Gender differences in association between expiratory dynamic airway collapse and severity of obstructive sleep apnea

Kim et al. examined the link between expiratory dynamic airway collapse (ECAC) and obstructive sleep apnea (OSA) severity, focusing on gender differences. Using inspiratory-expiratory CT scans and polysomnography in 901 participants, they found that women with moderate-to-severe OSA showed significantly higher ECAC—measured by greater reductions in lumen area and diameter—compared to men. In contrast, men’s airway changes were more characterized by wall thickness reduction. The Aview software enabled precise segmentation and measurement of tracheal parameters, revealing these gender-based structural variations. The study suggests that inherent airway differences may contribute to higher OSA vulnerability in women, positioning ECAC as a possible gender-specific biomarker for assessing OSA severity. However, the findings are limited to a single ethnic group and may require further validation across diverse populations. These results underscore the potential of personalized OSA assessments that consider gender-specific airway characteristics, paving the way for targeted diagnostics and interventions.