women than in men (7.4% vs. 3.8%, P = 0.001).

Conclusions

The proportion of severe OSAS in elderly patients was high. It was more severe in men than in women, but women tended to have more pronounced nighttime hypoxia. Therefore, clinical attention should be paid to sex differences in the effects of hypoxia on health in patients with OSAS.