What comes to your mind when asked to imagine a “typical” sleep apnea patient? You probably imagined someone overweight, sedentary, middle-aged, and masculine.

Although obstructive sleep apnea is still widely regarded as largely a male health issue, we’ve made significant strides in changing this stereotype. It’s a problem for women’s health because women are at a higher risk of developing sleep apnea.

Regarding obstructive sleep apnea (OSA), women frequently have distinct symptoms than males. Because of this different symptomatology and persisting, incorrect sleep apnea preconceptions, the vast majority of women with OSA go undiagnosed—or are misdiagnosed with another disorder.

As science focuses more on gender variations in sleep apnea, we’re finding that women may face unique hazards to their long-term health from this type of sleep-disordered breathing.

With this in mind, let’s look at the real tale of how women experience sleep apnea, as well as what the newest science tells us about the health dangers it poses—as well as the therapies that are most beneficial to women.

What is the Prevalence of Sleep Apnea in Women?

As we’ve learned more about how sleep apnea manifests in women, the answer to this question has shifted dramatically in recent years. While previous research suggested that men were up to 9 times more likely than women to suffer sleep apnea, we now know that sleep apnea is frequent in women, and the gender disparity is nowhere near that great. 

Current estimates imply that men are two to three times more often than women to have sleep apnea—but the gap diminishes as women age and hit menopause and can become a 1:1 ratio. And, because screening and diagnosis among women are still so inadequate, many of today’s figures are likely to be low.

According to a recent population-based study, around 6% of women of all ages have moderate or severe sleep apnea, with an additional 5% having a mild type of OSA. (13 percent of men had moderate to severe OSA, while an additional 14 percent had mild sleep apnea.) According to this study, 20 percent or more of women may acquire sleep apnea by the age of menopause.

This study also discovered significant increases in the prevalence of sleep apnea among men and women over the last two decades, with the greatest increases among younger women and men.

Another recent study identified sleep apnea in half of the women in a population-based sample of 400 women aged 20 to 70. Severe sleep apnea was prevalent in 14% of women aged 55-70 and 30% of women aged 55-70 who had a BMI (body mass index) of 30 or higher.

According to research, about one in every four women in the United States is at high risk for sleep apnea. Sadly, an estimated 90 percent of women with this sleep-related respiratory issue go untreated.

Women’s OSA Symptoms and Risk Factors

The following are the most common sleep apnea symptoms:

  • Snoring that is too loud and frequent
  • Observable episodes of respiratory lapses include gasping, coughing, and snorting sounds when sleeping (by partners)
  • Urine frequently during the night
  • Morning headaches, dry mouth, and sore throat
  • Having difficulty concentrating during the day
  • Excessive drowsiness during the day

Women may experience some or all of these symptoms. According to research, chronic snoring and excessive daytime sleepiness are prevalent symptoms among women at high risk for sleep apnea.

However, not all women with OSA will exhibit these symptoms. It is entirely possible to have OSA without snoring or noticeable periods of stopped breathing, for example. 

Furthermore, women with sleep apnea may experience other symptoms that they and their clinicians are less likely to attribute to this sleep problem. These are some examples:

  • Insomnia symptoms like difficulties falling asleep and staying asleep.
  • Sleep disturbances with frequent awakenings (even if you don’t need to use the restroom)
  • Restless Leg Syndrome symptoms include tingling in the legs whether sitting or sleeping in the evening.
  • Dreaming evolves
  • Nighttime heartburn Feeling angry during the day feeling stressed
  • Are you anxious or depressed?
  • A lack of vitality despite a good night’s sleep
  • Forgetfulness
  • A proclivity for accidents

Any of these symptoms warrant a discussion with your doctor, specifically about sleep apnea and a sleep apnea screening.

Does Sleep Apnea Affect Women?

Obesity

Like men, women who are overweight or obese are more likely to suffer from sleep apnea. (In fact, some evidence suggests that excess weight may play an even higher impact on women’s sleep apnea risk than it does on men’s risk). Other key risk factors shared by men and women include smoking, having a family member with sleep apnea, and aging.

Women have unique risk factors for sleep apnea that either women or their doctors don’t well understand.

Pregnancy 

Most of us do not link sleep apnea with pregnancy. However, pregnant women may be at a higher risk of developing OSA due to changes in sleep patterns, weight gain, and changes in women’s anatomy that impair breathing. 

According to new research, pregnant women who have OSA are more likely to develop excessive blood pressure and gestational diabetes. Pregnant women who suffer from sleep apnea are also far more likely to experience pregnancy issues that necessitate treatment in an intensive care unit.

Menopause 

According to current study estimates, OSA appears to occur nearly twice as frequently in males as in women before the age of 50. As women get older, the gender gap narrows significantly. Why? As a woman approaches menopause, her risk of sleep apnea increases considerably. 

The hormones estrogen and progesterone appear to have sleep and breathing protection effects in women. As those hormones diminish throughout menopause, so does the risk of sleep disturbed breathing, including OSA. This 2017 study discovered that menopause-related estrogen declines are associated with an increased risk of OSA in women.

According to other recent research, a woman’s risk of sleep apnea increases by 4% every year after perimenopause.

Because sleep apnea symptoms in women may be subtler than in men and may not necessarily conform to the conventional list of symptoms, women with OSA are at a higher risk of going undetected. Physicians aren’t always as aware of the risks of sleep apnea in women as in men, contributing to the estimated 9 out of 10 cases of women’s sleep apnea that go undiagnosed.

Weight gain, low energy and persistent weariness, worry and bad mood, stress, and a sense of being overwhelmed are all prevalent symptoms of sleep apnea in women. 

What Are the Health Hazards of Sleep Apnea in Women?

If left untreated, OSA relates to several major health problems, including heart disease, high blood pressure, stroke, weight gain and diabetes, and depression. Untreated sleep apnea dramatically raises the chance of an accident. It also causes impairments in cognitive function, such as memory, attention, and learning. 

These are major dangers that both men and women face. Scientists are learning more about the specific health hazards that women experience as they investigate gender disparities connected with OSA. Here are some of the most recent scientific findings.

  • Cardiovascular Disease
  • Depression 
  • Obesity and Physical Activity 

Diagnosing and Treating Sleep Apnea in Women

All women experiencing any changes in their sleep, emotions, cognitive performance, or energy levels to their doctor’s attention and request a sleep apnea examination. Women in perimenopause and menopause to talk to their doctors for sleep apnea screening, even if they don’t have any symptoms.

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