Missing the Mark: Stereotypes in Sleep Apnea Diagnosis

There is a persistent stereotype in the public at large that sleep apnea affects mainly older, overweight men. This leaves so many people, who don't fit that description, undiagnosed and struggling with debilitating sleep apnea symptoms.

My own obstructive sleep apnea (OSA) remained undiagnosed for more than a decade. This was despite regular trips to the doctor complaining of very common sleep apnea symptoms.

I suffered from anxiety, depression, intense morning headaches, dry mouth, daytime sleepiness, and snoring. I was barely holding down jobs in my 20s and was too exhausted to do anything outside of work.

I didn't fit the stereotype

At one doctor’s visit, I distinctly remember asking if we should consider if I had a sleep disorder. The doctor talked about sleep apnea and said it couldn’t be that since “that only affects men in their 50s.”

I was a slender, outwardly healthy 24-year-old woman. Now I realize I didn't fit my doctor's idea of what sleep apnea sufferers looked like.

I struggled for years before my sleep study

At the age of 30, after struggling for years, I asked my primary care physician to refer me for a sleep study. The results confirmed moderate sleep apnea. I was prescribed a CPAP machine and I have used it every night in the 12 years since.

My quality of life has been dramatically improved, but I’m conscious that I’m one of the lucky ones.

What sleep apnea looks like in women

Women, in particular, have been consistently overlooked when it comes to sleep apnea diagnoses.¹ 

Some of this might be due to the different symptoms women tend to exhibit with sleep apnea when compared with their male counterparts.

In my own case, I certainly suffered from daytime sleepiness, but I didn’t lead with that fact. I would sob and talk about how overwhelmed, anxious, and depressed I felt. This is very often what sleep apnea looks like in women and what makes it tricky for doctors to spot.

Fit men can have sleep apnea too

It’s not only women who are having a difficult time getting diagnosed with sleep apnea. Craig Baker is a 35-year-old personal trainer and athletic model with the 6-pack abs to prove it. He is the last person you would expect to suffer from sleep apnea.

He was recently diagnosed with OSA and has spent the last few months connecting the dots between the fatigue he has felt for years and his undiagnosed sleep apnea. Doctors repeatedly told Craig that it wasn’t worth testing for sleep apnea because that affects older, overweight men. He is originally from the UK, where he competed in athletics but was forced to scale back his decathlon goals because he couldn't cope with the volume of training required.

CPAP doesn't work for everyone

Craig has been using a continuous positive airway pressure (CPAP) machine since his diagnosis, a notoriously difficult therapy involving a face mask keeping the airway open at night with continuous airflow. It isn't always the magic bullet sufferers are looking for. Craig says, "I had high hopes that the CPAP would make me feel much better, but it hasn't so far."

Surgical options for sleep apnea

After consulting with an ENT, Craig decided on surgery to remove his tonsils and adenoids. He's hopeful that this will improve his airway and, therefore, his sleep. Like so many people, getting a sleep apnea diagnosis after many years, Craig feels relief to finally have answers to explain his symptoms.

Ending sleep apnea stereotypes

Neither Craig nor I fit the image doctors have in their mind of typical sleep apnea sufferers. It’s time to change these perceptions because it is part of the reason that sleep apnea goes undiagnosed in so many people.

I hope more people, especially those who don't fit the sleep apnea stereotype of older, overweight men, will seek out testing and treatment. Sleep apnea can explain all sorts of seemingly unrelated symptoms. Diagnosis and treatment can improve quality of life dramatically and the consequences of untreated sleep apnea are too grave to ignore.