Journal of Psychosomatic Research
Volume 59, Issue 6 , Pages 365-373 , December 2005

Diagnostic indicators of sleep apnea in older women and men: A prospective study

  • Sally Bailes

      Affiliations

    • S.M.B.D., Jewish General Hospital, Montreal, Quebec, Canada H3T 1E4
    • Corresponding Author InformationCorresponding author. Department of Psychiatry, ICFP, Jewish General Hospital, Montreal, Quebec, Canada H3T 1E4. Concordia University, Montreal, Quebec, Canada.
    • ,
  • Marc Baltzan

      Affiliations

    • Mount Sinai Hospital, Montreal, Quebec, Canada
    • McGill University, Montreal, Quebec, Canada
    • ,
  • Iris Alapin

      Affiliations

    • S.M.B.D., Jewish General Hospital, Montreal, Quebec, Canada H3T 1E4
    • ,
  • Catherine S. Fichten

      Affiliations

    • S.M.B.D., Jewish General Hospital, Montreal, Quebec, Canada H3T 1E4
    • Dawson College, Montreal, Quebec, Canada
    • McGill University, Montreal, Quebec, Canada
    • ,
  • Eva Libman

      Affiliations

    • S.M.B.D., Jewish General Hospital, Montreal, Quebec, Canada H3T 1E4
    • Concordia University, Montreal, Quebec, Canada
    • McGill University, Montreal, Quebec, Canada

Received 4 August 2004 ,Accepted 15 June 2005.

