Sex Differences in Etiologies of Sleep Disorders

Choi, Su Jung; Kim, Dongyeop; Hwang, Yoonha; Jo, Hyunjin; Joo, Eun Yeon

doi:2020.17.2.138

J Sleep Med > Volume 17(2); 2020 > Article

ORIGINAL ARTICLE

J Sleep Med. 2020;17(2):138-147. doi: https://doi.org/10.13078/jsm.200023

Sex Differences in Etiologies of Sleep Disorders

Su Jung Choi^1,2

, Dongyeop Kim²

, Yoonha Hwang²

, Hyunjin Jo²

, Eun Yeon Joo²

¹Department of Nursing, Department of Clinical Nursing Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
²Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Corresponding Author: Eun Yeon Joo ,Tel: +82-2-3410-3597, Fax: +82-2-3410-0052, Email: eunyeon.joo@gmail.com

Received: October 30, 2020 Revised: November 23, 2020 Accepted: December 3, 2020 Published online: December 31, 2020

ABSTRACT

Objectives: To investigate the etiologies of sleep disorders according to sex.
Methods: We enrolled 1,270 patients who complained of insomnia (n=328) or sleep apnea (n=942) for more than 6 months and classified them into primary insomnia (PI, n=120), comorbid obstructive sleep apnea with insomnia (COMISA, n=146), and obstructive sleep apnea (OSA, n=884) groups based on their polysomnography (PSG) findings, demographics, sleep-related symptoms, and questionnaire results (Insomnia Severity Index and Epworth Sleepiness Scale).
Results: The highest prevalence of females was observed in PI (71.7%), and the lowest in the OSA group (15.6%). Males were more prevalent than females in the COMISA group (58.2% vs. 41.8%). Regarding the etiology of insomnia, half of the male patients with complaints of insomnia had OSA, while only one-third of the females had OSA. Thirteen percent of female who complained of OSA-related symptoms were diagnosed as normal. There were few differences in PSG data between female and male patients in the PI and COMISA groups. Females with OSA showed longer total sleep time than males with OSA in PSG. The self-reported questionnaire responses of patients in the COMISA and PI groups were similar, and PSG data of patients in the COMISA and OSA groups were comparable regardless of sex.
Conclusions: Females and males have different sleep perceptions and sleep-related complaints. Thus, PSG must be carried out to clarify the etiology of sleep disorders and ensure appropriate treatment is provided.

Keywords: Insomnia | Obstructive sleep apnea | Symptom | Polysomnography | Sex