Implications for Women

Sleep Disordered Breathing—snoring, Upper Airway Resistance Syndrome, and Obstructive Sleep Apnea—was previously thought to be a primarily male condition. The stereotypical overweight middle-aged male who snored was the subject on which all research was concentrated. However, it is becoming widely known that Sleep Disordered Breathing occurs in women as well.

The airway is a muscle, and like any muscle it can lose its tone as we age. Women who are reaching middle age may experience the lack of airway patency that results in airway obstruction just as aging men do.

Research in Chest magazine determined that Upper Airway Resistance Syndrome is seen frequently in young women of all body types, not simply those who are overweight. UARS in women may be accompanied by gastroesophageal reflux, depression, bruxism, hypothyroidism, and asthma.

However, Sleep Disordered Breathing in women is frequently tied to hormone imbalances. Because the problems are internal, chemical ones, the telltale obesity and age that allows an easy diagnosis in men is not as clear in women.

Post-menopausal women are at a high risk for Sleep Disordered Breathing, according to a 2003 article in The American Journal of Respiratory and Critical Care Medicine. Their bodies cease to produce estrogen and progesterone, two hormones that are believed to be intimately connected to the ability to breathe. Estrogen dictates the location of fat on a woman’s body, and when that hormone ceases to be produced, any weight gain will instead be dictated by testosterone, gained in places more common to males, such as the neck and abdomen. Sleep Disordered Breathing occurs because a woman’s body cannot handle excess fat on the neck and abdomen. Although not completely understood, scientists believe progesterone stimulates breathing. When progesterone production ceases, coupled with a lack of estrogen, Sleep Disordered Breathing often results.

Pre-menopausal women are also at risk, as they are just beginning to enter menopause. Although their hormones are not depleted yet, they do experience imbalances. This can also trigger Sleep Disordered Breathing.

Women with reproductive disorders such as Polycystic Ovarian Syndrome are also at a higher risk for Sleep Disordered Breathing. Caused in part by irregular production of insulin and overproduction of male hormones (androgens), PCOS symptoms include irregular periods, obesity, excess hair growth, and alopecia (female balding). Research in the journal Sleep Medicine determined, however, that PCOS-induced obesity was not the cause of the resulting Sleep Disordered Breathing.

Thirty-three percent of women who are pregnant snore. A study published in Chest magazine reported that Sleep Disordered Breathing during pregnancy might cause growth retardation of the fetus. Also of concern is pre-eclampsia, hypertension during pregnancy, which can be fatal for both baby and mother.

Although previous research was devoted to males, the medical community is realizing that women suffer from Sleep Disordered Breathing in large numbers as well. If a woman you know suspects she might suffer from SDB, suggest she receive medical attention as soon as possible.