Obstructive sleep apnea (OSA) is when the upper airway collapses and obstructs the air flow. OSA is most often associated with men, snoring and obesity, so recognising the peculiar symptoms and potential risks for sleep apnea in women is increasingly important.
In many cases, it is often the disruptive effect on a partner that triggers concerns.
Sleep apnea is (quite frankly) when your breathing stops during sleep. This can be voluntary, like when you hold your breath, or involuntary, such as when you gasp with shock and you’re momentarily breathless. In these and most cases, your conscious response will kick in to get you breathing again. With sleep apnea, where breathing stops and starts while you are asleep, it can be dangerous if not diagnosed, understood or remedied.
Women at risk
Physiological differences between genders contributes to both perceived and actual sleep apnea risks for women. Women are generally more likely to experience low level and partial apnea (or hypopnea) than men. But, because signs of sleep apnea in women may be more discreet than in men, women are at greater risk of their OSA going undiagnosed.
Part of the danger is that common symptoms of sleep apnea are also indicators for other health issues. Sleep apnea in women has been associated with weight gain, lethargy and tiredness, stress, anxiety and depression. However, these are also signals for other problems. Ranging from insomnia, mental health issues, diabetes, high blood pressure and thyroid conditions through to menopause and even pregnancy. The incidence of heart attack and stroke also increase with OSA.
Symptoms in women
Obvious indicators for sleep apnea in women can mirror those for men, such as snoring and daytime sleepiness, but they may be less severe. Sleep apnea can cause and be part of a wider problem with insomnia or chronic fatigue. It can also lead to dissociative behaviour like failing memory or learning difficulties, as well as anger, irritability and even depression. Clinical indicators might include headaches, dry mouth or sore throat when waking in the morning.
The incidence of sleep apnea in women increases with age, especially as they enter menopause. While screening rates for OSA in women remain low, recognising and connecting symptoms may also come from a partner’s observations or greater self-awareness. A partner can observe loud and frequent snoring, whether you make gasping, choking or snorting sounds during sleep, or experience episodes where you stop breathing. You will know if you need to frequently urinate in the night, have lapses in concentration or nap during the day. Women’s health and wellness is easy to ignore, it can be just as easy to take action.
Testing for sleep apnea
OSA testing can be done in-home or in a dedicated sleep clinic. The level of testing depends on how symptomatic, moderate or severe your OSA is. Doctors use screening tools to determine eligibility for subsidised testing and can provide a referral. Simple home testing devices, available from some pharmacies, don’t require referral or significant cost.
In a clinic, a technician observes as well as using a Polysomnography (PSG) machine. It measures and records sleep stages, breathing and cardiac parameters, and limb movements. In-laboratory monitoring is limited in availability and costly, so self-operated home sleep tests are widespread. An in-home test can be a full polysomnography (PSG), a limited channel test monitoring various breathing parameters but without sleep assessment, or a limited channel monitoring just a couple of parameters, such as oximetry (oxygen in the blood).
These tests determine the severity of sleep apnea, measured by the average number of times breathing is disrupted each hour. 5-15 is mild with mostly minimal symptoms, while above 15 is determined as moderate to severe, where the OSA is possibly leading to other health problems.
Treating or living with sleep apnea
Effective treatment will depend on the severity of your OSA. Controlling or moderating risk factors like weight gain help, as can altering sleeping techniques or using nasal and dental anti-snoring devices for mild OSA.
The most effective method to treat moderate to severe sleep apnea is using a continuous positive airway pressure (CPAP) machine. CPAP machines connect to a mask and apply positive air pressure to prevent upper airway collapse. Various mask designs are available for individual comfort and the machines themselves are portable enough to travel with.
A CPAP machine is usually less disruptive to a partner than snoring, so everyone can get a good night’s sleep.
