Contrary to popular belief sleep apnea patients come in all shapes sizes races genders and can even have symptoms atypical of those common for sleep apnea For instance not all sleep apnea sufferers snore many are not obese or even overweight and not all of them are male
March is Womens Month so here we discuss the prevalence of sleep apnea in women and why they are often an under diagnosed and under served population suffering from this sleep disorder
Women with Sleep Apnea
Obstructive sleep apnea OSA is a sleep related breathing disorder in which either the throat muscles collapse the tongue falls back into the airway or enlarged tonsils andor adenoids impede airflow When your airway becomes cut off the brain has to wake itself to signal the respiratory system to kick back into gear This often leads to breathing resuming with loud gasps snorts or body jerks that may wake you from your slumber and disrupt your sleep
When you wake multiple times throughout the night your body and mind dont get the rest they need to function leaving you tired and drained during the daytime
According to the American Academy of Sleep Medicine it is estimated that as many as 26 of adults aged 30 70 years have obstructive sleep apnea
Men are twice as likely to have sleep apnea than women However men are often diagnosed with sleep apnea almost 8 times more often than women
If women are half as likely to have OSA as men but are diagnosed and treated for it only an eighth of the time something must be wrong Where does the problem lie Inpatient reporting doctor evaluation varying symptoms or a combination of all of the above
Under diagnosis and misdiagnosis for women with sleep apnea
When it comes to reporting sleep troubles women are much more likely to discuss their sleep problems with their primary care providers Unfortunately because of a combination of factors women with sleep apnea are often diagnosed and treated for other sleep disorders or get treated for co morbid conditions that are typical for sleep apnea patientsIt is commonly known within the sleep field that women with OSA present differently than men Says Angie Randazzo Behavioral Sleep Medicine Specialist at St Lukes Sleep Medicine Research Center They often dont have the stereotypical body type and dont always say they are sleepy Many will say they are fatigued leading clinicians to think they have insomnia versus OSA
Some of the reasons women arent diagnosed with sleep apnea may be
Many women talk with their general practitioners about their sleep problems rather than a sleep specialist Some of these doctors have preconceived notions about what a typical sleep apnea patient looks like and may overlook the reported symptoms by women when they dont fit the common portrait
Women are less likely to report loud chronic snoring
Womens symptoms are often slightly different than mens
Snoring is usually much lighter
Breathing problems during sleep are more subtle
Women tend to have lower apneahypopnea indexes AHI Apnea events are usually shorter in duration and frequency than mens are
Women usually report different bothersome symptoms than men that may lead to misdiagnosis of other disorders
Fatigue
Insomnia
Headaches
Mood disturbances
Lack of energy
Restless leg syndrome
Depression
Women with OSA tend to be more obese with lower AHI than men
Women are more likely to be prescribed prescription medications such as antidepressants rather than a sleep study for further testing
Men are less likely to be observant of their bedpartners sleep disturbances than women are Many men who seek treatment for OSA only do so because of concern by their bed partner
How can women get properly diagnosed with sleep apnea
Fortunately doctors are receiving better education on the prevalence of sleep apnea in women and recognizing the increased risk factors they have for developing OSA However with proper education for patients women themselves can better recognize the risk factors for developing OSA and avoid improper diagnosis
In addition to menopausal status and drug failure clinicians need to be aware of the tendency to diagnose based on gender stereotypes Says Dr Randazzo How women answer questions may mislead the clinician to assume the problem is insomnia be
cause they report how they feel when they are trying to get to sleep makes it sound like insomnia instead of sleep apnea
Here are some symptoms and risk factors typical of women with sleep apnea
Symptoms
Snoring even light snoringFull or partial cessations of breathing during sleep
fatigue
Excessive daytime sleepiness
Morning headaches
General lack of energy during the day
High blood pressure that is difficult to control with medication
Frequent trips to the bathroom during the night
Disturbed sleepwaking often in the middle of the night
Unrefreshing sleep
Fibromyalgia
Hypothyroidism
Risk factors
Womens risk for developing OSA increases as they transition through menopause Women are three times more likely to have post menopausal sleep apnea than pre menopausal Reasons for post menopausal OSA include weight gain and unclear hormonal changesPrior to menopause many women may develop upper airway resistance syndrome which can develop into sleep apnea after menopause
Women with a neck circumference greater than 16 inches
Women aged 55 70 years are 14 more likely to have severe OSA
Obese women aged 50 70 are 31 more likely to have OSA
Women are more likely to develop co morbid conditions such as anxiety and depression than men
The risk for developing OSA among women with the polycystic ovarian syndrome can be as high as 70
Pregnancy can increase the risk of developing OSA Untreated OSA in pregnant women can lead to complications during pregnancy including high blood pressure enlarged heart pulmonary blood clots more frequent preeclampsia neonatal intensive care unit admissions and cesarean delivery
If you believe that your sleep troubles may be due to sleep apnea rather than another sleep disorder contact a sleep specialist and ask if a sleep study is right for you
If you live in Alaska and would like to schedule a sleep study contact The Alaska Sleep Clinic and receive a free 10 minute phone consultation with a sleep educator Our clinic is owned operated and mostly staffed by women who can help provide top quality comprehensive care for our female patients suffering from obstructive sleep apnea
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