{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T19:25:52Z","timestamp":1774466752267,"version":"3.50.1"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsmedizin Greifswald"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sleep Breath"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder that is diagnosed more frequently in men. The aim of this population-based cross-sectional study was to describe sex-specific differences in sleep stage distribution and subjective daytime sleepiness in individuals with OSA. Special attention was given to the distribution of the apnea-hypopnea index (AHI) in rapid eye movement (REM) and non-REM sleep.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study analyzed data from the SHIP-TREND-0 cohort, a population-based study from northeastern Germany. Standardized polysomnography identified 604 participants with an AHI\u2009\u2265\u20095 (395 men, 209 women) who were included in this study. In addition, daytime sleepiness was recorded using the Epworth Sleepiness Scale (ESS). Sex differences were analyzed descriptively and evaluated according to effect sizes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to males, females were on average older and had higher BMI values. Women showed descriptively higher AHI values in REM sleep than in non-REM sleep, whereas men exhibited a more balanced distribution of AHI across sleep stages. Women had a longer REM sleep latency (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.36).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results indicate sex-specific differences in the distribution of obstructive events across sleep stages. The AHI during REM sleep should receive greater consideration in the diagnosis and assessment of severity, particularly in women. Further population-based studies are needed to confirm these findings and evaluate their clinical relevance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11325-026-03632-z","type":"journal-article","created":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T07:32:55Z","timestamp":1772263975000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex differences in obstructive sleep apnea: a population-based study from northeastern Germany"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3554-1192","authenticated-orcid":false,"given":"Kora","family":"Steinmetz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Kr\u00fcger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Obst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralf","family":"Ewert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Penzel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingo","family":"Fietze","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernd","family":"Korda\u00df","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Till","family":"Ittermann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chia-Jung","family":"Busch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Scharf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvia","family":"Stracke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beate","family":"Stubbe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amro","family":"Daboul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,28]]},"reference":[{"key":"3632_CR1","volume-title":"The AASM Manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Version 3","author":"MM Troester","year":"2023","unstructured":"Troester MM, Quan SF, Berry RB, Plante DT, Abreu AR, Alzoubaidi M (2023) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Version 3. American Academy of Sleep Medicine, Darien, IL"},{"key":"3632_CR2","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.5664\/jcsm.7234","volume":"14","author":"RK Malhotra","year":"2018","unstructured":"Malhotra RK, Kirsch DB, Kristo DA, Olson EJ, Aurora RN, Carden KA et al (2018) Polysomnography for obstructive sleep apnea should include arousal-based scoring: an American Academy of Sleep Medicine position statement. J Clin Sleep Med 14:1245\u20137. https:\/\/doi.org\/10.5664\/jcsm.7234","journal-title":"J