Sleep, Gender, and the Brain...

Obstructive sleep apnea (OSA)—a disorder in which breathing is constantly interrupted during sleep, deprivingthe body’s cells of oxygen—is linked to a litany of serious health threats, including heart disease, stroke, diabetes,dementia, and early death. OSA is less common inwomen than in men, yet its destructive cardiovascular and neuropsychological consequences are much more severe in female patients than in their male counterparts. What accounts for this troubling gender disparity?

That’s the question Dr. Paul Macey, Associate Professor inResidence at UCLA School of Nursing, wants to answer. Macey is an engineer who studies the role of brain function and dysfunction in people with OS A—specifically, how brain injury and other changes in the brain affect physical and psychological factors such as breathing, blood pressure, heart rate, anxiety, and depression in these patients.

Two recent studies led by Macey have shown that women with OSA have an even greater degree of brain damageand diminished autonomic responses than men with the same level of the disorder. This could help explainwhy OSA hits female patients harder and puts them at a disproportionally high risk of developing heart disease and other deadly illnesses, he says. His latest projects focuson how women’s brains respond to OSA interventions, like positive airway pressure (PAP) and stress reduction,compared with men’s.

These findings, Macey adds, point to a critical need for earlier detection and treatment of OSA in women, when’s there’s still time to prevent their brain injuries from becoming too extensive.

“Sleep apnea is more prevalent in males, so in clinical practice the male symptoms are considered the norm and the female symptoms are still considered atypical,” he says. “As a result, women with OSA are not diagnosed asoften, or they are misdiagnosed.”