Характеристика гендерных особенностей клинической картины синдрома обструктивного апноэ сна и качества жизни больных

1. Berry RB, Budhiraja R, Gottlieb DJ et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2012; 8: 597–619.
2. Block AJ, Boysen PG, Wynne JW, Hunt LA. Sleep apnea, hypopnea and oxygen desaturation in normal subjects. A strong male predominance. N Engl J Med 1979; 300 (10): 513–7.
3. Young T, Palta M, Dempsey J et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993; 328: 1230–5.
4. Kim J, In K, Kim J et al. Prevalence of sleep-disordered breathing in middle-aged Korean men and women. Am J Respir Crit Care Med 2004; 170 (10): 1108–13.
5. Young T, Hutton R, Finn L et al. The gender bias in sleep apnea diagnosis: are women missed because they have different symptoms. Arch Int Med 1996; 156 (21): 2445–51.
6. Fietze I, Laharnar N, Obst A et al. Prevalence and association analysis of obstructive sleep apnea with gender and age differences – Results of SHIP-Trend. J Sleep Res 2018: e12770.
7. Tishler PV, Larkin EK, Schluchter MD, Redline S. Incidence of sleep-disordered breathing in an urban adult population: the relative importance of risk factors in the development of sleep-disordered breathing. JAMA 2003; 289 (17): 2230–7.
8. Bahammam AS, Pandi-Perumal SR, Piper A et al. Gender differences in patients with obesity hypoventilation syndrome. J Sleep Res 2016; 4: 445–53.
9. Simpson L, Mukherjee S, Cooper MN et al. Sex differences in the Association of Regional Fat Distribution with the Severity of Obstructive Sleep Apnea. Sleep 2010; 33 (4): 467–74.
10. Буторова Е.А., Шария М.А., Литвин А.Ю., Устюжанин Д.В. Магнитно-резонансная томография в оценке анатомических дыхательных путей у пациентов с ожирением и разной степенью течения синдрома обструктивного апноэ сна. REJR. Рос. электронный журн. лучевой диагностики. 2015; 4: 33–40.
[Butorova E.A., Shariia M.A., Litvin A.Iu., Ustiuzhanin D.V. Magnitno-rezonansnaia tomografiia v otsenke anatomicheskikh dykhatel'nykh putei u patsientov s ozhireniem i raznoi stepen'iu techeniia sindroma obstruktivnogo apnoe sna. REJR. Ros. elektronnyi zhurn. luchevoi diagnostiki. 2015; 4: 33–40 (in Russian).]
11. Mazzuca E, Battaglia S, Marrone O et al. Gender-specific anthropometric markers of adiposity, metabolic syndrome and visceral adiposity index (VAI) in patients with obstructive sleep apnea. J Sleep Res 2014; 23 (1): 13–21.
12. Mohsenin V. Gender differences in the expression of sleep-disordered breathing: role of upper airway dimensions. Chest 2001; 120 (5): 1442–7.
13. Shigeta Y, Oqawa T, Venturin J et al. Gender- and age-based differences in computerized tomographic measurements of the orophaynx. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106 (4): 563–70.
14. Malhotra A, Huang Y, Fogel RB et al. The male predisposition to pharyngeal collapse: importance of airway length. Am J Respir Crit Care Med 2002; 166: 1388–95.
15. Jordan AS, Wellman A, Edwards JK et al. Respiratory control stability and upper airway collapsibility in men and women with obstructive sleep apnea. J Appl Physiol (Bethesda, Md: 1985) 2005; 99 (5): 2020–7.
16. Saaresranta Т, Anttalainen U, Polo O. Sleep disordered breathing: is it different for females? Eur Respir J Open Res 2015; 1 (2): 00063.
17. Guidozzi F. Sleep and sleep disorders in menopausal women. Climacteric 2013; 16: 214–9.
18. Chuang LP, Lin SW, Lee LA et al. The gender difference of snore distribution and increased tendency to snore in women with menopausal syndrome: a general population study. Sleep Breathing 2017; 21 (2): 543–7.
19. Westreich Р, Gozlan-Talmor A, Geva-Robinson S et al. The Presence of Snoring as Well as its Intensity Is Underreported by Women. J Clin Sleep Med 2019; 15 (3): 471–6.
20. Quintana-Gallego E, Carmona-Bernal C, Capote F et al. Gender differences in obstructive sleep apnea syndrome: a clinical study of 1166 patients. Respir Med 2004; 98: 984–9.
21. Lin CM, Davidson TM, Ancoli-Israel S. Gender differences in obstructive sleep apnea and treatment implications. Sleep Med Rev 2008; 12: 481–96.