Clin Sleep Med"},{"key":"3632_CR3","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.smrv.2016.07.002","volume":"34","author":"CV Senaratna","year":"2017","unstructured":"Senaratna CV, Perret JL, Lodge CJ, Lowe AJ, Campbell BE, Matheson MC et al (2017) Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev 34:70\u201381. https:\/\/doi.org\/10.1016\/j.smrv.2016.07.002","journal-title":"Sleep Med Rev"},{"key":"3632_CR4","doi-asserted-by":"publisher","DOI":"10.3390\/diseases9040088","volume":"9","author":"AK Mitra","year":"2021","unstructured":"Mitra AK, Bhuiyan AR, Jones EA (2021) Association and risk factors for obstructive sleep apnea and cardiovascular diseases: a systematic review. Diseases 9:88. https:\/\/doi.org\/10.3390\/diseases9040088","journal-title":"Diseases"},{"key":"3632_CR5","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1513\/pats.200709-155MG","volume":"5","author":"NM Punjabi","year":"2008","unstructured":"Punjabi NM (2008) The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc 5:136\u2013143. https:\/\/doi.org\/10.1513\/pats.200709-155MG","journal-title":"Proc Am Thorac Soc"},{"key":"3632_CR6","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.sleep.2022.04.003","volume":"96","author":"N Udholm","year":"2022","unstructured":"Udholm N, Rex CE, Fuglsang M, Lundbye-Christensen S, Bille J, Udholm S (2022) Obstructive sleep apnea and road traffic accidents: a Danish nationwide cohort study. Sleep Med 96:64\u201369. https:\/\/doi.org\/10.1016\/j.sleep.2022.04.003","journal-title":"Sleep Med"},{"key":"3632_CR7","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.3978\/j.issn.2072-1439.2015.06.11","volume":"7","author":"KA Franklin","year":"2015","unstructured":"Franklin KA, Lindberg E (2015) Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. J Thorac Dis 7:1311\u20131322. https:\/\/doi.org\/10.3978\/j.issn.2072-1439.2015.06.11","journal-title":"J Thorac Dis"},{"key":"3632_CR8","first-page":"412","volume":"25","author":"F Kapsimalis","year":"2002","unstructured":"Kapsimalis F, Kryger MH (2002) Gender and obstructive sleep apnea syndrome, part 1: clinical features. Sleep 25:412\u2013419","journal-title":"Sleep"},{"key":"3632_CR9","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1097\/MCP.0b013e328358be05","volume":"18","author":"FM Ralls","year":"2012","unstructured":"Ralls FM, Grigg-Damberger M (2012) Roles of gender, age, race\/ethnicity, and residential socioeconomics in obstructive sleep apnea syndromes. Curr Opin Pulm Med 18:568\u2013573. https:\/\/doi.org\/10.1097\/MCP.0b013e328358be05","journal-title":"Curr Opin Pulm Med"},{"key":"3632_CR10","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1164\/ajrccm.163.3.9911064","volume":"163","author":"EO Bixler","year":"2001","unstructured":"Bixler EO, Vgontzas AN, Lin H-M, Ten Have T, Rein J, Vela-Bueno A et al (2001) Prevalence of Sleep-disordered Breathing in Women: Effects of Gender. Am J Respir Crit Care Med 163:608\u2013613. https:\/\/doi.org\/10.1164\/ajrccm.163.3.9911064","journal-title":"Am J Respir Crit Care Med"},{"key":"3632_CR11","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1093\/sleep\/25.5.497","volume":"25","author":"F Kapsimalis","year":"2002","unstructured":"Kapsimalis F, Kryger MH (2002) Gender and obstructive sleep apnea syndrome, part 2: mechanisms. Sleep 25:497\u2013504. https:\/\/doi.org\/10.1093\/sleep\/25.5.497","journal-title":"Sleep"},{"key":"3632_CR12","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12062101","volume":"12","author":"M Kr\u00fcger","year":"2023","unstructured":"Kr\u00fcger M, Obst A, Ittermann T, Bernhardt O, Ivanovska T, Zygmunt M et al (2023) Menopause is associated with obstructive sleep apnea in a population-based sample from Mecklenburg\u2013Western Pomerania, Germany. J Clin Med 12:2101. https:\/\/doi.org\/10.3390\/jcm12062101","journal-title":"J Clin Med"},{"key":"3632_CR13","doi-asserted-by":"publisher","first-page":"3968","DOI":"10.1210\/jc.2016-1832","volume":"101","author":"H Kische","year":"2016","unstructured":"Kische H, Ewert R, Fietze