Effects of sex on sleep-disordered breathing in adolescents

Abstract

This study was conducted to determine the influence of puberty on features of sleep-disordered breathing (SDB) in adolescents.The study was performed in a general population sample of 226 adolescents of both sexes (aged 11-19 yrs) recruited from the secondary school population of the city of Seville, Spain. Subjects were divided into two groups: 1) postpubertal, i.e. females who had undergone menarche and males in whom axillary hair development or peak height velocity had occurred w1 yr before the study; and 2) peripubertal, i.e. females who had not undergone menarche and males who had not developed axillary hair nor reached peak height velocity, or subjects in whom these pubertal changes had appeared v1 yr before the study. All subjects answered a questionnaire on SDB and underwent overnight cardiorespiratory polygraphy.There were 50 males and 40 females (mean¡SD age 13.5¡1.2 yrs) in the peripubertal group, and 54 males and 82 females (age 16.3¡1.7 yrs) in the postpubertal group. Males exhibited significantly higher neck circumference/height index and waist/hip index than females in both the peripubertal and postpubertal groups. In the postpubertal group, snoring and polygraphic alterations (respiratory events and oximetric parameters) were significantly more frequent in males than in females. Postpubertal adolescents showed sex differences in clinical and polygraphic parameters that were not observed at earlier pubertal stages.These findings support the influence of sex hormones on sex differences in sleepdisordered breathing.

Clinical and polygraphic evolution of sleep-related breathing disorders in adolescents

“…In the first phase of the present study, there was no male predominance among the snorers [12], but when the population was divided by stage of pubertal development, sexrelated differences were observed among the post-pubertal adolescents, with a higher prevalence of snoring and more polygraphic disturbances in males [15]. In the current longitudinal study, a predominance of males among the habitual snorers (14 out of 18) was found at long-term follow-up.…”

“…A previously reported questionnaire [12][13][14][15] (see online supplementary data) was used in the follow-up study. The questionnaire was completed by a technician, and data were provided by the subject and their parents.…”

“…The overnight home polygraphy was performed using a portable ambulatory device (Apnoescreen II; Erich Jaeger GmbH, Wuerzburg, Germany) with continuous monitoring of oronasal airflow (thermistor), chest and abdominal respiratory movements (thoracic and abdominal belts), arterial oxygen saturation (Sa,O 2 ; digital pulse oximetry), heart rate (finger probe), electrocardiography, body position (mercury sensor) and actigraphy (wristband with activity sensor) [12,15]. The specific program for the analysis of the recordings was improved in the second phase to enable the recordings to be reproduced in real time.…”

“…The general features of SRBD in the adolescent age group have been reported previously [12][13][14][15]. A cross-sectional study was carried out by the present authors between 1997 and 2000 in a population of 267 adolescents ranging 11-19 yrs of age.…”

Brief communication (Original). Sleep-disordered breathing and risk factors in Thailand

“…According to Wolkove et al [25], older people increase occurrence of obesity predisposing to upperairway narrowing, decline in muscle tone enhancing upper-airway collapsibility, and impair pharyngeal sensory discrimination to make a persistence of upper-airway collapse during sleep. Fuentes-Pradera et al [26] explained that sex hormone might influence neuromuscular control of upper airway and central pattern of body fat distribution, which related to OSA. However, in our study, the differences disappeared after adjusting for BMI.…”