Obstructive Sleep Apnea occurs when muscles of the soft palate and throat relax during sleep, obstructing the airway and making breathing difficult and noisy (snoring). Eventually, the airway walls collapse, blocking airflow entirely, which results in a breathing pause or apnea.
Women are at an increased risk for Obstructive Sleep Apnea:
- If their BMI is high and/or they have central adiposity
- During pregnancy, especially third trimester
- During and after menopause
Pregnancy and Sleep
- Total sleep time lengthens
- Fragmentation increases
- Excessive daytime sleepiness/insomnia can develop
- Snoring increases by 15-20%
- Sleep in the mother is lower 3 months following birth
- Higher estrogen narrows the upper airway, increasing the risk for OSA
- 50-80% of menopausal women report sleep issues.
- Menopausal women have 3.4 times more odds of sleep disorders.
- Combination HRT has been shown to improve sleep quality and be somewhat helpful for OSA.
- Women’s risk for OSA increases at menopause.
Polycystic Ovarian Syndrom (PCOS) and Sleep
- >90% of PCOS patients have sleep complaints
- 9 times more risk of excessive daytime sleepiness
- Woman with PCOS show increased OSA (30 times more likely than controls)
- Low estrogen generally worsened sleep issues in PCOS patients
- ~70% of women with PCOS have OSA
- Unclear if it is caused by higher testosterone, lower progesterone, or insulin resistance
Helping your patients sleep better
- Add questions about sleep quality to your discussions with patients.
- Listen for descriptions of fatigue, exhaustion, lack of energy, and depression.
- Use the STOP-Bang OSA screener in overweight, menopausal, and PCOS patients.
- Contact CSCC for a recommendation about a sleep or insomnia specialist in your area.