Introduction
Obstructive sleep apnea (OSA) is a prevalent yet underdiagnosed sleep disorder that affects individuals worldwide. Recent research has dispelled the long-held belief that OSA primarily affects males, shedding light on its significant impact on women. OSA is characterised by recurrent partial or complete obstruction of the upper airway during sleep, resulting in pauses in breathing and oxygen deprivation. These episodes, which can last a few seconds to a few minutes, interrupt the natural sleep cycle and prevent individuals from experiencing restful slumber.
Frequent Risk Factors
While males are two to three times more likely to develop OSA, obesity and advancing age are well-known risk factors for OSA. Still, women confront unique physiological and experience risk factors. These include pregnancy-related hormonal alterations, pregnancy, menopause, and the use of oral contraceptives. In addition, anatomical variations in the upper airway structure and variations in adipose distribution may contribute to the development of OSA in women.
Cardiovascular System Health
Research shows women with OSA are at a greater risk of developing cardiovascular diseases than men. The repeated decreases in blood oxygen levels during apnea episodes strain the cardiovascular system, resulting in hypertension, arrhythmias, heart failure, and an increased risk of stroke. Understanding the connection between OSA and cardiovascular health is essential for identifying and managing potential hazards in women.
Effects on Metabolism and Hormones
OSA has also been linked to metabolic disorders and hormonal imbalances in women. The disturbed sleep patterns and prolonged sleep deprivation associated with OSA can negatively affect glucose metabolism, resulting in insulin resistance and an increased risk of type 2 diabetes. Hormonal imbalances, such as elevated cortisol levels and decreased growth hormone levels, may contribute to weight gain and increase the risk of metabolic disorders.
Mental Wellness
The effects of OSA on women’s mental health should not be ignored. There is an association between sleep disturbances induced by OSA and an increased risk of developing depression, anxiety, and mood disorders. Women with OSA may experience impaired concentration, memory issues, and diminished overall cognitive function, which can significantly impact their quality of life and health.
Results for Social Life
In addition to its physical and psychological effects, OSA can significantly impact a woman’s social life. The persistent fatigue and daytime sleepiness induced by OSA can make it difficult for women to engage in social activities, resulting in feelings of isolation and decreased participation in social events. The constant struggle to remain awake and vigilant during social interactions can diminish the pleasure and satisfaction of interacting with friends, family, and coworkers.
Relationships may also be negatively affected by OSA. One of the most prominent symptoms of OSA, snoring, can disturb the slumber of partners, causing resentment and strain on the relationship. Sleep disturbances and irritability can cause communication issues and emotional distance between partners.
OSA may have a harmful impact on the workplace or other professional productivity. The fatigue and cognitive impairment caused by insufficient sleep can result in decreased concentration, decreased productivity, and an increased likelihood of accidents or errors, affecting professional development and prosperity of women and their overall job satisfaction.
Treatment and Diagnosis Are Crucial
Given the potential consequences, early diagnosis and treatment of OSA are crucial for women. Due to the misconception that OSA predominantly affects males, OSA in women is frequently misdiagnosed or underdiagnosed. To facilitate prompt and accurate diagnosis, healthcare providers should know the unique risk factors and symptoms of OSA in women. Treatment options, such as continuous positive airway pressure (CPAP) therapy, lifestyle modifications, and, in some cases, surgery, can substantially improve the quality of sleep and mitigate the associated health risks.
Conclusion
The significant sleep disorder OSA affects both men and women. The impact of OSA on women’s cardiovascular health, metabolic function, and mental health can be particularly challenging. Educating healthcare providers and the general public about the prevalence and consequences of OSA in women is essential for early detection, accurate diagnosis, and appropriate management. Understanding the unique risk factors and symptoms of OSA in women can improve their quality of life and overall health.
References
1) Javaheri S, Barbe F, Campos-Rodriguez F, Dempsey JA, Khayat R, Javaheri S, Malhotra A, Martinez-Garcia MA, Mehra R, Pack AI, Polotsky VY, Redline S, Somers VK. Sleep Apnea: Types, Mechanisms, and Clinical Cardiovascular Consequences. J Am Coll Cardiol. 2017 Feb 21;69(7):841-858. doi: 10.1016/j.jacc.2016.11.069. PMID: 28209226; PMCID: PMC5393905.
2) Konstanty-Kurkiewicz V, Dzięciołowska-Baran E, Szczurowski J, Gawlikowska-Sroka A. Sleep-Disordered Breathing in Pregnancy. Adv Exp Med Biol. 2022;1375:101-109. doi: 10.1007/5584_2021_691. PMID: 34970727.
AuthorS:
Dr. Julius Goh Liang Chye
Clinical Lecturer and Otorhinolaryngologist / ENT Surgeon
Department of Otorhinolaryngology, Head & Neck Surgery
Faculty of Medicine
Universiti Malaya
Associate Prof. Dr. Jeyanthi Kulasegarah
Clinical Associate Professor and Otorhinolaryngologist / ENT Surgeon
Department of Otorhinolaryngology, Head & Neck Surgery
Faculty of Medicine
Universiti Malaya