Women & Snoring: The Risks and Causes

When asked to picture someone who has sleep apnea, chances are you imagine a larger middle-aged man whose wife must endure loud, trumpeting snoring. 

While the majority of Dr. Marc Kayem’s patients are men, women can have sleep apnea and snoring problems, as well. 

In fact, nearly 1 in 5 women have sleep apnea. But 9 in 10 women with sleep apnea are not even aware they have it.

And what’s even more alarming: There is evidence that women with sleep apnea could be more susceptible to heart disease than men are, so early diagnosis and treatment are crucial.

Why Is It Difficult to Diagnose Women with Sleep Apnea?

Statistics show that snoring occurs in roughly 57 percent of adult men and 40 percent of women. So, while it’s true that women are less likely to develop sleep apnea than men, it doesn’t mean they are not at risk. 

A 2007 sleep poll estimated that 25 percent of American women were at high risk of developing obstructive sleep apnea.

However, the American Academy of Sleep Medicine indicates that the rate of female diagnoses remains disproportionately low: 1 woman per 2-3 men. 

Why? There are a few reasons sleep apnea goes undetected in women.

GENDER BIAS

First, sleep apnea has historically been considered a man’s disorder. Going back to the 1970s and 1980s, studies erroneously suggested the condition is more prevalent in men by ratio of 1 to 60. Therefore, the research was then tailored to men, focusing on their symptoms and not accounting for any unique symptoms that women may have.

DIFFERENT SYMPTOMS

Loud snoring is the No. 1 symptom of sleep apnea in men, but women often present with other symptoms. These symptoms include headaches or swollen feet in the morning, fatigue and daytime sleepiness, insomnia, and frequent night waking. 

The 2007 National Sleep Foundation poll indicated that insomnia and restless legs syndrome put women at risk for sleep apnea, and the risk increased with age, higher weight, and menopause.

SNORING DENIAL

Research has found that women are less likely to self-report snoring, and even when they admit to snoring, they do not think they snore loudly.

In one study, 1,900 patients (both men and women) were asked to rate the severity of their snoring. Then, while sleeping, the volume of their snoring was measured by a sound meter. When the data were calculated, it was discovered that women snore just as loudly as men. 

Even more telling is that 28 percent of women said they didn’t snore at all, but this was only true for 9 percent of them.

FAULTY SLEEP TESTING

Women are more likely to wake up in response to apnea than men. They typically awaken before their oxygen levels fall by more than 4 percent, which is the Medicare threshold for diagnosing sleep apnea. 

When researchers used a 3 percent oxygen desaturation threshold, more women matched the criteria for sleep apnea.

Waking up more easily could be because women evolved to wake up to tend to children at night, according to researchers.

Additionally, sleep tests average the incidence of apnea over a total night because men experience apnea all night long, but women mostly experience apnea during the rapid eye movement stage of sleep. This means the intensity of the REM apnea gets underplayed when averaging the entire night, and women go undiagnosed.

Sleep Apnea Risks May Be Worse for Women

Studies have proven that women are more vulnerable to the negative effects of sleep apnea, including heart conditions, inflammation, high blood pressure and dementia. 

A Radiological Society of North America study showed that a group of snoring women (undiagnosed with sleep apnea) who received a cardiac MRI had increased left ventricular mass compared with a group of snoring men. This means that the heart needs to work harder to fulfill the body’s needs.

Besides cardiovascular disease, women may also suffer these conditions as a result of untreated sleep apnea:

  • High blood pressure
  • Diabetes
  • Stroke
  • Depression and other mood problems
  • Missing out on the joys of life: fun, laughter, relationships, intimacy
  • Accidents due to fatigue and daytime sleepiness
  • Problems with alertness, memory and learning
  • Increased sensitivity to pain
  • Overtreatment or mistreatment for other disorders

What Causes Women to Snore

Women share many of the same risks as men for developing sleep apnea, including obesity, smoking, genetics and age.

On the other hand, women have a specific list of risk factors that aren’t as well known.

POLYCYSTIC OVARY SYNDROME (PCOS)

A 2019 study showed that women with this endocrine disorder are more than twice as likely to develop sleep apnea.

PREGNANCY

Women who are pregnant may be at elevated risk for developing sleep apnea because of changes to sleep patterns, weight, and anatomy that affect breathing. On top of that, sleep apnea in pregnancy can lead to a host of other complications, including high blood pressure and gestational diabetes.

MENOPAUSE

A woman’s risk for sleep apnea goes up dramatically as she enters menopause. The hormones estrogen and progesterone have protective effects over women’s sleep, but the decline of these hormones in menopause can lead to sleep apnea. Research hints that from perimenopause onward, the risk of sleep apnea increases 4 percent per year.

Do You Have Sleep Apnea? 

If you are a woman and suspect that you might have sleep apnea, the next step is to seek the help of an experienced doctor like Dr. Marc Kayem. 

Dr. Kayem has spent over 25 years helping sleep apnea and snoring patients, so you will know you’re receiving incomparable treatment. 

Because the causes of snoring and sleep apnea are individual to each patient, Dr. Kayem will perform a thorough exam and recommend treatments based on your unique case to get you sleeping easy again.

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