Snoring and Sleep Apnea in Women

Snoring in women

Please read this article only if you are a snoring woman and suffer from sleep disorder called sleep apnea. May be it is embarrassing for you, may be you are disrupting your partner’s sleep, or may be your snoring is loud enough to even disturb the sleep of family members sleeping in other rooms in the house or the house next door.

I’m sure just about everyone is somewhat familiar with snoring. You probably know at least one person who snores. It could be your bed partner, your parents, and grandparents, even uncle or aunt who may snore at various sound levels. Some laugh and make jokes about it, but it can be a symptom of a serious disorder called obstructive sleep apnea (OSA). And if it is obstructive sleep apnea, then it is no laughing matter, and that individual needs to get evaluated by a sleep specialist.

Snoring in Women- Is it really a fact?

Snoring and sleep apnea are generally considered to be conditions predominantly affecting men. However, more recent research has recognized that snoring and sleep apnea in women is not as rare as was once thought. More recent studies on general populations have reported male: female prevalence ratios for sleep apnea are around 2:1.Some studies have found that men are twice as likely to be referred for a sleep study than women. Nearly half of women snorers do not report their symptoms to their doctor, often due to embarrassment or shame. Undiagnosed sleep apnea is far more prevalent in women than men. One study found that sleep apnea was undiagnosed in more than 90% of women with moderate to severe sleep apnea. Nearly half of all middle aged men snore, but women tend to snore later in life with an increased prevalence after menopause at around 50-60 years of age.

Risk Factors of Snoring in Women

Like in men, the symptoms of snoring and sleep apnea in women have an adverse effect on neurological and psychological function resulting in poor work performance, difficulty in concentrating, memory impairment, headache, nausea, impotence and decreased libido.

Symptoms of Snoring and OSA in Women

Typical symptoms of sleep apnea, snoring, apneas, choking and restless sleep, are similar in both men and women. Atypical symptoms such as daytime fatigue, headaches, insomnia, tension, depression and the use of sedatives are more frequent in women than men and may divert clinicians to diagnose and treat for other conditions. For example, because women are more likely to report insomnia and depression they are more likely to be treated for these symptoms rather than the underlying cause of their sleep apnea.

Obesity in women

Obesity seems to be the dominant factor for the occurrence of sleep apnea in women. There is evidence that obesity is greater in premenopausal women compared to postmenopausal women with sleep apnea. It has also been reported that premenopausal women have more severe apnea compared to postmenopausal women with the same BMI.

Hormonal effects

Female hormones may have a protective effect on the upper airway dilator muscles as they are believed to protect the airway from obstructing during sleep. Some studies in post menopausal women found modest improvements in snoring and sleep apnea with estrogen alone, whilst others found better improvements with both estrogen and progesterone. Testosterone has been found to increase upper airway collapsibility and the consequent risk of developing snoring and sleep apnea. This may explain in part why there is a male predominance in snoring and sleep apnea.

Diabetes

There is an increasing interest in the association between snoring, sleep apnea and diabetes mellitus. Diabetes is often associated with snoring and sleep apnea, predominantly in overweight males. Snoring women were twice as likely to suffer diabetes as non- snoring women.

Both diabetes and snoring and sleep apnea are influenced by sexual hormones. Snoring and diabetes often increase during pregnancy, after the menopause and in women with poly cystic ovary syndrome (PCOD). The sleep deprivation and cyclic decreases in oxygen levels that occur as a result of snoring and sleep apnea tend to increase insulin levels. It has been suggested that this may be the link between snoring and diabetes as one study reported that insulin sensitivity improved following treatment for snoring and sleep apnea.

Hypothyroidism

In patients with hypothyroidism, sleep disordered breathing appears to be common, yet in patients with snoring or sleep apnea, hypothyroidism is also very uncommon. Thyroxin therapy showed a reduction in snoring and excessive daytime sleepiness in hypothyroid sleep apnea patients.

Pregnancy Snoring and Diabetes

Sleep apnea is associated with a greatly increased incidence of gestational diabetes.

Sleep apnea was associated with a doubling of the incidence of gestational diabetes and a fourfold increase in the risk of pregnancy-induced hypertension. As you know obesity is a major risk factor for sleep apnea. Pregnancy can worsen sleep apnea, especially during the third trimester when a woman’s weight is greatest. When a mother’s oxygen level drops at night, it may also affect the oxygen level of the fetus. That is why it’s important for a pregnant woman with sleep apnea to be treated with CPAP during her pregnancy.

The body also secretes more hormones such as cortisol and epinephrine, and the body responds by producing more glucose coupled with a decreased sensitivity to insulin, which can lead to diabetes.

If sleep apnea is present in pregnancy, treatment in the form of nasal CPAP should be used and the blood pressure and blood sugar should be closely monitored. The most effective treatment for sleep apnea is an apparatus called nasal CPAP, which delivers air through a mask while the patient sleeps, keeping the airway open.