==== Front
Ann Saudi MedAnn Saudi MedAnnals of Saudi Medicine0256-49470975-4466King Faisal Specialist Hospital and Research Centre 10.5144/0256-4947.2008.226asm-3-226LettersReply Ibrahim Abdulsalam Saif Pulmonary Section, Department of Medicine Hamad Medical Corporation, Doha, Qatar, salam145@yahoo.comMay-Jun 2008 28 3 226 226 Copyright © 2008, Annals of Saudi Medicine2008This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
==== Body
The letter to the editor considering the predictors of obstructive sleep apnea (OSA) emphasized the effect of menopause as an important predictor of OSA in females. The effect of menopause on the quality of sleep and the presence of obstructive sleep apnea were well discussed in this letter to the editor. But it is interesting to note the disconnection between the subjective reports of poor sleep in menopause and the objective data obtained during sleep studies.1 The mean age was not different in our study between females with and without OSA (50.3±10.7 years versus 51.8±8.2 years; P=.609). It is of interest to note here that referral bias suggested by Lynne Lamberg1 may play a factor in the differences noted in OSA between males and females in epidemiological studies, and in addition, the small study sample of females would explain the lack of significance of age differences in females with or without obstructive sleep apnea in our study. This difference may only be shown in population-based studies rather than in a referral based like our study.
==== Refs
REFERENCES
1 Lamberg L   Menopause Not Always to Blame for Sleep Problems in Midlife Women JAMA 2007 297 1865 1866 17473285