Obstructive Sleep Apnea and Cardiovascular Disease in Women

Obstructive Sleep Apnea (OSA) is a common chronic disorder that affects 5–10% of the US population with a higher prevalence in men compared to women by 2:1 in population studies. By contrast, in patients with cardiovascular disease, its prevalence can exceed 50% depending on the specific disorder surveyed. Although sex differences have been well described for cardiovascular risk factors; existing data regarding the impact of sex on the relationship between OSA and cardiovascular outcomes is controversial. Similarly, while there is strong evidence for increased prevalence of cardiovascular conditions, such as systemic hypertension, atrial fibrillation, as well as heart failure amongst patients suffering from OSA; conflicting evidence exists regarding the incidence and bidirectional relationship between them as well as the impact of treatment of OSA on cardiovascular outcomes. In this paper, we will review the associations between OSA and cardiovascular diseases in women. The data on sex differences is limited, due to a number of reasons, including, but not limited to late presentation of OSA in women, difficulties in diagnosing both OSA and cardiovascular diseases in women and still suboptimal inclusion of adequate number of women in clinical trials. More studies are needed to better delineate sex differences in the clinical presentation as well as the pathophysiology of the associations between OSA and cardiovascular diseases so that we can provide patients with more personalized care.