November 30, 2017
Sleep apnea is a condition that afflicts an estimated 22 million Americans and is generally believed to be vastly under-diagnosed in the general population. The difficulty in diagnosis originates in the fact that many of the condition’s symptoms can be attributed to a number of ailments, and the medical community is still working to understand and recognize symptoms as possible indications of sleep apnea.
For women, the situation is compounded by the fact that their symptoms tend to deviate from the “classic” symptoms found in men. Chronic snoring, the most common tell-tale sign of sleep, is frequently replaced by other sleep disruptions in women.
A new study published this month in Menopause showed that hot flashes and night sweats, which are experienced by up to 80 percent of middle-aged women, may indicate an increased risk of obstructive sleep apnea.
The study leveraged self-reported data of 1,691 midlife women who were seen at Mayo Clinic and found that 24.9% were at intermediate to high risk for OSA. The data also showed that those who endure severe hot flashes were at a significantly higher risk for sleep apnea than those who reported experiencing mild to no hot flashes.
And while those results are certainly interesting, what is even more telling is that two years after their clinical consultation, 65 percent of those women determined to be intermediate to high risk remained undiagnosed with the sleep disorder.
It’s important to note that this study wasn’t sufficient to prove a cause-and-effect relationship between hot flashes and sleep apnea, but rather an association. It does, however, further solidify the fact that sleep apnea symptoms experienced by women often differ from those experienced by men. Due to that fact and other factors, sleep apnea in women frequently goes undiagnosed or misdiagnosed–at an even greater rate than in men–leaving them at risk for serious health issues such as high blood pressure, heart disease, stroke, and diabetes.
A few of the reasons women are often under or misdiagnosed:
- Women are less likely to suffer from loud, chronic snoring, which is a tell-tale sign of sleep apnea
- Women’s apneic events tend to be fewer and/or shorter than men’s
- Women’s sleep disturbances tend to be more subtle and less likely to be noticed by a bed partner
- Most sleep apnea symptoms can also be attributed to other ailments, which leads to misdiagnosis
- Women often reveal their symptoms to their general practitioners who may attribute the symptoms to another ailment and not be inclined to refer the woman to a sleep specialist who can screen for sleep apnea
In addition to the classic symptoms, these are common symptoms of sleep apnea in women:
- Mood disturbances
- Morning headaches
- Chronic fatigue
- Restless leg syndrome
- Disrupted sleep
Here are a few of the conditions that, according to the National Sleep Foundation, are often diagnosed in lieu of sleep apnea:
- Cardiac or pulmonary illnesses
- Fatigue from overwork
- Menopausal changes
As doctors and physicians continue to better understand the signs, associations, and correlations between sleep apnea and other ailments–as well as how those factors vary between genders–sleep apnea diagnosis is sure to rise. Fortunately, effective treatment of the condition significantly reduces the risk of its associated and alleviates many of its debilitating symptoms.
For women who suspect that sleep apnea may be an underlying cause of their symptoms, a sleep study, performed by a qualified sleep medicine specialist, will provide the data necessary for diagnosis. Once evaluated and diagnosed, treatment options range from a traditional CPAP machine to custom-fit and calibrated oral appliance therapy or surgery.