“When we talk about women having it all, what they really have all of is the work.” – Germain Greer
… and none of the sleep.
Traditionally seen as a “men’s disorder,” Obstructive Sleep Apnea (OSA) is fairly common in women too, and the consequences of leaving it untreated can even be worse for women. OSA happens when your upper airway interferes with your breathing during sleep. While a major symptom of OSA is snoring, health issues like obesity, high blood pressure, and diabetes put people at a higher risk of suffering from sleep apnea – in fact, sleep apnea even contributes to these issues, making it a cyclical problem.
With nearly 1 million Canadians diagnosed with OSA and 25% of adults at considerable risk for OSA, it’s important to get checked for it if you have any symptoms, risk factors, or chronic conditions such as diabetes, hypertension, heart disease, and mood disorders like depression, bipolar disorder, mania, or dysthymia – especially if you’re a woman.
Here are five things you don’t about women and sleep apnea that will make you take a sleep test ASAP:
1. WOMEN ARE FREQUENTLY MISDIAGNOSED
Unfortunately, more attention has been paid to sleep apnea’s impact on men’s health and quality of life – largely because medicine has painted a certain picture of sleep apnea patients as middle-aged, overweight or obese men who snoring incessantly. Physicians are trained to look for certain “classic” symptoms like snoring, breathing pauses, and daytime sleepiness because the disorder has primarily been studied in men. Since women tend to have different symptoms, OSA is often overlooked.
In addition, because women’s breathing disturbances tend to be more subtle, OSA can be tougher to diagnose. The National Sleep Foundation notes that women are commonly misdiagnosed with these conditions when they actually have sleep apnea:
- Cardiac or pulmonary illnesses
- Fatigue from overwork
- Menopausal changes
2. WOMEN HAVE DIFFERENT SYMPTOMS
Women’s bodies are different than men’s (yes, it’s a shocker!). In fact, even with the same disorder, sleep apnea, men and women will present with different symptoms, with the women’s symptoms being less obvious.
In fact, these symptoms, which can be linked to many other illnesses and disorders, are frequent fliers for women with OSA:
- Restless leg syndrome
- Insomnia and fatigue
- Anxiety and feeling overwhelmed
- Weight gain
- Morning headaches
- Nightmares and night terrors (hallucinations)
- Waking up feeling like garbage
- High blood pressure
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3. WOMEN HAVE DIFFERENT RISK FACTORS
As if menopause isn’t bad enough all on its own with hot flashes, day and night sweats, forgetfulness, and unpredictable mood swings, depression and anxiety, it also makes women 3.5 times more likely to have sleep apnea.
Often seen as a turning point in triggering OSA, postmenopausal women (aged 55 and up) more often have sleep apnea largely due to weight gain and hormonal changes, making it a marked risk factor. If you have polycystic ovarian syndrome (PCOS), your risk of developing sleep apnea jumps to 70%, and if you’re pregnant, your risk also increases.
4. SLEEP APNEA IS HARDER ON WOMEN THAN MEN
If its subtlety and misdiagnosis alone aren’t bad enough, the health consequences of OSA for women are worse than for men. In fact, women are more likely to have comorbid disorders and diseases which means their OSA comes with a nasty sidekick, such as:
- Cardiovascular disease
- Hyperlipidemia (high cholesterol)
- Arthropathy (joint inflammation)
Plus, women with sleep apnea are also more likely to develop cognitive impairments or dementia in old age because the lack of oxygen results in more brain white matter injury in women and women are more susceptible to adverse heart consequences of sleep apnea (untreated OSA is associated with cardiovascular death in women).
5. SLEEP APNEA CAN CAUSE PREGNANCY COMPLICATIONS
Pregnancy can trigger sleep apnea and pregnancy can make sleep apnea worse. Since pregnancy tends to cause sleep disturbances and exhaustion, it can be hard to tell if your symptoms are pregnancy or OSA related. More common in women who are overweight or obese when they become pregnant as well as those with high blood pressure, preeclampsia, or gestational diabetes, OSA can cause pregnancy complications.
For example, sleep apnea in pregnancy is linked to gestational diabetes, preeclampsia, preterm delivery, and low birth weight, meaning it can result in more neonatal intensive care (NICU) admissions and caesarian sections.
If you’re a woman and are presenting any of the aforementioned symptoms, don’t hesitate to talk to your doctor about sleep apnea. Alternatively, you can take our sleep quiz to see if you should talk to your doctor about a sleep test.