Sleep Apnea Symptoms In Women: What Are They? Why They Are Mostly Overlooked?

You may not be totally wrong if you think that there is some kind of gender bias when recognizing sleep apnea symptoms in women? It is said that at the time of diagnosing the condition, women patients are likely to be treated for depression, insomnia or hypothyroidism though the severity of sleep apnea symptoms in women may be the same as men.

Though there was a time when prevalence of sleep apnea was more in men than women, recent studies show the prevalence ratio of men and women are 2:1. An estimated 18 million Americans have sleep apnea including one in four women over 65.

Before we analyze the reasons for such misdiagnosis, let us first recapitulate what the typical symptoms of this distressful sleep disorder are. Some common warning signs are:

–          Morning tiredness

–          Loud and persistent snoring

–          Choking during sleep

–          Pauses in breathing

–          Unexplained weight gain

–          Excessive daytime drowsiness, strong enough to interfere with daily activities

Symptoms overlooked and condition undiagnosed: why?  

There could be a variety of reasons for this. For one, men get more referrals to sleep study centers for diagnosis of sleep apnea. Why? This is because men are more likely to seek medical help for their snoring and sleep apnea problems from their family physicians. On the other hand, only half of women report their snoring symptoms to a family doctor. This makes the General Physician send more male patients to the sleep clinic for diagnosis than women.

A recent study revealed that the condition remains undiagnosed with more than 90% women who are suffering from moderate to severe sleep apnea. A hypothesis is that sleep apnea symptoms in women often differ from the classical and typical clinical symptoms of the disorder that make the job of the diagnosing doctor easier.

Typical symptoms like snoring, choking, apnea episodes, restless sleep are common with both men and women; be that as it may, one study revealed that nearly half of the female patients did not report any of these to their doctor. Women usually report additional symptoms like insomnia and depression, restlessness, lack of energy fatigue, morning headaches, mood disturbances, etc. This often leads to misdiagnosis or no diagnosis at all.

Needless to mention, that these symptoms are mostly non-specific in nature that may not be related to sleep apnea. The consequence is that women remain less likely to be referred to a sleep clinic for diagnosis. It is also a fact that the breathing pauses and ensuing sleep disturbance in women are more subtle. Their apneas are more likely to be REM related and thus tougher to diagnose.

Factors that increase the risk of developing sleep apnea symptoms in women: 

–          Obesity, rather fat distribution is a predominant risk factor for sleep apnea in women. Women tend to have more fat deposition in the lower part of the airway.

–          Neck size of 16 inches or more

–          Alcohol consumption; high blood pressure

–          Menopausal or post menopausal age group. Increase in abdominal fat during menopause increases the risk of sleep apnea by 3.5 times.

–          Sleep apnea symptoms in women are pronounced during polycystic ovary syndrome, marked by an excess of male hormones. Women show 4-fold increase of snoring and sleep apnea.

–          Risk of apnea increases in women after 50.

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