I, Gross S, Wallaschofski H, V\u00f6lzke H et al (2016) Sex hormones and sleep in men and women from the general population: a cross-sectional observational study. J Clin Endocrinol Metab 101:3968\u201377. https:\/\/doi.org\/10.1210\/jc.2016-1832","journal-title":"J Clin Endocrinol Metab"},{"key":"3632_CR14","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1016\/j.chest.2018.04.005","volume":"154","author":"MF Pengo","year":"2018","unstructured":"Pengo MF, Won CH, Bourjeily G (2018) Sleep in women across the life span. Chest 154:196\u2013206. https:\/\/doi.org\/10.1016\/j.chest.2018.04.005","journal-title":"Chest"},{"key":"3632_CR15","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.smrv.2017.03.003","volume":"38","author":"J Theorell-Hagl\u00f6w","year":"2018","unstructured":"Theorell-Hagl\u00f6w J, Miller CB, Bartlett DJ, Yee BJ, Openshaw HD, Grunstein RR (2018) Gender differences in obstructive sleep apnoea, insomnia and restless legs syndrome in adults \u2013 what do we know? A clinical update. Sleep Med Rev 38:28\u201338. https:\/\/doi.org\/10.1016\/j.smrv.2017.03.003","journal-title":"Sleep Med Rev"},{"key":"3632_CR16","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0030-2019","volume":"28","author":"MR Bonsignore","year":"2019","unstructured":"Bonsignore MR, Saaresranta T, Riha RL (2019) Sex differences in obstructive sleep apnoea. Eur Respir Rev 28:190030. https:\/\/doi.org\/10.1183\/16000617.0030-2019","journal-title":"Eur Respir Rev"},{"key":"3632_CR17","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1056\/NEJM199304293281704","volume":"328","author":"T Young","year":"1993","unstructured":"Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328:1230\u20131235. https:\/\/doi.org\/10.1056\/NEJM199304293281704","journal-title":"N Engl J Med"},{"key":"3632_CR18","doi-asserted-by":"publisher","first-page":"493","DOI":"10.7326\/0003-4819-122-7-199504010-00003","volume":"122","author":"C Guilleminault","year":"1995","unstructured":"Guilleminault C, Stoohs R, Kim Y, Chervin R, Black J, Clerk A (1995) Upper airway sleep-disordered breathing in women. Ann Intern Med 122:493\u2013501. https:\/\/doi.org\/10.7326\/0003-4819-122-7-199504010-00003","journal-title":"Ann Intern Med"},{"key":"3632_CR19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5664\/jcsm.9684","volume":"18","author":"M\u00c1 Mart\u00ednez-Garc\u00eda","year":"2022","unstructured":"Mart\u00ednez-Garc\u00eda M\u00c1, Labarca G (2022) Obstructive sleep apnea in women: scientific evidence is urgently needed. J Clin Sleep Med 18:1\u20132. https:\/\/doi.org\/10.5664\/jcsm.9684","journal-title":"J Clin Sleep Med"},{"key":"3632_CR20","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1183\/09031936.00043210","volume":"37","author":"E Sforza","year":"2011","unstructured":"Sforza E, Chouchou F, Collet P, Pichot V, Barth\u00e9l\u00e9my JC, Roche F (2011) Sex differences in obstructive sleep apnoea in an elderly French population. Eur Respir J 37:1137\u20131143. https:\/\/doi.org\/10.1183\/09031936.00043210","journal-title":"Eur Respir J"},{"key":"3632_CR21","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1164\/ajrccm.149.3.8118642","volume":"149","author":"S Redline","year":"1994","unstructured":"Redline S, Kump K, Tishler PV, Browner I, Ferrette V (1994) Gender differences in sleep disordered breathing in a community-based sample. Am J Respir Crit Care Med 149:722\u2013726. https:\/\/doi.org\/10.1164\/ajrccm.149.3.8118642","journal-title":"Am J Respir Crit Care Med"},{"key":"3632_CR22","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1016\/j.sleep.2009.02.006","volume":"10","author":"L Ye","year":"2009","unstructured":"Ye L, Pien GW, Weaver TE (2009) Gender differences in the clinical manifestation of obstructive sleep apnea. Sleep Med 10:1075\u20131084. https:\/\/doi.org\/10.1016\/j.sleep.2009.02.006","journal-title":"Sleep Med"},{"key":"3632_CR23","doi-asserted-by":"publisher","first-page":"721","DOI":"10.2147\/NSS.S275051","volume":"12","author":"RA Bahammam","year":"2020","unstructured":"Bahammam RA, Al-Qahtani