22. Ambrogetti A, Olson LG, Saunders NA. Differences in the symptoms of men and women with obstructive sleep apnea. Australian New Zealand J Med 1991; 21: 863–6.
23. Cincinnati Children's Hospital Center. Best evidence statement (BESt). Long-term outcomes in obstructive sleep apnea. Cincinnati (ОН), 2009.
24. Gottlieb DJ, Whitney CW, Bonekat WH et al. Relation of Sleepiness to Respiratory Disturbance Index: The Sleep Heart Health Study. Am J Respir Crit Care Med 1999; 159: 502–7.
25. Baldwin CM, Kapur VK, Holberg CJ et al. Sleep Heart Health Study Group Associations between Gender and Measures of Daytime Somnolence in the Sleep Heart Health Study. Sleep 2004; 27: 305–11.
26. Panossian LA, Veasey SC. Daytime Sleepiness in Obesity: Mechanisms beyond Obstructive Sleep Apnea – A Review. Sleep 2012; 35: 605–15.
27. Appleton S, Gill T, Taylor A et al. Influence of Gender on Associations of Obstructive Sleep Apnea Symptoms with Chronic Conditions and Quality of Life. Int J Environment Res Public Health 2018; 15 (5): 930.
28. Lindberg E, Benediktsdottir B, Franklin KA et al. Women with symptoms of sleep-disordered breathing are less likely to be diagnosed and treated for sleep apnea than men. Sleep Med 2017; 35: 17–22.
29. Valipour A. Gender-related differences in the obstructive sleep apnea syndrome. Pneumologie 2012; 66 (10): 584–8.
30. Alonso J, Ferrer M, Gandek B et al. Health-related quality of life associated with chronic conditions in eight countries: Results from the International Quality of Life Assessment (IQOLA) Project. Qual Life Res 2004; 13 (2): 283–98.
31. Silva GE, An MW, Goodwin JL et al. Longitudinal evaluation of sleep-disordered breathing and sleep symptoms with change in quality of life: the Sleep Heart Health Study (SHHS). Sleep 2009; 32: 1049–57.
32. Silva GE, Goodwin JL, Vana KD, Quan SF. Obstructive Sleep Apnea and Quality of Life: Comparison of the SAQLI, FOSQ, and SF-36 Questionnaires. Southwest J Pulmonary Crit Care 2016; 13 (3): 137–49.
33. Chervin RD. Sleepiness, fatigue, tiredness, and lack of energy in obstructive sleep apnea. Chester 2000; 118 (2): 372–9.
34. Chervin RD. Epworth sleepiness scale? Sleep Med 2003; 4 (3): 175–6.
35. Tamanna S, Geraci SA. Major sleep disorders among women: (women’s health series). Southern Med J 2013; 106 (8): 470–8.
36. Ye L, Pien GW, Ratcliffe SJ, Weaver TE. Gender differences in obstructive sleep apnea and treatment response to continuous positive airway pressure. J Clin Sleep Med 2009; 5 (6): 512–8.
37. Macey PM, Kumar R, Yan-Go FL et al. Sex differences in white matter alterations accompanying obstructive sleep apnea. Sleep 2012; 35 (12): 1603–13.
38. Greenberg-Dotan S, Reuveni H, Simon-Tuval T et al. Gender differences in morbidity and health care utilization among adult obstructive sleep apnea patients. Sleep 2007; 30 (9): 1173–80.
39. Sampaio R, Pereira MG, Winck JC. Psychological morbidity, illness representations, and quality of life in female and male patients with obstructive sleep apnea syndrome. Psychol Health Med 2012; 17 (2): 136–49.
40. Ye L, Liang Z, Weaver TE. Predictors of health-related quality of life in patients with obstructive sleep apnea. J Advanced Nursing 2008; 63: 54–63.
41. Wimms А, Woehrle Н, Ketheeswaran S et al. Obstructive Sleep Apnea in Women: Specific Issues and Interventions. BioMed Res Int 2016: 1764837.
42. Polo-Kantola P, Rauhala E, Helenius H et al. Breathing during sleep in menopause: a randomized, controlled, crossover trial with estrogen therapy. Obstet Gynecol 2003; 102 (1): 68–75.
43. Ware JC, McBrayer RH, Scott JA. Influence of sex and age on duration and frequency of sleep apnea events. Sleep 2000; 23: 165–70.
44. Leech JA, Onal E, Dulberg C, Lopata MA. A comparison of men and women with occlusive sleep apnea syndrome. Chest 1988; 94: 983–8.
45. Sin DD, Jones RL, Man GC. Hypercapnic ventilatory response in patients with and without obstructive sleep apnea: do age, gender, obesity, and daytime PaCO(2) matter? Chester 2000; 117: 454–9.
