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      Gender Differences in the Clinical and Polysomnographic Characteristics Among Australian Aboriginal Patients with Obstructive Sleep Apnea

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          Abstract

          Background

          In this study, we assessed the clinical and polysomnographic (PSG) characteristics according to gender among Australian Aboriginal men and woman diagnosed to have obstructive sleep apnea (OSA).

          Methods

          In this retrospective study, all adult Aboriginal patients over 18 years of age diagnosed to have OSA with an apnea hypopnea index (AHI) > 5/hour over a 5 year period were included.

          Results

          Of the 337 patients (168 females and 169 males), who underwent a diagnostic PSG, 297 (88%) were diagnosed to have OSA (AHI) >5/hour), 154/297 males (52%) and 143/297 females (48%). Amongst male and female patients with OSA, 63% and 37% were in the severe spectrum (AHI>30/hour). The male cohort had higher stage N1 NREM sleep ( P<0.001), reduced N3 NREM sleep ( P<0.001), higher AHI severity ( P<0.001), higher NREM AHI ( P<0.001), and high arousal index ( P<0.005). REM sleep-related AHI was higher among female patients with all severity of OSA, along with severe oxygen desaturation during REM sleep. Among patients with severe OSA, the female cohort were younger (age 46 years vs 49 years, P=0.030) and had higher BMI with all severity of OSA, while males had larger neck circumference compared to females. Hypertension increased the odds of severe OSA versus the combined odds of mild and moderate OSA for both genders.

          Conclusion

          This study highlights some important differences in the way sleep apnea manifests in Australian Aboriginal males and females and further studies are warranted to explore avenues to look for a physiological basis for these observations and targeted interventions.

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          Most cited references41

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          Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis

          There is a scarcity of published data on the global prevalence of obstructive sleep apnoea, a disorder associated with major neurocognitive and cardiovascular sequelae. We used publicly available data and contacted key opinion leaders to estimate the global prevalence of obstructive sleep apnoea.
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            Racial/Ethnic Differences in Sleep Disturbances: The Multi-Ethnic Study of Atherosclerosis (MESA).

            There is limited research on racial/ethnic variation in sleep disturbances. This study aimed to quantify the distributions of objectively measured sleep disordered breathing (SDB), short sleep duration, poor sleep quality, and self-reported sleep disturbances (e.g., insomnia) across racial/ethnic groups.
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              Is Open Access

              Obstructive sleep apnea: current perspectives

              The prevalence of obstructive sleep apnea (OSA) continues to rise. So too do the health, safety, and economic consequences. On an individual level, the causes and consequences of OSA can vary substantially between patients. In recent years, four key contributors to OSA pathogenesis or “phenotypes” have been characterized. These include a narrow, crowded, or collapsible upper airway “anatomical compromise” and “non-anatomical” contributors such as ineffective pharyngeal dilator muscle function during sleep, a low threshold for arousal to airway narrowing during sleep, and unstable control of breathing (high loop gain). Each of these phenotypes is a target for therapy. This review summarizes the latest knowledge on the different contributors to OSA with a focus on measurement techniques including emerging clinical tools designed to facilitate translation of new cause-driven targeted approaches to treat OSA. The potential for some of the specific pathophysiological causes of OSA to drive some of the key symptoms and consequences of OSA is also highlighted.
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                Author and article information

                Journal
                Nat Sci Sleep
                Nat Sci Sleep
                nss
                nss
                Nature and Science of Sleep
                Dove
                1179-1608
                24 August 2020
                2020
                : 12
                : 593-602
                Affiliations
                [1 ]Department of Respiratory and Sleep Medicine, Royal Darwin Hospital , Darwin, Northern Territory, Australia
                [2 ]Department of Respiratory and Sleep Medicine, Flinders Medical Centre , Adelaide, South Australia, Australia
                [3 ]Darwin Respiratory and Sleep Health, Darwin Private Hospital , Darwin, Northern Territory, Australia
                [4 ]Department of Public Health, Charles Darwin University , Darwin, Northern Territory, Australia
                [5 ]Adelaide Institute for Sleep Health, a Flinders Centre for Research Excellence , Bedford Park, South Australia, Australia
                Author notes
                Correspondence: Subash S Heraganahally Email hssubhashcmc@hotmail.com
                Author information
                http://orcid.org/0000-0002-8379-8745
                http://orcid.org/0000-0003-0788-7137
                Article
                258330
                10.2147/NSS.S258330
                7455593
                32922104
                8df5b516-6733-4080-a848-7b0f86e02089
                © 2020 Mehra et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 15 April 2020
                : 03 August 2020
                Page count
                Figures: 1, Tables: 18, References: 49, Pages: 10
                Categories
                Original Research

                aboriginal,ethnic,female,gender,male,obstructive sleep apnea
                aboriginal, ethnic, female, gender, male, obstructive sleep apnea

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