KM, Aleissi SA, Olaish AH, Almeneessier AS, Bahammam AS (2020) The associations of gender, menopause, age, and asthma with REM-predominant obstructive sleep apnea: a prospective observational study. Nat Sci Sleep 12:721\u201335. https:\/\/doi.org\/10.2147\/NSS.S275051","journal-title":"Nat Sci Sleep"},{"key":"3632_CR24","doi-asserted-by":"publisher","first-page":"1465","DOI":"10.1164\/ajrccm.161.5.9904121","volume":"161","author":"C O\u2019Connor","year":"2000","unstructured":"O\u2019Connor C, Thornley KS, Hanly PJ (2000) Gender differences in the polysomnographic features of obstructive sleep apnea. Am J Respir Crit Care Med 161:1465\u201372. https:\/\/doi.org\/10.1164\/ajrccm.161.5.9904121","journal-title":"Am J Respir Crit Care Med"},{"key":"3632_CR25","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1164\/rccm.201706-1112OC","volume":"197","author":"RN Aurora","year":"2018","unstructured":"Aurora RN, Crainiceanu C, Gottlieb DJ, Kim JS, Punjabi NM (2018) Obstructive sleep apnea during REM sleep and cardiovascular disease. Am J Respir Crit Care Med 197:653\u2013660. https:\/\/doi.org\/10.1164\/rccm.201706-1112OC","journal-title":"Am J Respir Crit Care Med"},{"key":"3632_CR26","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0166-2023","volume":"33","author":"MR Bonsignore","year":"2024","unstructured":"Bonsignore MR, Mazzuca E, Baiamonte P, Bouckaert B, Verbeke W, Pevernagie DA (2024) REM sleep obstructive sleep apnoea. Eur Respir Rev 33:230166. https:\/\/doi.org\/10.1183\/16000617.0166-2023","journal-title":"Eur Respir Rev"},{"key":"3632_CR27","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1164\/rccm.201406-1136OC","volume":"190","author":"B Mokhlesi","year":"2014","unstructured":"Mokhlesi B, Finn LA, Hagen EW, Young T, Hla KM, Van Cauter E et al (2014) Obstructive sleep apnea during REM sleep and hypertension. Results of the Wisconsin Sleep Cohort. Am J Respir Crit Care Med 190:1158\u201367. https:\/\/doi.org\/10.1164\/rccm.201406-1136OC","journal-title":"Am J Respir Crit Care Med"},{"key":"3632_CR28","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1016\/j.smrv.2007.11.003","volume":"12","author":"CM Lin","year":"2008","unstructured":"Lin CM, Davidson TM, Ancoli-Israel S (2008) Gender differences in obstructive sleep apnea and treatment implications. Sleep Med Rev 12:481\u2013496. https:\/\/doi.org\/10.1016\/j.smrv.2007.11.003","journal-title":"Sleep Med Rev"},{"key":"3632_CR29","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1001\/jama.2016.18630","volume":"317","author":"S Redline","year":"2017","unstructured":"Redline S (2017) Screening for obstructive sleep apnea: implications for the sleep health of the population. JAMA 317:368. https:\/\/doi.org\/10.1001\/jama.2016.18630","journal-title":"JAMA"},{"key":"3632_CR30","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyac034","volume":"51","author":"H V\u00f6lzke","year":"2022","unstructured":"V\u00f6lzke H, Sch\u00f6ssow J, Schmidt CO, J\u00fcrgens C, Richter A, Werner A et al (2022) Cohort profile update: the Study of Health in Pomerania (SHIP). Int J Epidemiol 51:e372\u201383. https:\/\/doi.org\/10.1093\/ije\/dyac034","journal-title":"Int J Epidemiol"},{"key":"3632_CR31","volume-title":"The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications","author":"C Iber","year":"2007","unstructured":"Iber C, Ancoli-Israel S, Chesson AL, Quan SF (2007) The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, 1st ed. American Academy of Sleep Medicine, Westchester, IL","edition":"1st ed"},{"key":"3632_CR32","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.12770","volume":"28","author":"I Fietze","year":"2019","unstructured":"Fietze I, Laharnar N, Obst A, Ewert R, Felix SB, Garcia C et al (2019) Prevalence and association analysis of obstructive sleep apnea with gender and age differences \u2013 results of SHIP-Trend. J Sleep Res 28:e12770. https:\/\/doi.org\/10.1111\/jsr.12770","journal-title":"J Sleep Res"},{"key":"3632_CR33","doi-asserted-by":"publisher","unstructured":"Stubbe B, Penzel T, Fietze I, Obst A, Garcia C, Zimmermann