46. Jordan AS, McEvoy RD. Gender differences in sleep apnea: epidemiology, clinical presentation and pathogenicmechanisms. Sleep Med Rev 2003; 7 (5): 377–89.
47. O'Connor C, Thornley KS, Hanly PJ. Gender Differences in the Polysomnographic Features of Obstructive Sleep Apnea. Am J Respir Crit Care Med 2000; 161 (5): 1467–72.
48. Mokhlesi B, Punjabi NM. “REM-related” obstructive sleep apnea: an epiphenomenon or a clinically important entity? Sleep 2012; 35 (1): 5–7.
49. Oksenberg A, Arons E, Nasser K et al. REM-related obstructive sleep apnea: the effect of body position. J Clin Sleep Med 2010; 6 (4): 343–8.
50. Sunnetcioglu A, Sertogullarından B, Ozbay B et al. Obstructive sleep apnea related to rapid-eye-movement or non-rapid-eye-movement sleep: comparison of demographic, anthropometric, and polysomnographic features. Brazilian J Pulmonol 2016; 42 (1): 48–54.
51. Kutbay Оzçelik H, Akkoyunlu ME et al. The frequency and properties of REM related obstructive sleep apnea among the patients with mild related obstructive sleep apnea. Tuberk Toraks 2013; 61 (4): 283–7.
52. Sunnergren O, Broström A, Svanborg E. Positional sensitivity as a confounder in diagnosis of severity of obstructive sleep apnea. Sleep Breathing 2013; 17 (1): 173–9.
53. Uzer F, Toptas AB, Okur U et al. Comparison of positional and rapid eye movement-dependent sleep apnea syndromes. Ann Thoracic Med 2018; 13 (1): 42–7.
54. Lee SA, Paek JH, Han SH. REM-related sleep-disordered breathing is associated with depressive symptoms in men but not in women. Sleep Breathing 2016; 20 (3): 995–1002.
55. Vagiakis E, Kapsimalis F, Lagogianni I et al. Gender differences on polysomnographic findings in Greek subjects with obstructive sleep apnea syndrome. Sleep Med 2006; 7 (5): 424–30.

________________________________________________

1. Berry RB, Budhiraja R, Gottlieb DJ et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2012; 8: 597–619.
2. Block AJ, Boysen PG, Wynne JW, Hunt LA. Sleep apnea, hypopnea and oxygen desaturation in normal subjects. A strong male predominance. N Engl J Med 1979; 300 (10): 513–7.
3. Young T, Palta M, Dempsey J et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993; 328: 1230–5.
4. Kim J, In K, Kim J et al. Prevalence of sleep-disordered breathing in middle-aged Korean men and women. Am J Respir Crit Care Med 2004; 170 (10): 1108–13.
5. Young T, Hutton R, Finn L et al. The gender bias in sleep apnea diagnosis: are women missed because they have different symptoms. Arch Int Med 1996; 156 (21): 2445–51.
6. Fietze I, Laharnar N, Obst A et al. Prevalence and association analysis of obstructive sleep apnea with gender and age differences – Results of SHIP-Trend. J Sleep Res 2018: e12770.
7. Tishler PV, Larkin EK, Schluchter MD, Redline S. Incidence of sleep-disordered breathing in an urban adult population: the relative importance of risk factors in the development of sleep-disordered breathing. JAMA 2003; 289 (17): 2230–7.
8. Bahammam AS, Pandi-Perumal SR, Piper A et al. Gender differences in patients with obesity hypoventilation syndrome. J Sleep Res 2016; 4: 445–53.
9. Simpson L, Mukherjee S, Cooper MN et al. Sex differences in the Association of Regional Fat Distribution with the Severity of Obstructive Sleep Apnea. Sleep 2010; 33 (4): 467–74.
10. Butorova E.A., Shariia M.A., Litvin A.Iu., Ustiuzhanin D.V. Magnitno-rezonansnaia tomografiia v otsenke anatomicheskikh dykhatel'nykh putei u patsientov s ozhireniem i raznoi stepen'iu techeniia sindroma obstruktivnogo apnoe sna. REJR. Ros. elektronnyi zhurn. luchevoi diagnostiki. 2015; 4: 33–40 (in Russian).
11. Mazzuca E, Battaglia S, Marrone O et al. Gender-specific anthropometric markers of adiposity, metabolic syndrome and visceral adiposity index (VAI) in patients with obstructive sleep apnea. J Sleep Res 2014; 23 (1): 13–21.
