Authors: Amira Ishag-Osman, Brandon Barsky, Andrew Dakkak, Serena Spaleny, Nadir Osman, Edith Mensah-Osman.
Introduction: Obstructive sleep apnea (OSA) is a known risk factor for metabolic disturbances, cardiovascular diseases, dyslipidemia, depression, and anxiety. A high comorbidity burden worsens the prognosis of OSA and the distribution of comorbidities is known to differ between men and women with a prognostic impact. Careful assessment of comorbidities should become standard clinical practice for OSA patients, for better phenotypic characterization to help provide individualized care in their management.
Method: This was a retrospective analysis of over 1000 charts which included patients with a first time clinical and polysomnography diagnosis of obstructive sleep apnea at the center. Data was compiled from 851 patients with OSA out of which 487 were men and 358 women with an age range of 19-85 years old. There were 212 males of age <55yrs and 275 males of >55yrs of age. There were 158 females of age <55yrs and 200 females >55yrs of age. Descriptive analysis was performed to compare gender and age group for co-morbidities associated with OSA at a cut-of age of 55years.
Results: The percentage of males newly diagnosed with OSA by PSG was approximately 60%, and demonstrated high AHI value representing a severe case of OSA compared to females. Prevalence of comorbidities in females of all ages was depression (36.2%), anxiety (21.7%), hypertension (37.7%), hyperlipidemia (23.9%), CAD (3.6%), afib (2.9%) and other heart conditions (9.4%). The prevalence of comorbidities in males of all ages was depression (17.9%), anxiety (17.9%), hypertension (42.3%), hyperlipidemia (31.6%), CAD (13.7%), afib (4.8%), and other heart conditions (13.7%). Age was a predictive factor in gender related comorbidities associated with OSA. Female subjects at age <55yrs with OSA presented with higher trends of anxiety, fatigue, and headache compared to the males. For both females and males at age >55yrs, dementia became a concerning comorbidity, which was predominant in males. Chief complaints for male subjects at age >55yrs diagnosed with OSA were dementia, numbness, and pain. There were more males diagnosed with OSA with diagnosis of hyperlipidemia, coronary artery disease (CAD), hypertension (HTN) and atrial-fibrillation compared to women of this age with OSA who had more depression.
Conclusion: Differences in gender and age-related co-morbidities associated with OSA exist and may have a prognostic impact on disease progression. 55yrs is a good cut off to delineate the effect of age on co-morbidities associated with OSA. More studies with a larger and diverse population are needed to validate these findings and generalize the conclusions.
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