[Demographic, clinical and polysomnographic differences between men and women]. / Care sunt diferentele demografice, clinice si polisomnografice intre femei si barbati?

UNLABELLED: Obstructive sleep apnea (OSA) is still an undiagnosed disease in women, possibly due to differences in clinical presentation or a higher tolerance to symptoms. There are no studies to assess these differences in Romanian population. AIM: we conducted this study to assess these differences (demographics, clinical presentation, and polysomnographic findings) between men and women. MATERIAL AND METHODS: Our study group comprised 131 patients (57 women) diagnosed with OSA in the sleep lab from Clinic of Pulmonary Diseases, Iasi, Romania. We analyzed polysomnographic recordings, demographic data and all the information gathered in their personal files from sleep lab. RESULTS: Women were significantly older than men (59.3 +/- 12.6 vs, 46.7 +/- 22.8), and their body mass index was also significantly higher (39.6 +/- 5.7 vs, 31.2 +/- 7.9). Women declared more frequent insomnia, morning headaches and excessive daytime sleepiness. Men accuse more frequent snoring and witnessed apneas. Apnea-hypopnea index (AHI) was statistically higher in men compared to women (64.0 +/- 25.7 vs, 45 +/- 21.9, p < 0.001), and also the snoring percentage (35.7 +/- 23.9 vs. 16.8 +/- 2.5, P < 0.001); women had a higher sleep onset latency (26.8 +/- 36.5 vs. 20.6 +/- 25.4, P < 0.03), the arousal index was significantly higher in women than in men (AI: 42.7 +/- 34.5 vs. 25.4 +/- 15.6, P < 0.04), and also an increased total sleep time was observed in women compared to men. There were no significant differences between time bellow 90% saturation in men vs. women. CONCLUSION: women with OSA are presenting with complaints that send us to other disorders than sleep apnea (depressive moods, insomnia, morning headaches) and the polysomnographic features that characterize sleep quality are more affected in women. Clinicians need to be aware of these differences when assessing women for the possibility of OSA in order to allow a correct management of the disease.

[Effect of cpap therapy on sleep quality in patients with OSAS]. / Efectul terapiei cpap asupra calitutii somnului la pacientii cu saos evaluata prin sleep disturbances index (SDI).

UNLABELLED: For an adequate analysis of sleep quality was assessed a new composed index wich objectively approached variate polisomnographic parameters. We used this new concept--sleep disturbances index-SDI in patients with obstructive sleep apnea (OSAS), before and after the beginning of CPAP therapy. MATERIAL AND METHOD: 41 patients were evaluated and for each one we calculated SDI score. All patients were split in two groups according with apnea-hipopnea index (AHI), and we correlated SDI with AHI as marker of severity of the disease and with Epworth Sleepiness Scale's scores, as an subjective evaluation. After 1 month of CPAP therapy, SDI was reevaluated. RESULTS: SDI is correlating with the severity of the disease: for group 1, with 5 < AHI < 15, SDI= 2.24 +/- 0.88, r = 0.53, p < 0.01 and for group 2, with AHI >15, SDI = 3.23 +/- 0.69, p < 0.01, r = 0.46. There was no significant correlation between SDI and ESS scores (r = 0.23, p < 0.01). SDI lowers significant during CPAP therapy: SDI= 1.48 +/- 0.60, respectiv SDI = 1.90 +/- 1.23. CONCLUSION: The severity of OSAS is correlated with increased SDI, but can be seen interindividual variability. The effect of CPAP therapy is reflecting also in sleep quality.