How Sleep Apnea Affects Women

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Woman diagnosed with sleep apnea disorder
While snoring, gasping, and witnessing apneas are all common indications of sleep apnea in men, the signs and symptoms in women are slightly different.

Although women’s sleep has only been studied since the 1990s there is much more to be learned. It is clear that women’s sleeping patterns are more complex than those of men. This is due to the physiological changes that begin with puberty, continue throughout life, including pregnancy, childbirth, menopause, and menstruation.

One theory suggests that evolution may have favored women’s ability to alternate between waking up quickly to care for their infants and then grabbing a brief, deep, “power” sleep before being awakened for the next round of infant care. Fatigue and insomnia are more common in women than in men.

Insomnia is three to four times more common in women. Variations in women’s sleep patterns and ability to stay asleep are due to hormonal fluctuations. Premenstrual women are more likely to experience insomnia and fragmented sleep.

In the postmenstrual phase, however, falling asleep is usually easier. Women who have gone through menopause or older men may have a shorter sleep time and experience a lighter sleep cycle. Hot flashes can cause sleep disruptions in women during their hormonal transition years.

Hot flashes can cause daytime fatigue in women, which can have negative consequences for overall health. The effects of pregnancy on sleep are devastating. After childbirth, a woman may not experience the same quality of sleep she had before. Women are more likely to experience periodic limb movement during sleep (PLMS) and restless legs syndrome (RLS).

Sleep Apnea looks different in women

Sleep apnea has been a common condition in men for many years. It was 10 times more common than it was in women. The ratio of men and women with sleep apnea was closer to three to 1. 28 percent of middle-aged females snore regularly, compared to 44 percent of men. The rate of sleep apnea triples after menopause.

No longer is sleep apnea confined to men. Women may not experience the same symptoms of sleep apnea as men, which is why it has been so underdiagnosed in women. Men tend to snore loudly, and they have apneas that go on and off throughout the night. One in four women also snore, but this is usually limited to rapid eye movement (REM).

Women may also experience a quiet form of sleep apnea known as upper airway resistance syndrome (UARS). UARS can be more subtle than snoring but has the same long-term effects as obstructive sleeping apnea.

UARS causes a struggle to breathe, disrupts sleep, and lowers oxygen levels. UARS can be treated with continuous positive pressure (CPAP) just like obstructive sleeping apnea. UARS and sleep apnea may lead to hypertension and diabetes.

Women, Obesity and Sleep Apnea

Overweight adults account for one-third of all adults. Obese women are more likely than others to suffer from sleep apnea and other health risks associated with excess weight. The metabolic syndrome is a deadly mix of obesity, high blood pressure, diabetes, and high cholesterol that can lead to high mortality rates. It should be addressed from all angles.

Obstructive sleep apnea is a contributing factor to metabolic disorder. Treatment of sleep apnea must be included in a treatment plan that focuses on weight management, diabetes control, blood pressure, cholesterol, controlling blood pressure and maybe even sleep apnea surgery. How can you determine if you are obese?

Anyone with a BMI greater than 25 is considered obese according to the standard Body Mass Index (BMI). Your waist measurement should be less than 4 inches wider than your hips. This is called “central” obesity. It is more dangerous than the hips and thighs pattern of excess weight. You or someone you love falls into one of these categories.

It is a good idea to find out if you are suffering from sleep apnea. Ask your doctor to refer you to wellness programs that focus on weight management and lowering your cardiovascular risk. These programs are offered by most medical centers, and often insurance will cover them.

Pregnancy can be complicated by sleep apnea

Women often experience sleep apnea during pregnancy. About 25% of pregnant women experience sleep apnea episodes, especially in the third trimester. It is possible to snore lightly, but it is not usually a problem.

Heavy snoring can increase the risk of pregnancy complications. Snoring, in particular, can increase your chances of preeclampsia and hypertension.

The fetus’ growth can be impeded by excessive snoring from the mother. A visit to a specialist in sleep medicine is recommended if a woman is snoring during pregnancy or if her breathing becomes difficult. Pre- prescriptions can be made for CPAP therapy during pregnancy and it can be stopped if the baby is born.

Menopause Is More Common for Sleep Apnea

Hot flashes may not be enough to bother you, but menopausal women might have sleep apnea. After menopause, the chances of developing sleep apnea increase by three times. Normal women with an average weight can experience sleep apnea symptoms.

They may wake up at night and feel fatigued, coughing, or choking. Half of the women complain about their sleep after and during menopause. These sleep problems were once considered normal after menopause.

Under the assumption that low or fluctuating hormones cause sleep problems, hormone replacement therapy was prescribed. We now know that hormone replacement therapy does not reduce hot flashes or other sleep problems.

As symptoms of sleep disturbances after menopause, you should take them seriously as they could be signs of sleep apnea. A sleep study can help you determine if there are any issues. A researcher who studies women’s sleep cautions doctors that menopausal women should take the same seriousness to signs and symptoms that could normally prompt a complete sleep evaluation. Don’t wait for your family doctor or specialist to recommend a sleep study. They may not even think of it.


  • While women are more likely to experience insomnia than men, they are about one-third less likely to suffer from sleep apnea. After menopause, sleep apnea is more common.
  • Obesity and weight gain increase the severity of sleep apnea.
  • Sleep apnea is often associated with metabolic syndrome (obesity and diabetes, hypertension, and high cholesterol). This should be treated using CPAP and management weight, diabetes, and cholesterol.
  • Sleep apnea is when you wake up coughing, choking, or stopping breathing while you sleep. You should schedule a sleep study.

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