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The sound of silence: women keep quiet about snoring, sleep apnea

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  • Snoring
  • Sleep apnea

Sleep Education Archive  |  Aug 13, 2007
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It’s easy for women to talk to co-workers or friends about a poor night of sleep when they can place the blame on the relentless, ear-splitting sounds coming from the man who lies next to them.

But when the roles are reversed, and the snorer is sleeping on their own side of the bed, fewer women are as open and candid about their problem.

“It seems to be much more of a stigma for women to snore, whereas it’s accepted and almost expected among men,” said Dr. Nancy Collop, medical director of the Johns Hopkins Hospital Sleep Disorders Center in Baltimore. “Perhaps they find it more embarrassing than men.”

Women might be less embarrassed if they realized how common it is to snore. According to the American Academy of Sleep Medicine (AASM), occasional snoring is almost universal. Snoring is even more common as women age, and it may increase during pregnancy. About 24 percent of adult women are habitual snorers.

By itself a mild case of snoring may be only a nuisance. It can disturb the bed partner’s sleep more than it presents any serious health risks. The greater problem, however, is that many women who snore have a related sleep disorder that can have a severe effect on their overall health and well-being.

The problem behind the snoring

Loud and frequent snoring is one symptom of a common sleep disorder known as obstructive sleep apnea. It occurs when the muscles relax during sleep. This causes soft tissue in the back of the throat to collapse and block the upper airway.

As a result, breathing stops a few times each hour or even hundreds of times per night. The pauses in breathing can cause both drastic changes in your oxygen levels and frequent arousals that fragment your sleep.

This puts an enormous strain on your heart and can lead to an increase in your heart rate. Recent research shows links between sleep apnea and a host of other disorders and diseases. These include congestive heart failure, high blood pressure, stroke and diabetes.

According to the AASM, sleep apnea affects about four percent of men and two percent of women. About 80 to 90 percent of adults with sleep apnea are undiagnosed.

Overlooking the problem

Dr. Collop says that when it comes to sleep apnea and women, the medical community may be overlooking the problem.

“The studies show that the number of men who are evaluated in a sleep clinic, compared to women, are eight or nine to one,” she said. “But the prevalence in the general population is only two or three to one. Clearly, men are referred more than women for evaluation in regard to sleep apnea.”

She cites numerous reasons for this disparity. Among them is the snoring stigma that can keep many women from seeking medical help. There also is the fact that men seem to sleep more deeply than women. They are less likely to notice when their bed partner snores or stops breathing during the night.

As a result, women may be unaware of the severity of their breathing problems during sleep. So when they have health complaints they may not even mention their sleep to a doctor. Both women and their doctors are likely to point the finger at other problems instead of placing the blame on sleep apnea.

“Either they have different symptoms or they get blown off as being depressed,” Collop said. “In general, I would say that women tend to have more complaints of chronic fatigue or tiredness and insomnia.”

Treating the problem

The gold standard of sleep apnea treatments is “continuous positive airway pressure.” CPAP provides a steady stream of pressurized air through a mask that is worn during sleep. This airflow keeps the airway open, preventing pauses in breathing and restoring normal oxygen levels.

Although sleep apnea patients are often desperate for a good night of sleep, having to wear a CPAP mask all night can test even the strongest resolve. Many women have a negative response when they see the mask for the first time.

But CPAP manufacturers are starting to pay more attention to women’s needs and preferences. They are making masks that are less obtrusive and that come in petite sizes. Instead of a mask, one popular system uses “nasal pillows.” These are soft silicone tubes that fit directly in the nostrils. This system covers up less of the face and allows for more freedom in the choice of sleeping positions.

Studies show that using CPAP for an extended period of time produces many health benefits. It can reduce your risk of heart problems such as heart failure, high blood pressure and stroke. By improving your sleep it also can lead to a better quality of life.

“The majority of people, well over 50 percent, I’d say closer to 70 to 80 percent, will get an improvement in their sense of well-being, such as their level of energy,” said Collop.

Help for sleep apnea is available at more than 1,200 accredited sleep disorders centers across the country. According to Collop, this gives women who snore something to talk about. They shouldn’t keep quiet about their snoring and the health problems that may result from it.

“If they are snorers, they would want to consider investigating that further by talking to their physician about it,” she said. “Sleep apnea could be the cause for their complaints.”

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