Sex-specific prevalence and correlates of possible undiagnosed obstructive sleep apnea in rural Canada

Abstract Background Obstructive Sleep Apnea (OSA) has been under-investigated in rural communities, particularly through a sex/gender lens. The purpose of this study was to examine the prevalence and correlates of OSA risk among rural-dwelling women and men in Saskatchewan, Canada. Methods Participants for this cross-sectional study were 2340 women and 2030 men living in rural Saskatchewan, Canada and were without a prior diagnosis of OSA. The dependent variable, OSA risk, was estimated from self-reported symptoms of OSA and percentage body fat. Independent variables included socio-demographic characteristics, health behaviors, comorbidities, and quality of life indicators. Multivariable logistic regression was the primary statistical technique employed, conducted separately for women and men. Results A greater proportion of men (30.1%) than women (19.4%) were at high risk of OSA. While many of the correlates of OSA risk were similar for women and men, sex differences emerged for marital status, educational attainment, financial strain, depression, asthma, and perceptions of community support. Conclusion A sizable minority of rural women and men may have possible undiagnosed OSA, which in turn, is associated with substantial comorbidity and reduced quality of life. Additional research with enhanced measurement and a longitudinal design is required to test the veracity of these findings and further clarify the role of sex/gender in relation to OSA risk in rural adults.