Sleep apnea symptoms in women

Sleep apnea symptoms in women are often different and subtler than they are in men. Knowing these differences can help women and their loved ones spot and treat sleep apnea faster. Meanwhile, unawareness of these differences has led many cases of female sleep apnea to go unnoticed or misdiagnosed. We examine women’s unique sleep apnea symptoms so that more patients and their loved ones know what to look out for.

Sleep apnea is not a male-only disorder

Nearly 40% of patients diagnosed with obstructive sleep apnea today are female,¹ up from 30% just a decade ago.² UPenn sleep specialist Dr. Grace Pien credits greater awareness with the rise in female diagnoses, but warns that women may still “be less likely to be diagnosed and treated” because “physicians often have a predefined notion of the type of patient who has sleep apnea, like a middle-aged overweight or obese male.”³ So what makes sleep apnea symptoms in women different?

The key differences

Besides snoring (which is still the strongest predictor of sleep apnea in women and men),⁴ women can also experience:

• Insomnia
• Morning headaches
• Fatigue
• Tiredness
• Depression
• Anxiety⁵

Women with sleep apnea also tend to have fewer apneic events per hour (lower AHIs) than men,⁶ as well as more subtle and REM-related apneas.⁵ That makes them harder to diagnose and be noticed by their bed partners, according to Dr. Barbara Phillips, board member of the National Sleep Foundation.

Misdiagnoses

Due to these subtler and nontraditional sleep apnea symptoms, “women are often diagnosed in error with one of the following conditions,” according to the National Sleep Foundation:

• Anemia
• Cardiac or pulmonary illness
• Depression
• Diabetes
• Fatigue from overwork
• Fibromyalgia
• Hypertension
• Hypochondria
• Hypothyroidism
• Insomnia
• Menopausal changes
• Obesity³

So what should I do?

If you or a woman you know is experiencing these sleep apnea symptoms – and either haven’t been diagnosed or helped by treatment for one of the other diagnoses above, talk to a doctor about sleep apnea and how to get tested.

This blog post contains general information about medical conditions and potential treatments. It is not medical advice. If you have any medical questions, please consult your doctor.

References

1. Source: Medicare 5% sample & OptumInsight medical claims data, 2012
2. Source: Bixler EO et al. Prevalence of sleep-disordered breathing in women. Am J Respir Crit Care Med 2001;163(3.1):608–13.
3. Source: Phillips B. National Sleep Foundation. Ask the Expert: Women and Sleep Apnea. (accessed September 2, 2014)
4. Source: Young T et al. The gender bias in sleep apnea diagnosis. Arch Intern Med 1996;156(21):2445–51.
5. Source: Tamanna S and Geraci SA. Major sleep disorders among women. South Med J 2013;106(8):470–8.
6. Source: Macey PM et al. Heart rate responses to autonomic challenges in obstructive sleep apnea. PLoS 2013; DOI:10.1371/journal.pone.0076631