Older Women and Sleep Apnea Symptoms

There is a summary from Reuters of an article in the September 3rd online paper in the European Respiratory Journal Express. The study authors examined 379 women and 262 men with obstructive sleep apnea (OSA) ages 65 to 70 years old. Specifically, it looked at the different symptoms of OSA in older men versus women.

In this study, more men had severe OSA than women. Men also had a greater body mass index. The women were less likely to report snoring, apnea, or sleepiness, and more likely to be anxious and depressed, and be taking antidepressants and anti-anxiety medications.

This goes along with my clinical experience. Women (not just older women) report less snoring and apneas than men. It could be because they don't snore as much or as loud. Also, their husbands are sometimes less in tune to their wives sleep problems. Since patients rely on bed partners to note snoring or apneas, some women might never realize they are doing that in their sleep. All they know is that they might not sleep well or feel tired or sleepy in the daytime.

Finally, the study authors said older women with OSA were a greater hypertensive (high blood pressure) risk than men, and therefore may have greater cardiovascular mortality and morbidity. This would emphasize the need for early diagnosis to prevent cardiovascular risk. This is true to a point. When a patient reaches a certain age, treating OSA just to prevent cardiovascular disease becomes a "numbers" game. In other words, treating asymptomatic OSA in an 85 year old (male or female) is less likely to prolong life than in a 55 year old, since the 85 year old has already lived longer than the average US lifespan. However, often I suggest treatment in the older patients to improve quality of life, even in those who do not endorse overwhelming symptoms.