Obstructive Sleep Apnea Syndrome and Hypertension in Women

Obstructive Sleep Apnea Syndrome (OSAS) is a prevalent sleep disorder associated with significant cardiovascular complications, including hypertension. While the relationship between OSAS and hypertension has been extensively studied, gender-specific differences in clinical presentation, pathophysiological mechanisms, and treatment outcomes remain underexplored. Women with OSAS often present with atypical symptoms, which contribute to underdiagnοsis and delayed treatment. This systematic review examines the relationship between OSAS and hypertension in women, synthesizing findings from ten key studies and comparing them with existing literature. The methods for this review included a systematic analysis of cross-sectional and longitudinal studies that investigated OSAS and hypertension, focusing on gender-specific outcomes. Key findings reveal that women with OSAS are more likely to exhibit REM (Rapid Eye Movement) -predominant OSAS, which is strongly associated with nocturnal hypoxia and hypertension. Hormonal changes, particularly during menopause, exacerbate vascular dysfunction and elevate hypertension risk in women with OSAS. Treatment outcomes differ significantly between genders, with women demonstrating higher adherence rates to Continuous Positive Airway Pressure therapy. However, alternative treatments such as positional therapy, weight loss, and behavioral interventions may be necessary for women with milder OSAS or low CPAP adherence. Despite these advances, significant limitations persist in existing research. Diagnostic criteria based on traditional measures such as the Apnea-Hypopnea Index often fail to account for gender-specific symptoms and sleep patterns, leading to underdiagnosis in women.Future research should prioritize longitudinal studies, develop gender-sensitive diagnostic tools, and explore hormonal and behavioral interventions tailored to women’s unique needs.