Epidemiological insights into the public health burden of sleep disordered breathing: sex differences in survival among sleep clinic patients

Abstract

Although prevalence estimates of SDB vary according to definitions and methods of measurement, there is general agreement among the most rigorous studies that the prevalence of SDB meeting clinical criteria for sleep apnoea syndrome is in the range of 2–4%.3 In the largest population based study conducted with in-laboratory polysomnography, the prevalence of SDB in middle aged adults in the USA based on lesser severity—for example, an apnoea/hypopnoea index (AHI) of 5 or more—has been estimated at 9% for women and 24% for men.4 Other studies conducted elsewhere in the western world have yielded similar estimates.5 In addition to establishing the high prevalence of SDB, these population-based studies have shown, as is evident in the preceding prevalence estimate, that this is not a disease predominantly of men. Furthermore, women with SDB have been shown to have the same symptoms, risk factors, and health correlates as men.6 The discrepancy between the ratio of men to women with SDB in clinic patient populations (8:1) and in the general population (2–3:1) has underscored the need for more research on women as well as investigations into health care barriers experienced by women with SDB. Also noteworthy is the occurrence of a wide severity spectrum of unrecognised SDB in the population as this indicates that at present even severe cases of SDB are being missed.4