D22-01 Beyond Snoring: Gender Differences in OSA Symptom Burden Before and After PAP Therapy

Introduction Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that remains underdiagnosed in women. To better understand how OSA symptoms and burden vary by gender, this study 1) describes and compares patient-reported OSA symptoms, and 2) evaluates perceived symptom improvements following initiation of positive airway pressure (PAP) therapy in males and females. Methods Patients on PAP therapy (Resmed) for the treatment of OSA were invited to complete an e-survey on pre- and post-therapy OSA symptoms and experiences. OSA-related symptoms and burden were assessed across five domains: sleep & energy, physical health, emotional and mental wellbeing, cognition, and sexual health. Likert scales were used to retrospectively assess pre-therapy symptoms (1-not a problem; 5-severe problem), and post-therapy symptom improvement (1-significantly worsened; 5- significantly improved). Time to perceived symptom improvement following PAP initiation was also assessed. Analyses were limited to symptoms rated as “significant” or “severe” pre-therapy, and those rated as “significantly improved” post-therapy. Descriptive analyses examined outcomes by self-reported gender. Results 1,880 respondents were included in the analysis (mean age: 56.0 years, 54.6% female, 41.5% with severe OSA; 47.7% on PAP therapy < 30 days). Pre-therapy, significant and severe symptoms were reported for all symptom domains in both males and females. Snoring (64.7%), not feeling rested upon waking (63.9%), and feeling tired or drained (58.2%) were the most frequently reported burdensome symptoms. A greater proportion of females reported these symptoms than males (p < 0.05), with the exception of snoring (Figure 1). Females also more frequently reported emotional, mental wellness and cognitive burdensome symptoms compared to males, with highest symptom burden being brain fog (42.4% vs. 29.3%), stress (37.5% vs. 25.5%), and ability to focus (35.2% vs. 24.3%) (all p < 0.001). Following PAP therapy, 71.8% of females (vs. 79.5% of males) who experienced significant or severe symptoms at baseline reported a significant improvement in at least one symptom. 63.5% of females (vs. 74.0% of males) reported a significant improvement within the first seven days of therapy. Conclusion OSA-related symptoms can vary widely, and females experienced a greater frequency of burdensome symptoms than males across all symptom domains pre-therapy, except for snoring. PAP therapy significantly improved burdensome symptoms within the first week of initiation for both males and females, although early improvement rates differed by gender. Findings support that clinical screening for OSA in women should emphasize non-typical symptoms across cognitive, physical, and emotional and mental well-being domains. This abstract is funded by: Resmed