Over half of the 22 million cases of sleep apnea diagnosed yearly are men. However, this doesn’t mean women aren’t affected by serious sleep disorders. It causes your breathing to become shallow or stop altogether during sleep.

Recent evidence suggests that women are more likely to suffer from sleep apnea than was previously thought. According to the Society for Women’s Health Research, one in five women suffers from sleep apnea. Nine out of 10 women are unaware that they have sleep apnea, which can lead to serious health problems.

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What the Sleep Apnea Differences between Men and Women

Obstructive sleep apnea, the most severe and dangerous sleep disorder, is experienced differently by men and women. This was something that was only recently understood. Christine Won, M.D., Director of the Women’s Sleep Health Program, Yale Medicine New Haven, Connecticut, conducted a 2020 study in SLEEP. She found that two main factors contribute to obstructive sleeping apnea.

Females are more likely to experience sleep apnea in REM sleep than in NREM sleep. REM refers to “rapid eye movement,” a dream-like state of rest during which more brain energy has been used. NREM, or “non-rapid eye movement,” occurs before REM and is a shorter sleep that consists of three stages. Dr. Won says that REM sleep accounts for about 20% of our total sleep time, which may lead to fewer apneas in women at night. “But in REM sleep, the apneas are more severe and last longer, which can lead to significant drops in oxygen levels.

Some women are more susceptible to upper-airway resistance syndrome. This disorder is less severe than sleep disorders like sleep apnea, but it can be disruptive. She says that although women with this disorder still experience snoring and collapsible breathing, they don’t have frank or complete apneas. They also do not suffer from oxygen drop. Sleep fragmentation and awakenings can still be caused by airway resistance.

Dr. Won also notes another difference. Women are more likely to experience sleep disruptions and apnea than men.

Why OSA is underdiagnosed in women compared to men

Dr. Won believes that women with sleep apnea are more likely to be diagnosed than men due to how the disease has been defined.

Dr. Won states that obstructive sleep apnea can be diagnosed if there are more than five events per hour. Dr. Won says that although women are less likely to experience sleep apnea in NREM sleep than men, they have as many events per hour during REM sleep as men. This makes it harder to diagnose.

It is known that sleep apnea in REM sleep is a risk factor for people with cardiovascular disease. Dr. Won says that the current method of diagnosing OSA in women may not be able to detect real disease.

Women are also more likely to end their sleep apnea by waking up from sleep. Dr. Won states that oxygen drop symptoms associated with sleep apnea might be less well-known or more severe in women. Therefore, sleep apnea is less commonly recognized in women.

These sleep apnea-related sleep disturbances may be important mediators of cardiovascular disease. It may be difficult to diagnose an infection in her if you don’t catch or count these sleep disturbances when analyzing a woman (like many home tests for sleep apnea).

How underdiagnosis impacts women’s Health

Obstructive sleep disorder apnea can be more easily missed in women than men. This can have serious consequences for women’s Health. Recent research has shown that hypertension and other cardiovascular diseases can be linked to sleep apnea in REM sleep.

“Consequently, although women may experience fewer sleep apnea episodes throughout their sleep, they seem to have as many REM sleep apnea activities during REM sleep. This means that women could be just as vulnerable to the ill effects of sleep apnea.

Sleep apnea may increase your risk of developing asthma, atrial fibrillation, and cancers, as well as cognitive and behavioral disorders, diseases of the heart (heart attack and heart failure, stroke, high blood pressure, and stroke), eye conditions, metabolic conditions, and even pregnancy complications.

Sleep Apnea Risk Factors in Women

Obesity can be a strong risk factor for OSA in men and women. Dr. Won also notes that OSA results from hormonal status in women, so they tend to develop it later. She says that women are at greater risk for sleep apnea after menopause. “Female hormones might protect women against NREM sleep apnea, which is more common in men.”

Signs and symptoms of sleep apnea in women

Unsurprisingly, sleep apnea symptoms can look different in men than in women. Although snoring and gasping are the most common symptoms, they can also be seen in women.

Dr. Won states that although women may have the same symptoms as men, they are likelier to experience less of the ‘classic’ symptoms like insomnia, sleep fragmentation, or fatigue.

Contact your doctor immediately if you experience any symptoms of sleep apnea. Your doctor can set up a sleep study and a medical history to diagnose sleep apnea. They might also refer you to a specialist or center for the study.