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Reproductive Endocrinology

SUN-162 - Risk of Obstructive Sleep Apnea in Women with Polycystic Ovary Syndrome: A BMI-Matched Case-Control Study using the STOP-BANG Questionnaire

Sunday, June 14, 2026
9:00 AM - 4:00 PM CT
Location: ENDOExpo; Poster Floor
Disclosure(s):
Juliana Affonso Mathiles, MD: No financial relationships to disclose


Introduction: Polycystic ovary syndrome (PCOS) is one of the most common disorder in reproductive-aged women and is associated with reproductive, endocrine and metabolic abnormalities. Obstructive sleep apnea (OSA) is a sleep-related breathing disorder linked to increased cardiometabolic risk and underdiagnosed in women. Evidence suggests an increased risk of OSA in women with PCOS independent of body mass index (BMI), although findings are heterogeneous. This study used validated STOP-Bang questionnaire to estimate OSA risk in overweight/obese women with PCOS.

Methods: Observational case-control study including 44 reproductive-aged women with overweight/obesity (BMI ≥27 kg/m²), comparing PCOS women (Rotterdam criteria) (n=30) with normal-ovulatory controls (n=14); prior OSA diagnosis was excluded. Primary outcome: STOP-Bang–estimated OSA risk between groups. Data were analyzed using STATA version 14.0.

Results: PCOS and control groups were similar regarding age (35.2±9.1 vs 38.2±7.8; p=0.29), BMI (37.1±5.1 vs 34.1±5.7 kg/m²; p=0.06), waist circumference (110.3±12.1 vs 102±13.2 cm; p=0.1), systolic blood pressure (131.7±15.9 vs 125±14.6 mmHg; p=0.20), diastolic blood pressure (78.2±9.3 vs 80.3±9.8 mmHg; p=0.50), total cholesterol (192.83±41 vs 177.6±28.3 mg/dL; p=0.22), HDL (42.8±7.7 vs 43.8±8.3 mg/dL; p=0.7), LDL (122.7±33.3 vs 114.3±22.7 mg/dL; p=0.4), fasting glucose (90.4±11.9 vs 93.6±6.1 mg/dL; p=0.10), and HbA1c (5.5±0.4 vs 5.3±0.4%; p=0.07). The PCOS group had higher neck circumference (NC) (39.9±3.6 vs 37.5±2.7 cm; p=0.03) and triglycerides (131.5±51.8 vs 99.8±42.6 mg/dL; p=0.03), as well as a higher prevalence of metabolic syndrome (19/30 [67.9%] vs 4/14 [28.6%]; p=0.02). There was no difference in total STOP-Bang score (2.9±1.6 vs 2.1±1.5; p=0.13), which remained after adjustment for NC (p=0.63). Groups did not differ for the presence of snoring (p=0.35), tiredness (p=0.14) and observation of sleep apnea (p=0.46).

Discussion: In the presented data, STOP-Bang–estimated OSA risk was not higher in the overweight/obese PCOS women compared to matched controls, even after adjustment for NC. Although meta-analyses and population-based studies report increased OSA risk in PCOS, even after BMI adjustment, evidence remains heterogeneous. Strengths include PCOS diagnosis by a specialist and group homogeneity. Limitations include small sample size, lack of polysomnography, and restriction to classical phenotypes. Further studies with multiple accessing tools shall be necessary to address this relationship.

Conclusion: In overweight/obese women in our cohort, PCOS was not associated with higher STOP-Bang–estimated OSA risk versus controls, despite a worse metabolic profile. Sample size may have limited the findings.

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