Women & Sleep Apnea: Busting the Myths

As a woman, you may never think about sleep apnea, and if you do, your ideas about it may be based on outdated stereotypes. Sleep apnea is an issue that all women need to be aware of, and I’ll tell you why in this post. Let me start with busting these myths:

1. Only men get apnea. WRONG! 
2. Women only have apnea if they are overweight. WRONG!
3. The only way to treat apnea is with a C-PAP machine. WRONG!
4. Apnea is not a problem except for not getting good sleep. WRONG!

Let’s dig into the real truths about sleep apnea and women – and why you should care about it.

What exactly is sleep apnea?

Apnea means an episode of stopped breathing. It’s measured as mild, moderate or severe, depending on how many episodes occur per hour.

Apnea is one of the top major causes of disturbed sleep in the general population. The telltale symptoms can be:

• Loud and frequent snoring
• Gasping, choking, and snorting sounds during sleep
• Observable episodes of stopped breathing
• Need to urinate often during the night
• Morning headaches, dry mouth, and sore throat
• Trouble concentrating during the day
• Excessive daytime sleepiness

Women get sleep apnea too!

Yes, we do. However, it is vastly underdiagnosed in women. It’s often stereotyped either as a man’s condition or caused by obesity. However, recent studies show that apnea is far more widespread for women than we thought, and women can experience apnea differently than men. Here are a few stats of interest:

• One in four of all women is at risk for apnea.
• Your risk goes up during pregnancy.
• Every year of perimenopause adds 4% to your risk factors.
• After menopause women get apnea as often as men, it’s 50-50. It’s estimated that 47 – 67% of women after menopause have apnea.
• It is true that as your BMI goes up, so does your risk. But women of normal or low BMI also get sleep apnea!

If the reason for your fatigue or insomnia is sleep apnea, nothing else will fix it other than addressing your sleep apnea!

Why aren’t women diagnosed?

When men go to the doctor with fatigue, apnea is high on the radar. When women go to the doctor with fatigue, apnea is almost never on the radar, unless they are obese. Doctors may think about thyroid problems, depression, menopause, or other issues. After all, there are many reasons for fatigue.

There’s a gender gap in assessing and treating women for apnea. Research shows that women have lower referral rates to sleep clinics, and are underrepresented in clinical studies. For women, apnea historically has been overlooked, to our detriment. Fortunately, this IS changing, and you can help spread the word!

Women experience different symptoms

Not all women with apnea snore or have noticeable episodes of interrupted breathing. Furthermore, women may report different, more general symptoms that don’t seem connected to apnea. Men tend to report snoring and awareness of apnea. Women report insomnia, restless legs, depression, headaches, anxiety, nightmares, palpitations, and hallucinations. This study breaks down women’s symptoms:

• Trouble falling asleep (32%)
• Trouble staying asleep (19%)
• Restless legs syndrome (RLS) symptoms (33%)
• Daytime sleepiness (24%)
• Body movement (60%)
• Snoring (61%)
• Observable stopped breathing episodes (7%)

This sleep doctor adds these symptoms for women:

• Changes in dreaming
• Heartburn at night
• Irritability during the day
• Feeling regularly overwhelmed
• Feeling anxious or depressed
• Forgetfulness
• A tendency to be accident-prone

Why should women care about apnea?

Sleep apnea is not something to take lightly!  It can cause chronic and serious health risks:

• Systemic inflammation (C-reactive protein, tumor necrosis factor α, and interleukin-6 – all no-good inflammatory markers).
• Increased risk of heart failure, and a higher risk of atrial fibrillation, independent of weight.
• A higher risk of adverse pregnancy outcomes.
• High blood pressure.
• Depression.
• Atherosclerosis (coronary artery plaque from oxidative stress and free radicals that damage arterial linings).
• Higher risk of stroke.

These are no joke! It’s a feminist action for women to become aware of apnea as a real issue for us. If this rings a bell for you, consider getting tested with an at-home test or a sleep clinic. And rest assured, not all women with apnea end up needing a C-Pap machine! There are other therapies and devices you can explore, depending on the severity.

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