Sleep apnea among women on rise

Snoring can be fatal for health & home

 Snoring is not just a problem for males. Women snore just as loudly as men, and the health risks are identical. So, why is it routinely ignored and overlooked? If left untreated, Obstructive sleep apnea (OSA) has a severe impact on sleep quality and has been linked to high blood pressure, stroke, heart disease, and other health concerns.

Taboo attached to snoring

10-15% of women snore but do not discuss their snoring problems with doctors due to inhibitions and a lack of information about snoring-related health risks.
“OSA is frequent in women but very much underdiagnosed compared to men because women have different symptoms. Snoring, gasping, and coughing while sleeping are common signs of OSA. However, in addition to typical symptoms, women may have sleeplessness, depression, and morning headaches,” says Dr Ramanaprasad V V, Consultant Interventional pulmonologist & sleep specialist, KIMS Hospital Secunderabad.

Hormones’ Role

OSA can manifest differently in men and women because to hormones, physical appearance, and how the body regulates breathing and muscle tone. “Women may be less likely to have OSA during non-REM sleep and more likely to have osa symptoms during rapid eye movement (REM) sleep, but because REM accounts for only 20% of total sleep time, the average Apnea Hypopnea Index (AHI) in women will be lower than in men, making appropriate diagnosis of osa problematic,” says Dr Ramanaprasad V V.

Undiagnosed sleep apnea among women on rise

Obstructive sleep apnea is more likely to go unnoticed in women than in males, therefore underdiagnosis can have a major impact on women's health. “Recent research indicates that sleep apnea during REM sleep, regardless of what occurs in NREM sleep, is a risk factor for hypertension and other cardiovascular disorders. Therefore, even though women may have less sleep apnea events across the entire duration of sleep, since they appear to have just as many sleep apnea events during REM sleep, women may be just as susceptible as men to the ill effects of sleep apnea,” says Dr Ramanaprasad V V adding, “Sleep apnea can raise the risk of asthma, atrial fibrillation, malignancies, chronic renal disease, cognitive and behavioural issues, and diseases of the heart and blood vessels.”

CAN BE FATAL

Aside from being a serious health danger, snoring has been identified as the third leading cause of divorce in the United States. In India, too, snoring by spouses has exacerbated marital issues, leading to legal action. Snoring can occur at any age, but it typically worsens around middle age.

Snoring – a medical issue

The medical fraternity has emphasised the importance of sleep quality and the negative influence of snoring on one's health.
Dr. Jagdish Chaturvedi, a nose and sinus specialist, adds, “It is past time for patients to start treating snoring disorders with medical procedures. In the long run, not following the doctor’s recommendations on snoring can have negative health consequences.”

Risk factors for snoring

Commenting on the risk factors of snoring, Dr Charan Teja Koganti, neuropsychiatrist at KIMS and associate professor at VRK Medical College, explains, “The most common causes of snoring include obesity and overweight. When people gain weight, the loose areas around the neck collect fat, and subcutaneous fat already exists. All of them exert pressure on the respiratory tract, which transports air into and out of the lungs. The air-carrying tract narrows due to fat and pressure. It creates a gap in breathing, which leads to snoring. Snoring is common in those who have respiratory problems such asthma, COPD, or allergies.”

“Lifestyle also plays a role in snoring. Those who have alcohol and eat heavy meals prior to sleeping are more at risk of snoring. Alcohol acts as a depressant for the central nervous system and suppresses brain activity. So it’s advised that these are avoided at least a few hours before sleep. It is also important to keep changing the sleep position from day to day,” adds Dr Charan Teja.

Physical and psychological implications

Dr. Teja elaborates on the impact on physical and psychosocial health, saying, “Surveys and studies have shown that existing marital problems are exacerbated by snoring. It’s embarrassing for the patient, and they’re unaware of their snoring habit until their spouse or someone sleeping next to them brings it out. Partners said they are not attracted to someone who snores, which affects physical intimacy as well. Sleep and snoring problems have a negative impact on confidence, interpersonal and marital relationships.”

While occasional light snoring is not reason for concern, loud and chronic snoring can be harmful to one’s health. “Snoring and sleep apnea are linked and have been a major cause of cardiac arrest and death during sleep.  It also increases the risk of stroke because blood circulation to the brain via the carotid artery is impaired,” explains Dr Teja. Bed-wetting is another issue for some snorers. “Due to snoring, people get disturbed or fragmented sleep, which can manifest as dementia, Parkinson's disease, clinical depression and bipolar mood disorder later in life,” he goes on to say. The doctor recommends treatment with medications, a C-PAP device, or surgery, depending on the severity of the problem, in addition to lifestyle adjustments and weight loss.