Sleep Apnea in Women

Sleep apnea is a sleep disorder in which you briefly stop breathing over and over during sleep. By far, the most common type is obstructive sleep apnea (OSA). It occurs when your throat muscles relax and block your airway.

Another form is central sleep apnea. This disorder happens when your brain does not control breathing while you sleep.1

Signs of sleep apnea in women

Snoring is the most frequent symptom of sleep apnea. Other symptoms include:1,3,4

  • Choking, gasping, or snorting during sleep
  • Daytime sleepiness and accident proneness
  • Difficulty concentrating
  • Disturbed or restless sleep
  • Morning headache and irritability
  • Frequent bathroom visits at night
  • Sexual dysfunction
  • Waking with a dry mouth

Women often complain about these symptoms:4,5

  • Fatigue
  • Insomnia
  • Depression, anxiety, or impatience
  • Changes in dreaming
  • Forgetfulness and foggy or fuzzy thinking
  • Leg cramps or other unpleasant leg feelings
  • Nighttime heartburn

Risk factors for sleep apnea

Nearly 1 woman in 5 has OSA. Before age 50, men may be 2 or 3 times more likely to have OSA than women. As women enter menopause, the difference decreases.2 Other health conditions that increase women’s risk for OSA include:2,4,6,7

  • Polycystic ovary syndrome, a common hormone disorder in women
  • Pregnancy
  • Severe hot flashes

Other risk factors of sleep apnea that are shared with men include:1,4,8

  • Overweight
  • Family member with sleep apnea
  • High blood pressure
  • Low thyroid function
  • Older age
  • Small jaw or narrow upper airway

Dangers of sleep apnea for women

Sleep apnea is especially dangerous for women. Research has found an increased risk for pregnancy-related problems, such as preterm birth, neonatal intensive care admission, and death of the mother. Sleep apnea is a greater risk for women than men for cardiovascular disease and heart failure.3,10,11

These conditions are connected with sleep apnea in both men and women:12-14

  • Asthma
  • Dementia
  • Diabetes
  • Joint disease
  • Reflux/stomach inflammation
  • Stroke

Diagnosing sleep apnea in women

Women with sleep apnea may not have the same symptoms as men and this can make it harder to diagnose accurately. For example, women with sleep apnea often have trouble falling asleep or staying asleep. They may not gasp or choke at night like men often do. Also, women sometimes have sleep apnea during later stages of sleep when their bed partners are sleeping. This means no one is awake to hear their snoring or pauses in breathing.

Doctors estimate that 9 out of 10 women with sleep apnea are not diagnosed. Your doctor may diagnose and treat you for a symptom, such as depression or insomnia, without thinking that you also have sleep apnea.15,16

If you think you may have sleep apnea, tell your doctor. Bring a record of your symptoms, your medications, and any observations by your bed partner.1

Your doctor may ask you to complete the Epworth Sleepiness Scale. Women tend to score lower than men so this test may miss women with sleep apnea.5

There are 2 types of tests for sleep apnea, the home sleep apnea test or the overnight sleep lab test. The home test is not as accurate for women as it is for men. This means the test may not accurately diagnose women with less severe sleep apnea.16,17

An in-lab sleep study (polysomnography) is more accurate because it is a more sensitive test. However, even at a sleep center, sleep apnea in women may not be measured accurately. When the number of breathing stops is computed for the entire night, the average comes out lower for a woman, even if she has as many – or more – events during REM sleep than a man.17,18

Treating sleep apnea in women

If you are overweight, shedding pounds may cure your sleep apnea. Sleeping on your side instead of your back may reduce breathing problems.

The most effective treatment is a continuous positive airway pressure (CPAP) device. CPAP blows air through a mask into your nose and/or mouth. The air helps keep your airway open while you sleep.1

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Written by: Ina Fried | Last reviewed: June 2020