Women Suffering from Fatigue May Have Sleep Apnea.

Sleep apnea is not uncommon in women, but women's sleep apnea symptoms are different than men's. Women with daytime sleepiness may have sleep apnea.

Many people assume that sleep apnea affects only older, overweight men. Yet medical studies show that sleep apnea affects women and children as well. Doctors estimate that for every two to three men with sleep apnea, one woman has the condition.

A woman is less likely to receive a sleep apnea diagnosis than a man, however. For every woman diagnosed with obstructive sleep apnea (OSA), eight to nine men receive a diagnosis. Women should learn about sleep apnea symptoms and be aware that the disorder can affect them too.

Sleep Apnea Diagnosis Challenges for Women

When women suffer from excessive sleepiness (fatigue even after sleeping seven to eight hours) doctors are likely to overlook the possibility of a sleeping disorder, according to Dr. Barbara Philips of the National Sleep Foundation. Female sleep apnea sufferers are often misdiagnosed with disorders such as the following:

• anemia
• cardiac or pulmonary illnesses
• depression
• diabetes
• fatigue from overwork
• fibromyalgia
• hypertension
• hypochondria
• hypothyroidism
• insomnia
• menopausal changes
• obesity

One challenge of diagnosing women's sleep disorders is that women tend to sleep more lightly than men. As a result, women hear their male bed partners snoring and express concern. This prompts many men to see doctors about sleep disorders. Men may sleep more soundly than their female bed partners, and so fail to notice female nighttime breathing problems, according to Dr. Nancy A. Collop of Johns Hopkins University Sleep Disorders Center. Women are thus often unaware that they have sleep apnea symptoms.

Sleep Apnea Effects in Women

Another challenge for diagnosing sleep apnea in women is that sleep apnea causes additional conditions that complicate diagnosis. One such condition that arises from sleep apnea is depression. Women are more open to taking anti-depressants for depression than men are. Men suffering from depression may request a sleep study rather than take anti-depressants, while women leave the doctor's office with a prescription.

One of the primary effects of sleep apnea is daytime sleepiness. Men are less likely than women to have other reasons for fatigue, such as anemia or an exhausting schedule of work and family responsibilities, according to Dr. Anita L. Blosser. It is thus easier for doctors to quickly recognize a possible sleep disorder in male patients. Women patients who complain of fatigue are more likely to receive blood tests for anemia or thyroid problems than a referral for a sleep study.

Sleep Apnea Symptoms in Women

Sleep apnea affects women differently than men. The "classic" symptoms that affect men include loud snoring, long breathing pauses at night and excessive daytime sleepiness. Women, however, may instead report symptoms such as lack of energy, insomnia, morning headaches, restless legs and depression.

Since men tend to sleep more soundly than women, a female patient may not have a bed partner who can report on her nighttime breathing patterns. Researchers are also discovering that women experience sleep apnea differently than men. According to Dr. Barbara Philips, female patients suffer from "more subtle breathing disturbances" and more REM-related apneas.

In sleep studies, women may have lower scores for AHI (apnea-hypopnea index) than men, indicating fewer full-blown apneas (10-second pauses in breathing). This lower AHI may indicate a form of sleep apnea known as UARS (upper airway resistance syndrome), which is more common in women, according to some doctors.

Sleep apnea symptoms in women include the following:

• "tossing and turning," feeling that it's difficult to stay asleep (some women report this as insomnia)
• waking up feeling tired and poorly rested
• chronic fatigue or lack of energy
• snoring or choking
• frequent nighttime urination
• awakening gasping
• excessive daytime sleepiness
• morning headaches
• dry mouth upon waking up
• edema (swelling) of the feet
• hypertension
• high blood pressure that does not respond well to medication
• unexplained weight gain.

Women are at greater risk of sleep apnea if they are overweight, obese, or past menopause.

Sleep Apnea Treatment for Women

The most effective treatment for sleep apnea is CPAP (continuous positive airway pressure). The good news is that although women may find it somewhat harder than men to find out they have sleep apnea, women are more likely than men to comply with CPAP treatment, according to Dr. Blosser.

CPAP treatment requires wearing a breathing mask over the mouth at night, which provides pressurized air to hold the airway open. Women who suspect sleep apnea should talk to a doctor about a sleep study to find out if CPAP treatment would help them.