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Increased Prevalence of Obstructive Sleep Apnea Syndrome in Obese Women with Polycystic Ovary Syndrome1
Abstract
Obstructive Sleep Apnea (OSA) is considerably more common in men than women. Preliminary data suggest that androgens may play a role in the male predominance of apnea. Polycystic Ovary Syndrome (PCOS) is characterized by menstrual disturbances, androgen excess, and frequently obesity. These features suggest that women with PCOS may be at increased risk for OSA. To determine whether obese women with PCOS have an increased prevalence of sleep apnea compared with age and weight-matched reproductively normal women, we performed overnight polysomnography for determination of the apnea-hypopnea index (AHI) in 18 obese women with PCOS and age and weight-matched control women. Additional measurements included waist, hip, and neck circumferences, serum total testosterone, unbound testosterone, and DHEAS. Women with PCOS had a higher AHI than controls (22.5 +/- 6.0, vs. 6.7 +/- 1.0, P = 0.008). Women with PCOS were also more likely to suffer from symptomatic OSA syndrome (44.4% vs. 5.5%, P = 0.008). AHI correlated with waist-hip ratio (r = 0.51, P < 0.03), serum testosterone (r = 0.52, P < 0.03) and unbound testosterone (r = 0.50, P < 0.05) in women with PCOS. We conclude that obese women with PCOS are at increased risk of OSA when compared with matched reproductively normal women. Women with PCOS should be carefully questioned regarding symptoms of sleep apnea.
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“with only five of the eight studies having adjusted or matched their control group by age, BMI and/or ethnicity (15, 17, 18, 21, 40).”
From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [15]
In the citing paper
“Past cross-sectional studies have shown that OSAS is highly prevalent in women with PCOS (15–19) compared with the general population of reproductive-aged women (17-75% vs. 9-28%) (9, 10), with lower rates in adolescents with PCOS (0-57%) (20, 21).”
From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [15]
In the citing paper
“All eight studies employed PSG to measure OSAS (as this was an inclusion criterion) (15–21, 40), five of which also assessed the presence of other OSAS-related symptoms such as excessive daytime sleepiness (15, 16, 18, 19, 21).”
From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [15]
In the citing paper
“The present meta-analysis reported, for the first time, a ~5-fold higher effect estimate for AHI≥5 with symptoms compared to AHI≥5 only outcomes among individuals with PCOS (OR: 17.95 vs. OR: 3.90) (15, 17–21, 40).”
From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [15]
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References 51 · Cited by 274
Metadata
- Authors
- Fogel, R. B., Malhotra, A., Pillar, G., Pittman, S. D., Dunaif, A., & White, D. P.
- Affiliations
- Brigham and Women's Hospital (US)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2001-03
- Volume
- 86
- Issue
- 3
- Pages
- 1175-1180
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2159415187
- Cited by
- 274
- References
- 51
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 8 · 2022: 10 · 2021: 9 · 2020: 6 · 2019: 11 · 2018: 9 · 2017: 14 · 2016: 13 · 2015: 11 · 2014: 15 · 2013: 6 · 2012: 8
- FWCI
- 5.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Sleep Foundation
- Brigham and Women's Hospital
- University of Pennsylvania
- National Institutes of Health (1f32hl010246-01)
- National Heart, Lung, and Blood Institute (HL 60292, HL-48531, HL-10246, P50HL060292, R01HL048531)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- obstructive sleep apnea, polycystic ovary syndrome, obesity, women, apnea-hypopnea index, hyperandrogenism, testosterone, dehydroepiandrosterone sulfate, waist-to-hip ratio, sleep apnea prevalence, risk factors
- MeSH terms
- Adult, Body Constitution, Female, Humans, Obesity, Polycystic Ovary Syndrome, Risk Factors, Testosterone, Body Mass Index, Linear Models, Dehydroepiandrosterone Sulfate, Sleep Apnea, Obstructive
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- CoChat. (2026). Citation check: Increased Prevalence of Obstructive Sleep Apnea Syndrome in Obese Women with Polycystic Ovary Syndrome1. https://app.cochat.ai/papers/10.1210/jcem.86.3.7316
- The paper
- Fogel, R. B., Malhotra, A., Pillar, G., Pittman, S. D., Dunaif, A., & White, D. P. (2001). Increased Prevalence of Obstructive Sleep Apnea Syndrome in Obese Women with Polycystic Ovary Syndrome1. The Journal of Clinical Endocrinology & Metabolism. https://doi.org/10.1210/jcem.86.3.7316