12. Mohsenin V. Gender differences in the expression of sleep-disordered breathing: role of upper airway dimensions. Chest 2001; 120 (5): 1442–7.
13. Shigeta Y, Oqawa T, Venturin J et al. Gender- and age-based differences in computerized tomographic measurements of the orophaynx. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106 (4): 563–70.
14. Malhotra A, Huang Y, Fogel RB et al. The male predisposition to pharyngeal collapse: importance of airway length. Am J Respir Crit Care Med 2002; 166: 1388–95.
15. Jordan AS, Wellman A, Edwards JK et al. Respiratory control stability and upper airway collapsibility in men and women with obstructive sleep apnea. J Appl Physiol (Bethesda, Md: 1985) 2005; 99 (5): 2020–7.
16. Saaresranta Т, Anttalainen U, Polo O. Sleep disordered breathing: is it different for females? Eur Respir J Open Res 2015; 1 (2): 00063.
17. Guidozzi F. Sleep and sleep disorders in menopausal women. Climacteric 2013; 16: 214–9.
18. Chuang LP, Lin SW, Lee LA et al. The gender difference of snore distribution and increased tendency to snore in women with menopausal syndrome: a general population study. Sleep Breathing 2017; 21 (2): 543–7.
19. Westreich Р, Gozlan-Talmor A, Geva-Robinson S et al. The Presence of Snoring as Well as its Intensity Is Underreported by Women. J Clin Sleep Med 2019; 15 (3): 471–6.
20. Quintana-Gallego E, Carmona-Bernal C, Capote F et al. Gender differences in obstructive sleep apnea syndrome: a clinical study of 1166 patients. Respir Med 2004; 98: 984–9.
21. Lin CM, Davidson TM, Ancoli-Israel S. Gender differences in obstructive sleep apnea and treatment implications. Sleep Med Rev 2008; 12: 481–96.
22. Ambrogetti A, Olson LG, Saunders NA. Differences in the symptoms of men and women with obstructive sleep apnea. Australian New Zealand J Med 1991; 21: 863–6.
23. Cincinnati Children's Hospital Center. Best evidence statement (BESt). Long-term outcomes in obstructive sleep apnea. Cincinnati (ОН), 2009.
24. Gottlieb DJ, Whitney CW, Bonekat WH et al. Relation of Sleepiness to Respiratory Disturbance Index: The Sleep Heart Health Study. Am J Respir Crit Care Med 1999; 159: 502–7.
25. Baldwin CM, Kapur VK, Holberg CJ et al. Sleep Heart Health Study Group Associations between Gender and Measures of Daytime Somnolence in the Sleep Heart Health Study. Sleep 2004; 27: 305–11.
26. Panossian LA, Veasey SC. Daytime Sleepiness in Obesity: Mechanisms beyond Obstructive Sleep Apnea – A Review. Sleep 2012; 35: 605–15.
27. Appleton S, Gill T, Taylor A et al. Influence of Gender on Associations of Obstructive Sleep Apnea Symptoms with Chronic Conditions and Quality of Life. Int J Environment Res Public Health 2018; 15 (5): 930.
28. Lindberg E, Benediktsdottir B, Franklin KA et al. Women with symptoms of sleep-disordered breathing are less likely to be diagnosed and treated for sleep apnea than men. Sleep Med 2017; 35: 17–22.
29. Valipour A. Gender-related differences in the obstructive sleep apnea syndrome. Pneumologie 2012; 66 (10): 584–8.
30. Alonso J, Ferrer M, Gandek B et al. Health-related quality of life associated with chronic conditions in eight countries: Results from the International Quality of Life Assessment (IQOLA) Project. Qual Life Res 2004; 13 (2): 283–98.
31. Silva GE, An MW, Goodwin JL et al. Longitudinal evaluation of sleep-disordered breathing and sleep symptoms with change in quality of life: the Sleep Heart Health Study (SHHS). Sleep 2009; 32: 1049–57.
32. Silva GE, Goodwin JL, Vana KD, Quan SF. Obstructive Sleep Apnea and Quality of Life: Comparison of the SAQLI, FOSQ, and SF-36 Questionnaires. Southwest J Pulmonary Crit Care 2016; 13 (3): 137–49.
33. Chervin RD. Sleepiness, fatigue, tiredness, and lack of energy in obstructive sleep apnea. Chester 2000; 118 (2): 372–9.
34. Chervin RD. Epworth sleepiness scale? Sleep Med 2003; 4 (3): 175–6.
35. Tamanna S, Geraci SA. Major sleep disorders among women: (women’s health series). Southern Med J 2013; 106 (8): 470–8.
