Dentist - Dr. Amy Norman, DDS, PS

Women Get Sleep Apnea, Too

 When you picture the typical sleep apnea patient, what comes to mind? For many, it's an image of an overweight, middle-aged man snoring through the night. This is a common conception not only with the general population, but also with doctors, according to Dr. Amy Norman, DDS, a dentist in Everett, Washington, who treats many sleep apnea patients in her practice.  

"For years, men have been the poster children of sorts for sleep apnea," she said. "There are many reasons for this. Women are affected differently by sleep apnea in many cases and don’t always snore. They are often misdiagnosed since their symptoms don’t always align with a doctor’s idea of what a typical sleep apnea patient looks like."


Research Says Women Are Under Diagnosed

According to research published in Biomed Research International, fewer women receive the right diagnosis when it comes to sleep apnea. The average male-to-female ration for obstructive sleep apnea is three to one, but in clinical settings that number jumps to eight to one and sometimes all the way up to 10 to one. This data shows women are not being diagnosed as frequently as men. Biological differences in the airway, the way fat is distributed throughout the body, respiratory stability and hormones all play a role in what makes sleep apnea present so differently in men and women. The study suggests a more personalized approach could provide better diagnosis and care for both men and women.

The study reports that even women who present with feelings of sleepiness similar to men still score lower on the Epworth Sleepiness Scale, which is one tool used in the diagnosis of sleep apnea. The scale has yet to be endorsed for women suspected of having or diagnosed with obstructive sleep apnea. Some researchers believe these discrepancies in testing could have to do with women and men having different thresholds when it comes to feelings of sleepiness.

Difference in Symptoms Could Be Cause for Under Diagnosis

The most common symptoms presented by women with obstructive sleep apnea include insomnia, restless leg syndrome, depression, nightmares, heart palpitations and hallucinations, according to the study. For men, snoring and episodes of suspended breathing are the most common symptoms.

"If you think about it, women are often lighter sleepers," she said. "Most of the patients I see for sleep apnea are men whose wives or partners have noticed their apneic episodes or snoring and encourage them to come in for help. This alone is a good indicator to me as to why women are so underrepresented in sleep apnea diagnoses. It’s not that they aren’t suffering as well."

Another reason the disorder may not be noticed is subtle changes in breathing for female sleep apnea patients. Not only is snoring typically lighter, but the episodes of apnea are also shorter and less frequent in the typical female patient. In addition, the study notes that the symptoms reported most often to doctors by women are more generalized daytime symptoms, like anxiety, headaches, depression and sleepiness, which are often treated as mental health concerns instead of sleep disruption.

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