S et al (2016) Polysomnography in a Large Population Based Study-the Study of Health in Pomerania Protocol. J Sleep Disord Manag 2. https:\/\/doi.org\/10.23937\/2572-4053.1510010","DOI":"10.23937\/2572-4053.1510010"},{"key":"3632_CR34","unstructured":"Deutsche Adipositas-Gesellschaft (DAG) (2024) e.V. S3-Leitlinie Adipositas - Pr\u00e4vention und Therapie; version 5.0\u00a0https:\/\/register.awmf.org\/de\/leitlinien\/detail\/050-001"},{"key":"3632_CR35","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1016\/j.sleep.2005.12.014","volume":"7","author":"E Vagiakis","year":"2006","unstructured":"Vagiakis E, Kapsimalis F, Lagogianni I, Perraki H, Minaritzoglou A, Alexandropoulou K et al (2006) Gender differences on polysomnographic findings in Greek subjects with obstructive sleep apnea syndrome. Sleep Med 7:424\u201330. https:\/\/doi.org\/10.1016\/j.sleep.2005.12.014","journal-title":"Sleep Med"},{"key":"3632_CR36","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1093\/sleep\/14.6.540","volume":"14","author":"MW Johns","year":"1991","unstructured":"Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14:540\u2013545. https:\/\/doi.org\/10.1093\/sleep\/14.6.540","journal-title":"Sleep"},{"key":"3632_CR37","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1093\/sleep\/20.10.844","volume":"20","author":"M Johns","year":"1997","unstructured":"Johns M, Hocking B (1997) Daytime sleepiness and sleep habits of Australian workers. Sleep 20:844\u2013847. https:\/\/doi.org\/10.1093\/sleep\/20.10.844","journal-title":"Sleep"},{"key":"3632_CR38","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"J Cohen","year":"1988","unstructured":"Cohen J (1988) Statistical Power Analysis for the Behavioral Sciences, 2nd ed. Lawrence Erlbaum Associates, Publishers, Hillsdale, NJ","edition":"2nd ed"},{"key":"3632_CR39","unstructured":"R Core Team (2024) R: A language and environment for statistical computing"},{"key":"3632_CR40","unstructured":"RStudio Team (2023) RStudio: Integrated Development Environment for R"},{"key":"3632_CR41","unstructured":"Wickham H, Miller E, Smith D, Haven (2022) Import and Export SPSS. Stata and SAS Files"},{"key":"3632_CR42","unstructured":"Wickham H, Fran\u00e7ois R, Henry L, M\u00fcller K, Dplyr (2022) A Grammar of Data Manipulation"},{"key":"3632_CR43","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1164\/rccm.201704-0672LE","volume":"197","author":"S Patel","year":"2018","unstructured":"Patel S, Kon SSC, Nolan CM, Barker RE, Simonds AK, Morrell MJ et al (2018) The Epworth sleepiness scale: minimum clinically important difference in obstructive sleep apnea. Am J Respir Crit Care Med 197:961\u20133. https:\/\/doi.org\/10.1164\/rccm.201704-0672LE","journal-title":"Am J Respir Crit Care Med"},{"key":"3632_CR44","doi-asserted-by":"publisher","first-page":"593","DOI":"10.2147\/NSS.S258330","volume":"12","author":"S Mehra","year":"2020","unstructured":"Mehra S, Ghimire RH, Mingi J, Hatch M, Garg H, Adams R et al (2020) Gender differences in the clinical and polysomnographic characteristics among Australian Aboriginal patients with obstructive sleep apnea. Nat Sci Sleep 12:593\u2013602. https:\/\/doi.org\/10.2147\/NSS.S258330","journal-title":"Nat Sci Sleep"},{"key":"3632_CR45","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1007\/s11325-017-1482-9","volume":"22","author":"OK Basoglu","year":"2018","unstructured":"Basoglu OK, Tasbakan MS (2018) Gender differences in clinical and polysomnographic features of obstructive sleep apnea: a clinical study of 2827 patients. Sleep Breath 22:241\u20139. https:\/\/doi.org\/10.1007\/s11325-017-1482-9","journal-title":"Sleep Breath"},{"key":"3632_CR46","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.bbi.2016.09.005","volume":"59","author":"C Hirotsu","year":"2017","unstructured":"Hirotsu C, Albuquerque RG, Nogueira H, Hachul H, Bittencourt L, Tufik S et al (2017) The relationship between sleep apnea, metabolic dysfunction and inflammation: the gender influence. Brain Behav Immun 59:211\u20138. https:\/\/doi.org\/10.1016\/j.bbi.2016.09.005","journal-title":"Brain