April 2, 2024

Women Handle Sleep Apnea Better: Here's Why


Avanthika Nityanand

M.Sc Human Genetics, B.Sc Plant Biology & Plant Biotechnology

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Women Handle Sleep Apnea Better: Here's Why
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What Is Sleep Apnea?

Sleep apnea is a sleep disorder characterized by repeated interruptions of breathing during sleep. These pauses in breathing, known as apneas, can last from a few seconds to minutes and may occur 30 times or more an hour.

After each pause, normal breathing usually resumes, sometimes with a loud snort or choking sound. Sleep apnea is typically a chronic condition that disrupts sleep, resulting in poor sleep quality and excessive daytime sleepiness.

There are two main types of sleep apnea:

  1. Obstructive Sleep Apnea (OSA): The more common form, caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses and closes during sleep.
  2. Central Sleep Apnea: Unlike OSA, the airway is not blocked, but the brain fails to signal the muscles to breathe, due to instability in the respiratory control center.

Sleep apnea can affect anyone at any age, including children, but certain factors increase the risk, such as being overweight, male, older age, having a family history of sleep apnea, smoking, and the use of alcohol or sedatives.

Untreated sleep apnea can lead to a number of health issues, including high blood pressure, stroke, heart failure, diabetes, depression, and headaches. Treatment often includes lifestyle changes, mouthpieces, breathing devices, and surgery.

Are Women Protected Against Sleep Apnea?

Recent research suggests that there may be gender differences in how sleep apnea affects individuals, with some studies indicating that women might have certain protective metabolic factors against the adverse effects of sleep apnea.

These studies have observed that women's bodies may regulate blood lipid levels more effectively in the presence of sleep apnea, potentially offering a metabolic advantage that could protect against some of the condition's harmful cardiovascular impacts.

This difference could partly explain why, statistically, women with sleep apnea may have a lower prevalence of related comorbidities, such as Type II diabetes and cardiovascular disease, compared to men.

The Study

A team at the University of Ottawa, led by Professor Pascal Imbeault of the School of Human Kinetics and a member of the Institut du savoir Montfort, along with Dr. Ruwan Amaratunga, has uncovered that sleep apnea's effects on blood lipid metabolism vary between the sexes, with females managing lipid levels more effectively than males.

This research, involving Nicholas Goulet, Caroline Marcoux, Renée Morin, Jean-François Mauger, and Vincent Bourgon, explored how high-fat meals and periodic low oxygen conditions—a hallmark of sleep apnea—affect triglycerides, blood pressure, and oxygen saturation in both genders.

Imbeault elaborates that they simulated sleep apnea conditions and observed the lipid levels in healthy men and women after consuming fatty foods.

Their discoveries indicate distinct male-female differences in triglyceride levels in response to a high-fat meal when also experiencing low oxygen levels intermittently.

The insights from this study not only shed light on the interaction between gender, intermittent low oxygen levels, and lipid responses post-meal but also could inform future scientific inquiries and health practices within physiological disciplines.

Imbeault points out that this metabolic edge in women may help shield them from sleep apnea's harmful outcomes, possibly accounting for the observed lower rates of related diseases such as Type II diabetes and cardiovascular disease in women compared to men.

The research, conducted between 2018 and 2023, breaks new ground in assessing the role of gender in lipid regulation under simulated sleep apnea conditions.

These revelations emphasize the necessity for gender-specific approaches in ongoing research and clinical care involving blood lipid management.

Link to the study

Can Sleep Apnea Kill You?

While sleep apnea itself is not directly fatal, the complications arising from the condition can increase the risk of life-threatening health issues.

These complications include high blood pressure, stroke, heart disease, diabetes, and daytime fatigue that can lead to accidents.

Specifically, obstructive sleep apnea increases the risk of heart failure and arrhythmias, which can be fatal.

Furthermore, the repeated oxygen deprivation and the stress of frequent awakenings can lead to a cascade of metabolic and cardiovascular disturbances.

It's also associated with a higher risk of sudden cardiac death during sleeping hours.

Therefore, while sleep apnea might not directly cause death, its severe implications can significantly shorten life expectancy and quality if not properly managed.

This highlights the importance of diagnosing and treating sleep apnea to mitigate these risks.

Can Sleep Apnea be Cured?

Sleep apnea, particularly obstructive sleep apnea (OSA), can often be managed effectively with the right treatment, though it might not always be completely "cured" in the traditional sense.

Treatment effectiveness can depend on the severity of the condition and the underlying cause.

In some cases, lifestyle changes such as weight loss, quitting smoking, and altering sleeping positions can significantly reduce symptoms.

Medical treatments include the use of Continuous Positive Airway Pressure (CPAP) machines, dental appliances, and, in some cases, surgery to remove obstructions or modify airway structures.

For some individuals, these interventions can effectively eliminate symptoms. However, ongoing management may be required, especially if the condition is linked to factors like obesity or structural abnormalities.

How Sleep Apnea is Treated?

Treatment for sleep apnea varies based on its cause and severity, as well as the individual's specific health profile.

The most common form, obstructive sleep apnea, is often initially treated with lifestyle changes such as weight loss, avoiding alcohol before bedtime, and sleeping on one's side.

Continuous Positive Airway Pressure (CPAP) therapy is a cornerstone treatment for moderate to severe cases, where a machine is used to deliver air pressure through a mask to keep the airway open during sleep.

Other treatments include the use of oral appliances designed to keep the throat open.

Surgical options may be considered for those who don't respond to other treatments, focusing on removing or reducing the tissue that blocks the airway.

Less commonly, for central sleep apnea, which involves the brain's control over breathing, treatments may focus on managing the underlying conditions or using adaptive servo-ventilation devices.

Each treatment plan is tailored to the individual's needs, aiming to restore regular breathing during sleep and alleviate symptoms.

In Sleep Apnea, What is AHI?

AHI stands for Apnea-Hypopnea Index, which is a measure used to determine the severity of sleep apnea.

It calculates the number of apneas (complete stoppages of breathing) and hypopneas (partial reductions in breathing) per hour of sleep.

The AHI is crucial in diagnosing sleep apnea and assessing its severity: an AHI of 5-15 events per hour is considered mild, 15-30 is moderate, and over 30 events per hour are classified as severe sleep apnea.

This index helps healthcare providers decide on the best treatment plan.

By quantifying the disruptions in breathing, the AHI provides a clear indicator of how significantly a person's sleep is being affected by breathing disturbances, guiding the approach to management and treatment.

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