Walking the fine line between OSA and aging

Obstructive sleep apnea syndrome is the most common sleep disordered breathing. In recent years, literature has focused on the anatomical and functional factors in the pathophysiology of patients to better understand their clinical and polysomnographic features, aiming for personalized treatment. Studies suggest that sleep-disorders breathing in women are underestimated and associated with cardiovascular and metabolic disorders. Women tend to experience more mood disorders and behavioral symptoms, leading to a reduced quality of life. The sleep and respiratory pathophysiology in women are complex and varies with age and hormonal status. This review summarizes recent knowledge on this topic, emphasizing the pathophysiological mechanisms to explain the typical clinical and polysomnographic patterns observed in females. In sleep respiratory medicine, gender- specific approaches are now essential for personalized patient care.