Behav Immun"},{"key":"3632_CR47","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2016\/1764837","volume":"2016","author":"A Wimms","year":"2016","unstructured":"Wimms A, Woehrle H, Ketheeswaran S, Ramanan D, Armitstead J (2016) Obstructive sleep apnea in women: specific issues and interventions. Biomed Res Int 2016:1\u20139. https:\/\/doi.org\/10.1155\/2016\/1764837","journal-title":"Biomed Res Int"},{"key":"3632_CR48","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1016\/j.sleep.2022.11.025","volume":"101","author":"S Votteler","year":"2023","unstructured":"Votteler S, Knaack L, Janicki J, Fink GR, Burghaus L (2023) Sex differences in polysomnographic findings in patients with obstructive sleep apnea. Sleep Med 101:429\u2013436. https:\/\/doi.org\/10.1016\/j.sleep.2022.11.025","journal-title":"Sleep Med"},{"key":"3632_CR49","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1378\/chest.08-1414","volume":"135","author":"K Yukawa","year":"2009","unstructured":"Yukawa K, Inoue Y, Yagyu H, Hasegawa T, Komada Y, Namba K et al (2009) Gender differences in the clinical characteristics among Japanese patients with obstructive sleep apnea syndrome. Chest 135:337\u201343. https:\/\/doi.org\/10.1378\/chest.08-1414","journal-title":"Chest"},{"key":"3632_CR50","unstructured":"Deutsche Gesellschaft f\u00fcr Schlafforschung und Schlafmedizin e.V. (DGSM) (2017) S3-Leitlinie Nicht erholsamer Schlaf\/Schlafst\u00f6rung Kapitel \u201eSchlafbezogene Atmungsst\u00f6rungen bei Erwachsenen; version 2.0.\u00a0https:\/\/register.awmf.org\/de\/leitlinien\/detail\/063-001"},{"key":"3632_CR51","doi-asserted-by":"publisher","first-page":"A234","DOI":"10.1093\/sleep\/zsad077.0532","volume":"46","author":"A Wimms","year":"2023","unstructured":"Wimms A, Benjafield A, Valentine K, Malhotra A (2023) 0532 global prevalence of mild obstructive sleep apnea in females. Sleep 46:A234\u2013A234. https:\/\/doi.org\/10.1093\/sleep\/zsad077.0532","journal-title":"Sleep"}],"container-title":["Sleep and Breathing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11325-026-03632-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11325-026-03632-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11325-026-03632-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T18:14:11Z","timestamp":1774462451000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11325-026-03632-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,28]]},"references-count":51,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["3632"],"URL":"https:\/\/doi.org\/10.1007\/s11325-026-03632-z","relation":{},"ISSN":["1520-9512","1522-1709"],"issn-type":[{"value":"1520-9512","type":"print"},{"value":"1522-1709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,28]]},"assertion":[{"value":"1 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 February 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 February 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 February 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This data analysis is based on data from the SHIP cohort study. The SHIP protocol was approved by the ethics committee of the University Medicine Greifswald (reference: BB 39\/08) and complies with the 1964 Declaration of Helsinki in its current version. Written informed consent was obtained from all participants prior to inclusion. Participation was voluntary and could be withdrawn at any time without negative consequences.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"Although the co-author Thomas Penzel is the Editor of the journal, there was no involvement with the peer review process for this article. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}},{"value":"During the preparation of this work, the authors used ChatGPT (OpenAI) in order to improve the readability and language of the manuscript. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the published article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Generative AI and AI-assisted technologies in the writing process"}}],"article-number":"70"}}