There are at least a dozen reasons why women may wake up with a headache, jitter with anxiety, or struggle to keep their eyes open at work, no matter how well they think they slept: menstruation, menopause, motherhood—the list truly goes on. But these symptoms, as vague as they are, could actually stem from a health condition that’s historically been deemed a “male disease”: obstructive sleep apnea, or OSA.
If you immediately pictured an older man snoozing on a couch and snoring like a lawn mower, you’re not alone. It wasn’t until the ’90s that researchers first recognized that OSA, which causes you to repeatedly stop breathing while asleep, often presents differently in women than it does in men. For starters women with the condition may not even snore.
There’s still much to discover about the biology underlying these distinctions, but research suggests that hormonal fluctuations throughout life, differences in upper airway anatomy, and even social stigmas about how women should sleep are likely at play.
“The disease itself was defined in men,” explains Jennifer Martin, PhD, a behavioral sleep medicine specialist and professor at Florida International University’s Herbert Wertheim College of Medicine in Miami. “The way men and women breathe when they’re asleep is not the same, and our definition of the disease doesn’t account for that.”
Although obstructive sleep apnea appears to be less common and typically milder in women (at least before menopause), studies suggest that the consequences of the disease, if left untreated, can be similar, if not worse, for us, making it vital to learn the signs and seek help. Here’s what we know about obstructive sleep apnea and its impact on women. Plus, experts explain how to advocate for the best care if you think you may have the condition.
How and why sleep apnea differs in women
Sleep apnea is one of several conditions that fall under the sleep-disordered breathing umbrella. The most common type is OSA, which happens when your upper airway repeatedly collapses during sleep, making it harder for air to reach your lungs, says Anita Valanju Shelgikar, MD, a sleep medicine physician with University of Michigan Health and president of the American Academy of Sleep Medicine.
The textbook symptoms of this condition—which, for the record, were determined based on studies mostly involving men—include loud snoring and dramatic gasps for air as a person tries to continue breathing while asleep. But this often isn’t the case for women, Dr. Shelgikar tells SELF. Instead, women with OSA are more likely to have nightmares, wake up multiple times a night, have trouble staying asleep, and deal with insomnia, which then causes symptoms like daytime fatigue, morning headaches, and mood swings. Women also have more hypopneas (shallow breaths with less oxygen flow), whereas men tend toward apneas (complete pauses in breathing).