This article was refreshed in December 2021 to reflect recent research and information.
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Quality sleep is important for a woman’s overall health and wellness.
A Providence sleep doctor explains sleep apnea – a condition that affects about 10 percent of women.
Sleep apnea blocks the flow of air while you sleep. It can pose health risks, but there are several treatments available, including a CPAP machine.
When was the last time you got a good night’s sleep? Did you wake up feeling well-rested? Were you asleep for more than seven hours? Sadly, sleep often takes a back seat to other tasks on never-ending to-do lists. But getting enough quality sleep is important for overall health and wellness. And a lot of women don’t get enough of it.
A Centers for Disease Control and Prevention (CDC) survey found that about half of nonpregnant women ages 40-59 didn’t wake up feeling well-rested 4 days or more in the past week. More than 1 in 3 out of the same group slept less than 7 hours on average in a 24-hour period.
There are many factors – such as menopause and other hormonal changes – that can affect how well you sleep. One factor that you may not have considered is sleep apnea. It is a common problem that affects about 10 percent of women. Sleep apnea can disturb your sleep and affect your health. But the good news is that it’s often treatable, says Richard D. Simon, MD, the medical director of the Kathryn Severyns Dement Sleep Disorders Center in Walla Walla, Washington. Here’s what you need to know about sleep apnea.
What is sleep apnea?
Sleep apnea is a sleep disorder that causes breathing to start and stop throughout sleep. It happens during sleep because of how the muscles relax and paralyze. “In many cases, the cortex, the thinking part of the brain, looks much more active during dream sleep than when you’re wide awake,” says Dr. Simon. “Then the question comes up, why don’t you act out your dreams every night? And that’s because just before you go into dream sleep another part of the brain paralyzes the skeletal muscles.”
Among those muscles are the tongue and the back of the throat. “For most of us, that isn’t a problem,” explains Dr. Simon. “But for people with sleep apnea, their throats are configured in such a way that when the back of the throat collapses, the back of the tongue in particular can fall over the breathing tube, partially or completely blocking the flow of air. They can actually start to suffocate.” This is called obstructive sleep apnea, which is the most common type.
What are the effects of sleep apnea?
One of the most obvious consequences of sleep apnea is snoring and being more tired. “The brain has to wake itself up, sometimes hundreds of times a night, to keep you breathing, so you get a very fragmented sleep — you get daytime fatigue and sleepiness,” says Dr. Simon.
Sleep apnea can take a toll in other areas, too, such as heart health. “Mild apnea is associated with a slightly increased risk of high blood pressure,” notes Dr. Simon. “But if you look at the studies of patients who have had heart attacks and strokes — the really bad cardio stuff — typically the sleep apnea has to be more severe, which means you stop breathing during a sleep study more than 30 times an hour. If you stop breathing 20 times an hour, we consider that mild to moderate.”
Because apnea can cause sleep deprivation, it also can lead to a higher risk of health issues associated with lack of sleep, such as loss of focus, poor brain function, weight gain and premature aging.
How do I know I have sleep apnea?
A doctor doesn’t have to study you in a sleep lab to make a sleep apnea diagnosis. “Quite frequently it can be diagnosed with a simple home study,” says Dr. Simon. “The diagnosis of apnea is not like it was five or 10 years ago, where you had to come in and get hooked up to all these different wires. We still do lab studies on complicated patients, but for the simple patient who’s young and snores, we typically do a home study and treat them.”
What is used for sleep apnea treatment?
Typically, treatment for obstructive sleep apnea involves keeping the throat open at night, since it tends to collapse when it’s relaxed. “So what we usually use is what we call a CPAP machine, which stands for continuous positive airway pressure,” explains Dr. Simon.
“It’s a mask that fits into your nose or over your nose and mouth. It has a hose that’s hooked to a small machine that’s plugged into the wall, and all this machine does is quietly and gently blow heated, humidified air through the nose and into the throat. This provides a mechanical air splint to the back of the throat. So when the throat relaxes at night, the air pressure helps it stay open.”
The benefits of using a CPAP machine
While the CPAP can be difficult for people who tend to feel claustrophobic or are unused to wearing something on their face, it is incredibly effective, says Dr. Simon. “It can cure apnea in over 90 percent of patients as long as they wear it. It’s like putting a pair of glasses on — you put your glasses on, you see; you put your CPAP on, and you don’t have apnea.”
The CPAP is also inexpensive, as insurance companies cover it, and it’s easy to use, says Dr. Simon. “Generally, I can see a patient today, do a home study tonight and have them on a CPAP tomorrow.”
Mouth guards for sleep apnea
For people with mild apnea who don’t like the CPAP, there’s a second line of therapy. These are oral devices that look like football mouth guards. Fitted to your teeth, the device pushes the lower jaw forward a few millimeters, giving the back of the throat more room to collapse when it relaxes. “It doesn’t work as well as CPAP, but for mild apnea patients it can be dramatically effective,” says Dr. Simon.
There is also weight loss or positional sleep therapy. “If you lose weight, your neck gets thinner and tends to open up,” says Dr. Simon. “For other people, their apnea is only present when they sleep on their back because the tongue falls straight back.”
Surgical options for sleep apnea
If those steps don’t work, it may be time to look at surgical options. “There are some simple surgeries such as somnoplasty where we reduce the size of tissues in the mouth and nose,” says Dr. Simon. There are also options for jaw surgery. In very severe cases, a tracheostomy can work, where a hole is cut in the neck for easy breathing, but that is usually a temporary measure.
“An interesting treatment that’s been promoted over the last couple of years is a 12th cranial nerve stimulator,” says Dr. Simon. “We basically put a pacemaker-type device in and run a wire up the neck and attach it to the nerve that goes to the tongue. You turn it on at night with a magnet, and it stimulates that nerve, so the tongue doesn’t relax when you fall asleep. That is showing some promise.”
Prioritizing sleep is important for women’s health
No matter the cause, getting enough sleep is important. Women can be especially prone to sleep problems during hormonal changes including menopause. Not getting enough sleep is linked to risks for conditions such as heart disease and diabetes.
So, when it comes to sleep, do what you can to prioritize full, complete rest. If you think you may have a sleep condition like sleep apnea, talk to your doctor. There are options to get you the sleep you need.
Find a doctor
You can learn more about sleep apnea or another sleep condition by reaching out to your doctor. If you need to find a doctor, you can use our provider directory. Through Providence Express Care Virtual, you can access a full range of healthcare services.
This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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