36. Ye L, Pien GW, Ratcliffe SJ, Weaver TE. Gender differences in obstructive sleep apnea and treatment response to continuous positive airway pressure. J Clin Sleep Med 2009; 5 (6): 512–8.
37. Macey PM, Kumar R, Yan-Go FL et al. Sex differences in white matter alterations accompanying obstructive sleep apnea. Sleep 2012; 35 (12): 1603–13.
38. Greenberg-Dotan S, Reuveni H, Simon-Tuval T et al. Gender differences in morbidity and health care utilization among adult obstructive sleep apnea patients. Sleep 2007; 30 (9): 1173–80.
39. Sampaio R, Pereira MG, Winck JC. Psychological morbidity, illness representations, and quality of life in female and male patients with obstructive sleep apnea syndrome. Psychol Health Med 2012; 17 (2): 136–49.
40. Ye L, Liang Z, Weaver TE. Predictors of health-related quality of life in patients with obstructive sleep apnea. J Advanced Nursing 2008; 63: 54–63.
41. Wimms А, Woehrle Н, Ketheeswaran S et al. Obstructive Sleep Apnea in Women: Specific Issues and Interventions. BioMed Res Int 2016: 1764837.
42. Polo-Kantola P, Rauhala E, Helenius H et al. Breathing during sleep in menopause: a randomized, controlled, crossover trial with estrogen therapy. Obstet Gynecol 2003; 102 (1): 68–75.
43. Ware JC, McBrayer RH, Scott JA. Influence of sex and age on duration and frequency of sleep apnea events. Sleep 2000; 23: 165–70.
44. Leech JA, Onal E, Dulberg C, Lopata MA. A comparison of men and women with occlusive sleep apnea syndrome. Chest 1988; 94: 983–8.
45. Sin DD, Jones RL, Man GC. Hypercapnic ventilatory response in patients with and without obstructive sleep apnea: do age, gender, obesity, and daytime PaCO(2) matter? Chester 2000; 117: 454–9.
46. Jordan AS, McEvoy RD. Gender differences in sleep apnea: epidemiology, clinical presentation and pathogenicmechanisms. Sleep Med Rev 2003; 7 (5): 377–89.
47. O'Connor C, Thornley KS, Hanly PJ. Gender Differences in the Polysomnographic Features of Obstructive Sleep Apnea. Am J Respir Crit Care Med 2000; 161 (5): 1467–72.
48. Mokhlesi B, Punjabi NM. “REM-related” obstructive sleep apnea: an epiphenomenon or a clinically important entity? Sleep 2012; 35 (1): 5–7.
49. Oksenberg A, Arons E, Nasser K et al. REM-related obstructive sleep apnea: the effect of body position. J Clin Sleep Med 2010; 6 (4): 343–8.
50. Sunnetcioglu A, Sertogullarından B, Ozbay B et al. Obstructive sleep apnea related to rapid-eye-movement or non-rapid-eye-movement sleep: comparison of demographic, anthropometric, and polysomnographic features. Brazilian J Pulmonol 2016; 42 (1): 48–54.
51. Kutbay Оzçelik H, Akkoyunlu ME et al. The frequency and properties of REM related obstructive sleep apnea among the patients with mild related obstructive sleep apnea. Tuberk Toraks 2013; 61 (4): 283–7.
52. Sunnergren O, Broström A, Svanborg E. Positional sensitivity as a confounder in diagnosis of severity of obstructive sleep apnea. Sleep Breathing 2013; 17 (1): 173–9.
53. Uzer F, Toptas AB, Okur U et al. Comparison of positional and rapid eye movement-dependent sleep apnea syndromes. Ann Thoracic Med 2018; 13 (1): 42–7.
54. Lee SA, Paek JH, Han SH. REM-related sleep-disordered breathing is associated with depressive symptoms in men but not in women. Sleep Breathing 2016; 20 (3): 995–1002.
55. Vagiakis E, Kapsimalis F, Lagogianni I et al. Gender differences on polysomnographic findings in Greek subjects with obstructive sleep apnea syndrome. Sleep Med 2006; 7 (5): 424–30.

Н.Т. Хачатрян1, Е.М. Елфимова*1, О.О. Михайлова1, А.Ю. Литвин1,2, И.Е. Чазова1
1ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва, Россия;
2ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*eelfimova@gmail.com

________________________________________________

Narine T. Khachatryan1, Evgeniia M. Elfimova*1, Oksana O. Mikhailova1, 
Aleksandr Yu. Litvin1,2, Irina E. Сhazova1
1National Medical Research Center of Cardiology, Moscow, Russia;
2Pirogov Russian National Research Medical University, Moscow, Russia
*eelfimova@gmail.com