Abstract Introduction Obstructive Sleep Apnea (OSA) is a major cardiovascular risk factor and has worse health outcomes. Novel OSA-driven metrics have been associated with worse outcomes. However, data on women from unrepresentative groups, such as the Hispanic/Latino population outside the USA, is scant. This study aims to quantitatively describe the clinical and novel OSA-driven phenotypes among women from Latin America. Methods We performed a prospective, multicenter study including women with suspected OSA from 18 sleep clinics in 8 countries (Argentina, Bolivia, Chile, Colombia, Costa Rica, Mexico, Peru, and Uruguay). We extracted the raw data from the baseline sleep study from October 2022 to December 2023. To determine 1). Sleep Apnea Specific hypoxic burden (SASHB) is defined as the total area under respiratory event-related desaturation curves; 2) Specific Heart Rate Response (ΔHR), defined as the difference between a maximum heart rate during a subject-specific search window and an event-related minimum heart rate; 3) Ventilatory burden, defined as the event-specific area under the ventilation signal, identified by amplitude changes in the nasal pressure signal; and 4) Desaturation sensitivity (i.e., the tendency to desaturate) was defined as a hypoxic burden divided by a ventilatory burden. Results A total of 318 women were included 26% non-OSA, 38% mild OSA, and 36% moderate to severe OSA). The average AHI3% was 16.5 ev/hr, SASHB was 43.4%min/hr; VB was 244.3 %eupnea*min/h; ΔHR was 8.2 bpm, and the desaturation sensitivity was 0.16. Among OSA patients, the AHI3% was 21.78 ev/hr; SASHB was 57.8 %min/hr; VB was 338.1 %eupnea*min/h; ΔHR was 8.14 bpm, and the desaturation sensitivity was 0.18. Based on high SASHB (≥ 60%min/hr) or high ΔHR (≥ 10 bpm), 19% and 26% of the sample are at risk of worse cardiovascular outcomes, respectively, and 7.4% of the sample reported both criteria associated with adverse outcomes. Conclusion Among OSA women from Latin America, OSA-physiologically driven metrics are reproducible and similar to previous publications. Further studies are needed to fully understand the clinical utility of these metrics in clinical practice. Study register ISRCTN11936746. Support (if any) The Chest /AASM (7868 ); NIH(1R21HL161766-01); SRS (07-SRG-22); Universidad de Concepcion(2022000589)