Sleep apnea symptoms in women: Are they different?

Are sleep apnea symptoms in women different than those in men? A study published in October by the UCLA School of Nursing on the topic of sleep apnea in women suggests that the answer is yes.

“Women with obstructive sleep apnea may appear to be healthy — having, for instance, normal resting blood pressure — and their symptoms also tend to be subtler, which often means their sleep problem is missed and they get diagnosed with other conditions,” wrote Laura Perry for the UCLA Newsroom  in a summary of the study, which was funded by the National Institutes of Health and the National Institute of Nursing Research.

The health risks of sleep apnea are well known, as is the extent of the condition — according to the study, more than 20 million U.S. adults are affected.¹ But because of conventional wisdom that men are more susceptible, sleep apnea in women may be less diagnosed than in men, the study suggests.

And that’s the dangerous part, since sleep apnea may impact women’s health in different, and possibly more dangerous ways, according to the study authors. Three tests were conducted in the study, all focusing on the effects of heart rate changes in patients with and without sleep apnea.

“The heart-rate results for these tests show that the impact of sleep apnea, while bad in men, is more severe in women,” Macey said. “This may mean that women are more likely to develop symptoms of heart disease, as well as other consequences of poor adaptation to daily physical tasks. Early detection and treatment may be needed to protect against damage to the brain and other organs.”

Detecting sleep apnea symptoms in women

These findings could be particularly important given that sleep apnea in women tends to be less frequently diagnosed. Some experts suggest that this could be due to misdiagnoses that arise because sleep apnea symptoms in women are different than men.

“I didn’t snore, I didn’t have any of the typical symptoms of sleep apnea,” Cathy Rossi, a sleep apnea patient told ABC News  in 2012. ”Anytime you see anything [about sleep apnea] on television… it’s always some big guy sawing logs.”

Rossi didn’t snore or report any difficulty sleeping. For her, the trouble began when she started experiencing mental blank-outs — sometimes while driving.

The ABC News story enlisted Dr. Grace Pien, assistant professor at the Sleep Medicine Division of the Perelman School of Medicine, to clear up some of the misunderstandings of sleep apnea in women.

“The symptoms we think about with sleep apnea (such as snoring and daytime sleepiness) are those that were first described in men,” said Dr. Pien, who explained that, even though only about half the number of women have the condition as men, sleep apnea symptoms in women are subtler and more often lead to an incorrect diagnosis of other conditions.

”Women oftentimes are worked up for other things, for hyperthyroidism, for inactive thyroid, or for depression or other types of medical conditions before somebody says oh, you know maybe this woman does have sleep apnea,” Pien said. That’s especially true for menopausal woman, she added.

So what are some of the more common sleep apnea symptoms in women? “Women tend to have more complaints of chronic fatigue or tiredness and insomnia,” according to Nancy A. Collop, MD, medical director at Johns Hopkins Hospital Sleep Disorders Center. “Since these aren’t the classic symptoms of sleep apnea, these symptoms are often put off to being something else.”

Some women “may notice that they wake themselves up feeling as if they are gasping for air or choking,” Dr. Pien adds, and they may “report that they wakened, but they’re not entirely sure what awakened them.”

If any of these sleep apnea symptoms in women sound familiar — to you, or for someone you know — it may be time to speak to your doctor about getting a sleep apnea test.

Also, check out our earlier report of the connection between sleep apnea and pregnancy for more details on sleep apnea in women.