RSNA 2018: Obstructive sleep apnea, snoring may impact women more than men

Obstructive sleep apnea (OSA) and snoring may impact cardiac function in women more than it does in men, according to new research presented at RSNA 2018 in Chicago. 

The National Sleep Foundation notes that 18 million American adults exhibit OSA, though patients can present symptoms at any age. Additionally, OSA is often under-diagnosed and is associated with increased rates of cardiovascular disease, including hypertension, heart attacks, strokes and atrial fibrillation.

Researchers, led by Adrian Curta, MD, of the Munich University hospital in Munich, Germany, assessed cardiac function related to diagnosed OSA and snoring in patients who underwent cardiac MRI.

"Our analysis showed that in both genders of the OSA and snoring groups there was an increase in left ventricular mass, meaning that the walls of the heart's main pumping chamber are enlarged, making the heart work harder," Curta said in a prepared statement. "We also found that men showed an increase in the ejection fraction of both ventricles."

The researchers specifically looked at data from more than 4,800 patients who are part of the UK Biobank. The patients were stratified into three study groups—118 patients with OSA, 1,886 patients who reported snoring and the largest group of 2,477 patients who did not exhibit OSA or snoring. Comparing the MRI scans of patients with and without OSA/snoring, the researchers found:

  • Women who snored were more likely to exhibit a “significant increase” in left ventricular mass.
  • Cardiac changes in the self-reporting snorers may have earlier impairment in cardiac function, and this might be an indication of undiagnosed OSA.
  • Consistent with information provided by the National Sleep Foundation, OSA may be “vastly” underdiagnosed among snorers.

"We found that the cardiac parameters in women appear to be more easily affected by the disease and that women who snore or have OSA might be at greater risk for cardiac involvement,” Curta said in the same statement. "We also found that the prevalence of diagnosed OSA in the study group was extremely low. Together with the alterations in cardiac function in the snoring group, it leads us to believe that OSA may be grossly underdiagnosed."

Curtis and his group noted that the transition from snoring to OSA is an "evolving process” that is linked to left ventricular hypertrophy, a predictor for increased adverse events and in-hospital mortality.