Issue Navigator

Volume 14 No. 09
Earn CME
Accepted Papers

Scientific Investigations

Prevalence of Obstructive Sleep Apnea and Obesity Among Middle-Aged Women: Implications for Exercise Capacity

Martinha Millianny Barros de Carvalho, RpT1; Ricardo Quental Coutinho, MD2; Isly Maria L. Barros, MD, PhD2; Laura O.B.F. Costa, MD, PhD2; Ana Kelley L. Medeiros, RN1; Thais C. Lustosa, RpT1; Carolina A. Medeiros, RN1; Marcus Vinícius França, RpT1; Tarcya L.G. Couto, RpT1; Ulisses R. Montarroyos, PhD3; Virend K. Somers, MD, PhD4; Rodrigo Pinto Pedrosa, MD, PhD1,5
1Sleep and Heart Laboratory, Pronto Socorro Cardiológico de Pernambuco (PROCAPE) da Universidade de Pernambuco, Brasil; 2Pronto Socorro Cardiológico de Pernambuco (PROCAPE) da Universidade de Pernambuco, Recife, Brasil; 3Institute of Biological Sciences (ICB) da Universidade de Pernambuco, Recife, Pernambuco, Brasil; 4Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; 5Hospital Memorial São José - Rede D′Or São Luiz, Pernambuco, Brasil

Study Objectives:

The aim of the current study was to evaluate the association between obstructive sleep apnea (OSA) and exercise capacity in middle-aged women.


Consecutive middle-aged female subjects without cardiovascular disease, aged 45 to 65 years, from two gynecological clinics underwent detailed clinical evaluation, portable sleep study, and treadmill exercise test.


We studied 232 women (age: 55.6 ± 5.2 years; body mass index [BMI]: 28.0 ± 4.8 kg/m2). OSA (apnea-hypopnea index ≥ 5 events/h) was diagnosed in 90 (39%) and obesity (BMI > 30 kg/m2) in 76 (33%) women, respectively. Participants with OSA were older, had a higher BMI, and an increased frequency of arterial hypertension compared to women without OSA. Multiple logistic regression models were used to evaluate the association between OSA and exercise capacity, controlling for traditional risk factors including BMI, age, hypertension, diabetes, and sedentary lifestyle. In multivariate analysis, the presence of obesity without OSA was associated with low exercise capacity (odds ratio [OR] 2.88, 95% confidence interval [CI] 1.02–8.11, P = .045), whereas the presence of OSA without obesity was not (OR 1.07, 95% CI 0.31–3.69, P = .912). However, the coexistence of obesity and OSA increased markedly the odds of reduction in exercise capacity (OR 9.40, CI 3.79–23.3, P < .001).


Obesity and OSA are common conditions in middle-aged women and may interact to reduce exercise capacity. These results highlight the importance of obesity control programs among women, as well as the diagnosis of comorbid OSA in older women.


de Carvalho MM, Coutinho RQ, Barros IM, Costa LO, Medeiros AK, Lustosa TC, Medeiros CA, França MV, Couto TL, Montarroyos UR, Somers VK, Pedrosa RP. Prevalence of obstructive sleep apnea and obesity among middle-aged women: implications for exercise capacity. J Clin Sleep Med. 2018;14(9):1471–1475.

Supplemental Material

Login to view supplemental material

Please login to continue reading the full article

Subscribers to JCSM get full access to current and past issues of the JCSM.

Login to JCSM

Not a subscriber?

Join the American Academy of Sleep Medicine and receive a subscription to JCSM with your membership

Subscribe to JCSM:  $75/volume year for individuals or $140/volume year for institutions to access all current articles and archives published in JCSM.

Download this article*:   $20 to access a PDF version of a specific article from the current issue of JCSM.

*Purchase of an electronic download of JCSM provides permission to access and print the issue/article for personal scholarly, research and educational use. Please note: access to the article is from the computer on which the article is purchased ONLY. Purchase of the article does not permit distribution, electronic or otherwise, of the article without the written permission of the AASM. Further, purchase does not permit the posting of article text on an online forum or website.