Decades ago, heart disease was thought of as a ”man’s disease” before public education campaigns increased cardiac illness awareness among women and its profound impact on their health. Similarly, one of the most common sleep disorders, obstructive sleep apnea (OSA), has received a masculine label.
Granted, obstructive sleep apnea affects half as many women as men, but it is far from rare — about 6 percent of women suffer from this condition .
Women and Sleep Apnea – the Symptoms
OSA is characterized by repeated episodes of the throat closing or narrowing enough to restrict airflow, which results in fluctuations in the amount of oxygen in the blood. This leads to numerous brief disruptions of sleep as well as poor sleep quality.
According to the National Sleep Foundation, women may experience daytime fatigue, lack of energy or excessive sleepiness despite getting an adequate amount of sleep (usually 7-8 hours) at night. They may notice headaches when they first awaken. Their bed partner may report that they have heavy snoring, or that they have breathing pauses during their sleep and make choking sounds sometimes with these. Women themselves may notice that they have frequent unexplained awakenings at night, awaken frequently to urinate, or sometimes awaken from sleep at night feeling as if they are gasping or choking.
OSA Through the Lifespan
Untreated OSA is a risk factor for high blood pressure, heart disease and stroke, and is associated with overall decreased quality of life and wellbeing. The ”textbook” symptoms primarily include loud snoring, episodes of gasping for air often witnessed by bed partners, excessive daytime sleepiness, and waking up unrefreshed.
Another difference among men and women is the change in the OSA risk throughout the lifespan. While a man’s risk increases linearly as he ages, a woman’s risk is relatively low until menopause and then sharply increases to reach that of similarly aged men .
Therefor, we also know that women’s risk for sleep apnea increases as they transition through menopause, so that post-menopausal women are up to three times more likely to have OSA compared to premenopausal women. Also, women who are overweight and obese are at greater risk for having sleep apnea. Women who have high blood pressure that is difficult to control despite taking medication and have some of these symptoms may also wish to be evaluated for sleep apnea, as diagnosis and treatment of OSA can help with blood pressure control.
Common Women and Sleep Apnea Misdiagnoses
On standardized questionnaires, women with OSA tend to be as sleepy as men, but are more likely to complain of insomnia, depression and fatigue rather than the textbook symptoms of the disorder . Women are often diagnosed in error with one of the following conditions, rather than sleep apnea.
- Cardiac or pulmonary illnesses
- Fatigue from overwork
- Menopausal changes
It is essential to educate both health care providers (physicians and dentists) and the population at large on the prevalence of OSA in women in order to recognize and appropriately treat women with OSA. Early diagnosis and treatment can help prevent the complications mentioned above, improve overall wellbeing, and indirectly reduce the costs of managing multiple, preventable chronic illnesses.
Are you or a loved one at risk for obstructive sleep apnea (OSA)? Snoring could be more than annoying – it could be a danger to your health. Click here to take a quick quiz to see if you may be at increased risk of having sleep apnea.
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2) Quintana-Gallego E1, Carmona-Bernal C, Capote F, et al Gender differences in obstructive sleep apnea syndrome: a clinical study of 1166 patients. Respir Med. 2004 Oct;98(10):984-92.
3) Larsson LG1, Lindberg A, Franklin KA, Lundbäck B. Gender differences in symptoms related to sleep apnea in a general population and in relation to referral to sleep clinic Chest. 2003 Jul;124(1):204-11.