References 

  1. Ancoli-Israel S, Kripke D, Klauber M, Fell R, Stepnowsky C, Estline E, et al. Morbidity, mortality and sleep-disordered breathing in community dwelling elderly. Sleep. 1996;19:277–282
  2. Strohl KP, Redline S. Recognition of obstructive sleep apnea. Am J Respir Crit Care Med. 1996;154:279–289
  3. Dement WC, Netzer NC. Primary care: is it the setting to address sleep disorders?. Sleep Breath. 2000;4(1):1–9
  4. Kramer NR, Cook TE, Carlisle CC, Corwin RW, Millman RP. The role of the primary care physician in recognizing obstructive sleep apnea. Arch Intern Med. 1999;159:965–968
  5. Ancoli-Israel S, Coy T. Are breathing disturbances in elderly equivalent to sleep apnea syndrome?. Sleep. 1994;17:77–83
  6. Ancoli-Israel S, Kripke DF, Klauber MR, Mason WF, Fell R, Kaplan O. Sleep-disordered breathing in community-dwelling elderly. Sleep. 1991;14:486–495
  7. Lichstein KL, Reidel BW, Lester KW, Aguillard RN. Occult sleep apnea in a recruited sample of older adults with insomnia. J Consult Clin Psychol. 1999;67(3):405–410
  8. Larsson L-G, Lindberg A, Franklin KA, Lundback B. Gender differences in symptoms related to sleep apnea in a general population and in relation to referral to sleep clinic. Chest. 2003;124:204–211
  9. Young T, Hutton R, Finn L, Badr S, Palta M. The gender bias in sleep apnea diagnosis. Are women missed because they have different symptoms?. Arch Intern Med. 1996;156(21):2445–2451
  10. Ware JC, Mcbrayer RH, Scott JA. Influence of sex and age on duration and frequency of sleep apnea events. Sleep. 2000;23(2):165–170
  11. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr D. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–1235
  12. Kapsimalis F, Kryger MH. Gender and obstructive sleep apnea syndrome: Part 1. Clinical features. Sleep. 2002;25(4):412–419
  13. Bixler EO, Vgontzas AN, Lin H-M, Have TT, Rein J, Vela-Bueno A, et al. Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med. 2001;163(3):608–613
  14. Popovic RM, White DP. Effect of short term hormone replacement on the EMG activity of an upper airway dilator muscle in postmenopausal women during wakefulness. Sleep Res. 1996;25:336
  15. Keefe DL, Watson R, Naftolin F. Hormone replacement therapy may alleviate sleep apnea in menopausal women: a pilot study. Menopause. 1999;6(3):196–200
  16. Cunningham SL, Sholar MB, Winkelman JW, Anandan S, Dorsey CM, Lukas SE. Gender differences in polysomnographic features of sleep-disordered breathing events. Sleep Res. 1996;25:230
  17. O'Connor C, Thornley KS, Hanly PJ. Gender differences in the polysomnographic features of obstructive sleep apnea. Am J Respir Crit Care Med. 2000;161(5):1465–1472
  18. Popovic RM, White DP. Influence of gender on waking genioglossal electromyogram and upper airway resistance. Am J Respir Crit Care Med. 1995;152(2):725–731
  19. Rowley JA, Zhou X, Vergine I, Shkoukani MA, Badr MS. Influence of gender on upper airway mechanics: upper airway resistance and Pcrit. J Appl Physiol. 2001;91(5):2248–2254
  20. Mohsenin V. Gender differences in the expression of sleep-disordered breathing: role of upper airway dimensions. Chest. 2001;120(5):1442–1447
  21. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-IV). Washington (DC): APA; 1994;
  22. Beck A, Steer R, Brown G. BDI-II: Beck Depression Inventory manual. 2nd ed.. San Antonio: The Psychological Corporation, Harcourt Brace & Company; 1996;
  23. ICSD (International Classification of Sleep Disorders). Diagnostic and coding manual. Diagnostic Classification Steering Committee, Thorpy MJ, Chairman. Rochester (Minn): American Sleep Disorders Association; 1990;
  24. ASDA (American Sleep Disorders Association) Standards of Practice Committee of the American Sleep Disorders Association. Practice parameters for the use of polysomnography in the evaluation of insomnia. Sleep. 1995;18:55–57
  25. Lacks P. Daily sleep diary. In:  Lacks P editors. Behavioral treatment for persistent insomnia. New York: Pergamon; 1987;p. 70–73
  26. Fichten CS, Creti L, Amsel R, Brender W, Weinstein N, Libman E. Poor sleepers who do not complain of insomnia: myths and realities about psychological and lifestyle characteristics of older good and poor sleepers. J Behav Med. 1995;18(2):189–223
  27. Libman E, Creti L, Amsel R, Brender W, Fichten CS. What do older good and poor sleepers do during periods of nocturnal wakefulness? The Sleep Behaviors Scale: 60+. Psychol Aging. 1997;12(1):170–182
  28. Libman E, Creti L, Levy RD, Brender W, Fichten CS. A comparison of reported and recorded sleep in older poor sleepers. J Clin Geropsychol. 1997;3(3):199–211
  29. Fichten CS, Libman E, Creti L, Amsel R, Tagalakis V, Brender W. Thoughts during awake times in older good and poor sleepers: the Self-Statement Test: 60+. Cog Ther Res. 1998;22(1):1–20
  30. Hoddes E, Zarcone V, Smythe H, Phillips R, Dement WC. Quantification of sleepiness: a new approach. Psychophysiology. 1973;10:431–437
  31. Johns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep. 1991;14(6):540–545
  32. Johns MW. Reliability and factor analysis of the Epworth Sleepiness Scale. Sleep. 1994;15(4):376–381
  33. Johns MW. Sleepiness in different situations measured by the Epworth Sleepiness Scale. Sleep. 1994;17(8):703–710
  34. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The Fatigue Severity Scale. Arch Neurol. 1989;46:1121–1123
  35. Lichstein KL, Wilson NM, Noe SL, Aguillard RN, Bellur SN. Daytime sleepiness in insomnia: behavioral, biological and subjective indices. Sleep. 1994;17(8):693–702
  36. Chalder T, Berelowitz G, Pawlikowska T, Watts L, Wessely S, Wright D, et al. Development of a fatigue scale. J Psychosom Res. 1993;37(2):147–153
  37. Beck A, Guth D, Steer R, Ball R. Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for Primary Care. Behav Res Ther. 1997;35:785–791
  38. Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the State-Trait Anxiety Inventory (Form Y). Palo Alto (CA): Consulting Psychologists Press; 1983;
  39. Eysenck HJ, Eysenck SBG. Manual of the Eysenck Personality Scales (EPQ adults). London: Hodder and Stoughton; 1991;
  40. Eysenck HJ, Eysenck SBG. Manual: Eysenck Personality Inventory. San Diego: Educational and Industrial Testing Service; 1968;
  41. Digman JM. Personality structure: emergence of the 5-factor model. Ann Rev Psychol. 1990;41:417–440
  42. Derogatis LR, Rickels K, Rock AF. The SCL-90 and the MMPI: a step in the validation of a new self-report scale. Br J Psychiatry. 1976;128:280–289
  43. Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 health survey: manual and interpretation guide. Lincoln (RI): Quality Metric Incorporated; 1993;
  44. Hopman WM, Towheed T, Anastassiades T, Tenenhouse A, Poliquin S, Berger C, et al. Canadian normative data for the SF-36 health survey. CMAJ. 2000;163(3):265–271
  45. American Thoracic Society . Indications and standards for cardiopulmonary sleep studies. Am Rev Respir Dis. 1989;139:559–568
  46. In:  Rechtschaffen A,  Kales A editor. A manual of standardized terminology, techniques, and scoring system for sleep stages of human subjects. Bethesda, MD: National Institute of Health, Publication 204, U.S. Government Printing Office; 1968;
  47. ASDA (American Sleep Disorders Association) Sleep Disorders Task Force. EEG arousals: scoring rules and examples. Sleep. 1992;15:173–184
  48. American Academy of Sleep Medicine Task Force. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep. 1999;22:667–689
  49. Atlas Task Force of the American Sleep Disorders Association. Recording and scoring leg movements. Sleep. 1993;16:749

☆ This research was carried out at both the Jewish General Hospital and the Mount Sinai Hospital in Montreal, Quebec, Canada, with the assistance of a grant from the Canadian Institutes of Health Research (number MT-15546).

PII: S0022-3999(05)00204-7

doi: 10.1016/j.jpsychores.2005.06.067

Journal of Psychosomatic Research
Volume 59, Issue 6 , Pages 365-373 , December 2005

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