July 2007

Women & Sleep Apnea

When a woman complains of daytime sleepiness and snoring, sleep apnea may not immediately come to mind as a possible culprit. But many more women than originally thought suffer from the disorder.

“Women often go undiagnosed for sleep apnea,” says pulmonologist and St. John’s Sleep Disorders Center medical director John Brabson, M.D. “When women with sleep apnea complain of headaches, mood changes and daytime fatigue, they may be prescribed a sleep aid or an antidepressant, which can make the sleep apnea worse. A sleep study is the only way to accurately diagnose sleep apnea or any other suspected sleep disorder.”

Sleep apnea is a serious sleep disorder that occurs when a person’s breathing is interrupted during sleep – sometimes up to hundreds of times a night. The most common type, obstructive sleep apnea, is caused by the blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep.

People with sleep apnea may wake up with a sore or dry throat. They may on occasion wake up with a choking or gasping sensation, or sometimes seem to wake themselves up with their own snoring. They will often feel sleepy during the day due to fragmented sleep, or have morning headaches, forgetfulness or mood changes.

Sleep apnea is the most common sleep disorder, affecting 10 percent of men and 5-6 percent of women. Because the disorder primarily affects middle-aged men and women, symptoms in women are sometimes attributed to menopause, says nurse practitioner Sarah Cates, MSN, RN, BC, FNP, who practices with Dr. Brabson at the center.

Other symptoms of sleep apnea include hypertension and irregular heart rhythms, Cates says.
“Cardiologists refer a lot of patients to us to rule out a sleep disorder as a possible cause for cardiac symptoms,” she says.

CPAP (continuous positive airway pressure) devices or surgery to reduce nose and throat tissue are used to treat sleep apnea. A CPAP device is a small pump that delivers room air (not oxygen) through flexible tubing to a mask, typically fitting over the nose only. A sleep study performed at St. John’s Sleep Disorders Center can determine the exact CPAP pressure (or prescription level) that will keep the patient’s airway open during sleep.

“It is a tremendous benefit to keep your airway open during sleep,” says Terry Yarnell, Sleep Disorders Center director. “Patients who snore and have obstructive events experience repetitive decreases in bloodstream oxygen, thereby creating much more work for their heart during sleep. Sleep researchers from Stanford University have projected that keeping your airway open at night can increase your lifespan by 10 years.”

Yarnell, a CPAP user himself adds, “I can sleep half a night with CPAP and still feel better than a whole night without it. CPAP users obtain deeper restorative sleep once they eliminate snoring and apnea-related arousals. These arousals may not wake you up, but they will keep you in light sleep (stages 1 and 2) throughout most of the night instead of letting you progress into deeper and restorative sleep (stages 3 and 4).”

St. John’s Sleep Disorders Center provides full diagnostic capabilities for different types of insomnia, parasomnias, restless legs syndrome and narcolepsy.

To refer a patient to St. John's Sleep Disorders Center, please call 417-820-5467.