Although the prevalence of obstructive sleep apnea syndrome (OSAS) is about 4% in men and 2% in women, women are underrepresented in clinical routine. The aim of this study was to determine whether differences in clinical features of OSAS may in part explain the bias observed. 224 men and 24 women with polysomnographically confirmed OSAS filled in a symptom-focussed multiple-choice questionnaire. Polysomnographical results were comparable in both groups. With regard to snoring, daytime sleepiness and tendency of falling asleep there were no differences between both groups. Women more frequently complained about difficulties of initiating and maintaining sleep and about apneas. Further investigations have to concentrate on the pathomechanisms of OSAS in women which may in part explain the gender differences in sleep apnea associated symptoms.