For years, sleep apnea was considered a “man’s disease.” The classic image of someone with obstructive sleep apnea (OSA) has often been a middle-aged, overweight man who snores loudly. As a result, countless women with sleep apnea have gone undiagnosed or misdiagnosed, leaving them struggling with unexplained fatigue, poor sleep, and an increased risk of serious health conditions.
Why Do Women Go Undiagnosed?
1. Different Symptoms, Same Condition
While loud snoring and gasping for air during sleep are hallmark symptoms of sleep apnea in men, women tend to present with more subtle or different symptoms. Many women with OSA experience:
Fatigue and unrefreshing sleep
Insomnia or difficulty staying asleep
Morning headaches
Mood disturbances, anxiety, or depression
Because these symptoms overlap with conditions like anxiety, depression, and insomnia, many women are misdiagnosed and put on treatments that do not address the root cause: sleep apnea.
2. Research Has Focused Primarily on Men
Much of what we know about sleep apnea comes from studies conducted primarily on men. This has led to diagnostic criteria and clinical expectations that do not fully capture how sleep apnea presents in women. Researchers have discovered that women tend to have fewer breathing pauses in the early non-REM stages of sleep, but in REM sleep, their breathing is just as disrupted as men’s. However, these nuances have not always been considered in standard diagnostic approaches.
3. The Role of Hormones
Before menopause, women have a lower risk of sleep apnea compared to men. However, after menopause, that risk increases significantly, making them nearly as likely as men to develop OSA. Hormonal fluctuations related to the menstrual cycle, polycystic ovary syndrome (PCOS), and menopause can influence airway stability, leading to changes in sleep apnea risk over time.
4. Overlooked Risk Factors in Women
While obesity and a larger neck circumference are well-known risk factors for sleep apnea, the thresholds for women are different. For instance, a neck circumference of 16 inches or greater is considered a significant risk for women. Additionally, conditions like PCOS, which is linked to hormonal imbalances and metabolic changes, also increase the likelihood of developing sleep apnea.
The Need for Change
The medical community is starting to recognize these differences, but there is still work to be done. Raising awareness among healthcare professionals and women themselves is crucial for improving diagnosis and treatment.
What Women Can Do
If you experience persistent fatigue, poor sleep, or symptoms that don’t seem to have an explanation, consider discussing sleep apnea with your doctor. Diagnostic tools such as home sleep tests and in-lab polysomnography can help identify sleep-disordered breathing, even in those without classic symptoms.
Recognizing the gender differences in sleep apnea is an important step toward more effective, personalized treatments. As research continues, we can hope for diagnostic approaches and therapies that better address the unique needs of women with sleep apnea.
For more information on how sleep apnea affects women, visit the National Heart, Lung, and Blood Institute.
Looking for more ways to improve your sleep? Read our latest blog on how gut health can improve your sleep quality.