Purpose Obstructive sleep apnea (OSA) is a common sleep disorder which prevalence is 22% in men and 17% in women. It is well described that females presented different clinical and polysomnographic characteristics compared with men. Those studies were performed in plain areas. We described the analysis by gender and clinical profiles of a sample of patients with diagnostic of OSA and living at high altitude. Patients and Methods It is an observational study that describes differences between clinical and polysomnographic characteristics by gender in patients with OSA. Additionally, an unsupervised cluster algorithm was used to find groups of patients with similar clinical and polysomnographic characteristics. Results We included 709 patients, 51.6% were females and 48.3% were males with mean age of 64 and 62 years old, respectively, in which 90.97% presented OSA. Men presented a higher apnea and hypopnea index than women (p=0.002), besides presented more sleep polysomnographic alterations. Meanwhile, women evidenced better sleep quality based on parameters. Additionally, in the sample of patients, we found four separated clinical profiles characterized mainly by differences in the severity of polysomnographic parameters. Conclusion The patients were more obese, older, and had lower SpO 2 values than most of those previously reported. Men had greater severity in most of the parameters measured by polysomnography. Polysomnographic variables were different both in the OSA patient profiles and in the gender comparison. However, the REM sleep apnea hypopnea index did not differ between sexes, indicating the importance of this variable in the evaluation of OSA severity in women. In contrast to previous reports, clinical and demographic characteristics showed few differences in both analyses. This result suggests that the behavior of OSA at high altitudes may have particularities with respect to low altitudes.
Background: Sexual dysfunction (SD) is a common comorbidity in people with multiple sclerosis (pwMS). It affects the quality of life and remains an overlooked condition. We will describe how Colombian neurologists assess and treat SD in pwMS.Methods: In this observational cross-sectional study we developed a questionnaire for neurologists with 4 sections ( demographic data, evaluation and treatment of SD, and possible reasons for not discussing sexual dysfunction.) It was sent via email to 326 Colombian neurologists. We grouped the answers according to the type of consultation (neurologists from a MS program or no MS program). We described through absolute frequencies and proportions. Results: 50 neurologists answered the survey, 5 have never attend pwMS; the section 2-4 was not answered by them. 29% work in a MS program, all of them asked their patients about sexual function, but 18.75% of physicians working outside an MS program have never asked about it. Reasons for not talking about sexual dysfunction were lack of knowledge (65.1%), presence of a companion (65.1%) and lack of time (55.8%). 91% of the neurologists reported that their patients usually and frequently ask about sexual function. Neurologists use informal questions to assess sexual function (80%), although 64.4% said that they are aware of SD questionnaires. When sexual dysfunction is detected, 91% of neurologists refer patients to another specialist and 87% do not start any treatmentConclusions: Colombian neurologists are concerned about sexual function. There is still a gap in the treatment and evaluation of sexual dysfunction.
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