Gender differences on polysomnographic findings in Greek subjects with obstructive sleep apnea syndrome.

BACKGROUND AND PURPOSE: Studies from North American clinics have reported that females with obstructive sleep apnea syndrome (OSAS) are about the same age as males but are heavier, have less severe apnea and make up a much smaller proportion of cases. We examined polysomnographic differences between Greek men and women with OSAS in order to study the influence of gender on clinical presentation and laboratory findings. PATIENTS AND METHODS: This retrospective study included a cohort of 1,010 Greek patients (844 males, 166 females) diagnosed with OSAS by overnight polysomnography (PSG), who were referred to the Sleep Disorders Center of Evangelismos Hospital, Athens Medical School, University of Athens. All patients were studied over a period of three consecutive years, during which time clinical and polysomnography (PSG) findings were compared. RESULTS: Body mass index (BMI) was similar in men and women with OSAS (BMI=31.6+/-5.5kg/m(2) in men versus BMI=32.5+/-8.1 (SD) kg/m(2) in women). Female patients were significantly older than male patients (56.9+/-10.6 versus 50.6+/-11.7 year, P=0.001). The mean apnea-hypopnea index (AHI) during total sleep time was higher in men than in women (42.4+/-28.2 versus 33.2+/-27.7 events/h, P<0.001). The AHI in non-rapid eye movement (NREM) sleep was higher in men than in women (42.9+/-28.9 versus 32.6+/-28.7 events/h, P<0.001), but in rapid eye movement (REM) sleep AHI was similar in men and women (36.0+/-23.3 versus 34.9+/-25.4 events/h). Forty percent of men had AHI-REM sleep >AHI-NREM compared to 62% of women, and the difference between REM and NREM-AHI was significantly less in men than in women (14.21+/-11.18 versus 19.76+/-13.43 events/h, P<0.001)). Several aspects of sleep were worse in women versus men: sleep efficiency index was lower (79.4+/-16.1% versus 85.1+/-12.5%, P<0.001); sleep onset latency (27.7+/-27.7 versus 17.9+/-18.1min, P<0.001), and REM onset latency (161.5+/-76.2 versus 145.7+/-71.4min, P<0.018) were longer; wake time after sleep onset (WASO) was also greater in women (42.6+/-46.5 versus 30.7+/-34.9min, P<0.003). CONCLUSIONS: In Greek subjects with OSAS, there was no difference in BMI, and female patients were significantly older than male patients. OSAS was diagnosed in men five times more often than in women. AHI was greater in men than in women, but women are more likely than men to have a higher AHI in REM than NREM. Sleep quality is worse in female than in male patients.

Hypercalcaemia in Greek patients with tuberculosis before the initiation of anti-tuberculosis treatment.

Hypercalcaemia has been known to occur in association with granulomatous diseases. The aim of this study was to ascertain the incidence of hypercalcaemia and determine the prevalence of symptoms associated with it in Greek patients with newly-diagnosed tuberculosis (TB), before the initiation of anti-tuberculosis treatment. We prospectively evaluated all patients with newly-diagnosed TB presenting, either as inpatients or as outpatients, to our hospital, during a 3-year period. We evaluated 88 patients with TB (50 males and 38 females), aged between 23 and 89 years (mean age+/-SD: 46.4+/-19 years), and 65 age- and sex-matched controls with chronic obstructive pulmonary disease (36 males and 29 females), aged between 28 and 88 years (mean age+/-SD: 47.2+/-18 years). Among TB patients, 56 had pulmonary TB, 20 had pleural TB without evidence of pulmonary parenchyma involvement, eight had pulmonary and pleural TB, and four had disseminated disease. The mean (+/-SD) albumin-adjusted serum calcium concentration and the mean ionized calcium concentration were significantly higher in the TB group (2.49+/-0.21 mmol l(-1) and 1.27+/-0.02 mmol l(-1) respectively) than in the control group (2.36+/-0.11 mmol l(-1) and 1.19+/-0.02 mmol l(-1), P<0.05). In the TB group no correlation between type of disease and albumin-adjusted or ionized calcium concentration was seen. Hypercalcaemia was detected in 22 patients with TB (25%) but only three showed symptoms associated with it. We conclude that, although hypercalcaemia is a common laboratory finding among Greek patients with TB before anti-TB chemotherapy, it is usually asymtomatic.