A claim you hear on longevity podcasts

Do women with sleep apnea have different symptoms than men?

Leaning for. Of 10 studies that test it, 7 partly agree and 3 agree.

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The claim checked: Women with sleep apnea show fatigue, headaches and insomnia rather than the classic signs Hear it at 3:52

What do the studies say?

Leaning for

Studies find a difference, but not as clean as said. Three of ten agree: women reported more fatigue, morning headaches or insomnia, and men more loud snoring and witnessed pauses. Seven partly agree. In 663 adults, women reported more morning headache and men more snoring and choking, with the same number of symptoms overall. In 303 adults, snoring and sleepiness were similar in men and women. An Australian study found women with a diagnosis were more likely to have the classic signs, loud snoring included, as well as insomnia.

Computed from 10 studies that test this point, each judged by two readers, in full. 10 more studies are waiting for a full read and do not count yet.

What was said on the podcast?

“Now these are all clues worth paying attention to, and women are especially important here too because women present with symptoms like fatigue, headaches, and insomnia rather than the stereotypical presentation people associate with sleep apnea.”
Mark Hyman, The Doctor's Farmacy · Sleep Apnea: Why CPAP Isn't Fixing the Real Problem (This Does!) · 3:52 on YouTube
Episode check Treating sleep apnea can bring weight loss without trying, the episode says. Nine of ten studies disagree. 6 claims checked against 68 studies · 5 chapters not checked yet See the whole episode →
The point checked Leaning for

Women with obstructive sleep apnea present with fatigue, headaches and insomnia rather than the typical symptoms seen in men, such as loud snoring

Agree 3

other primary study · 2020

“Females more frequently reported symptoms such as fatigue and headaches in the morning, nocturnal awakenings, nocturia, nightmares, memory loss, and attention problems.”

Gender Differences in Obstructive Sleep Apnea: The Value of Sleep Questionnaires with a Separate Analysis of Cardiovascular Patients. J Clin Med
Who: Adults referred to a Greek sleep clinic with symptoms suggesting OSA, 2016-2018, men and women matched for OSA severity; women older with higher BMI
PMID 31947711

trial or observed group · 2019

“En nuestro estudio, la historia clásica de ronquido intenso habitual y apneas presenciadas por testigos fue más prevalente en varones, mientras que los síntomas inespecíficos de ansiedad, depresión, insomnio, cefalea matinal, somnolencia diurna y pobre calidad del sueño fueron reportados con mayor frecuencia por las mujeres3,31.”

[Gender differences in clinical features and performance of sleep questionnaires in adults with obstructive sleep apnea syndrome]. Rev Med Chil
Who: 1,464 adults at a Chilean sleep clinic, 509 women; 509 women also paired with 509 men by age and apnea-hypopnea index
PMID 32186637

other primary study · 2024

“Our study shows that females present with different symptoms; headache, depression, nocturia, and fatigability were found more frequently than males.”

Sex-specific differences in presenting symptoms of obstructive sleep apnea. Lung India
Who: 514 Indian adults diagnosed with OSA (AHI >=5) at a referral sleep lab in central India (367 men, 147 women; women mean age 55.97, men 50.2)
PMID 38700405

Partly agree 7

other primary study · 2021

“Our study showed that daytime sleepiness and snoring symptoms were similar between male and female patients with OSAS, and males showed more witnessed apneas.”

Gender differences of clinical and polysomnographic findings with obstructive sleep apnea syndrome. Sci Rep
Who: 303 Chinese adults with polysomnography-diagnosed OSAS at one sleep center, 237 men and 66 women
PMID 33723369

other primary study · 2020

“Although the number of symptoms presented was similar in men and women, their nature differed, with snoring and nocturnal choking being more frequent in men, and morning headache and leg discomfort more often reported by women.”

Epidemiological characteristics of obstructive sleep apnea in a hospital-based historical cohort in Lebanon. PLoS One
Who: 663 adults (506 men, 157 women, mean age 60.8) referred to a Beirut sleep laboratory for suspected sleep-disordered breathing; 526 had OSA
PMID 32413035

other primary study · 2019

“Insomnia and anxiety were significantly higher among females.”

Diagnosis of obstructive sleep apnea in women: Is there any difference?- Experience from a tertiary care hospital of North India. J Family Med Prim Care
Who: 150 adults referred to a tertiary-care sleep clinic in North India for suspected OSA (94 men, 56 women; mean age 51.85), all given a full-night sleep study; 19 had AHI <5
PMID 31742155

other primary study · 2018

“For example, the positive relationship of OSA with waist circumference (p-heterogeneity 0.0009) and witnessed apnoea (p-heterogeneity <0.0001) were stronger in males, whereas the positive associations with physical inactivity (p-heterogeneity 0.005) and daytime sleepiness (p-heterogeneity <0.0001) were stronger in females.”

Sex differences in the associations of obstructive sleep apnoea with epidemiological factors. Eur Respir J
Who: US health professionals: 143,326 female nurses aged 48-93 (NHS, NHS-II) and 22,896 male health professionals aged 65-101 (HPFS), with self-reported OSA diagnosis
PMID 29449424

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other primary study · 2018

“Women who report being diagnosed with OSA are more likely than diagnosed men to have the classical clinical features of the syndrome (obesity, loud snoring, daytime sleepiness) as well as have independent associations with insomnia, respiratory disease, high cholesterol, and poor overall health.”

Influence of Gender on Associations of Obstructive Sleep Apnea Symptoms with Chronic Conditions and Quality of Life. Int J Environ Res Public Health
Who: Community-dwelling Australian adults aged 30 to 100 years in the North West Adelaide Health Study 2015 postal follow-up; 95 men and 27 women with self-reported diagnosed OSA
PMID 29735909

other primary study · 2021

“Among individuals with mild OSA, women were more likely than men to report symptoms related to disturbed sleep while men were more likely than women to present with symptoms of moderate daytime sleepiness.”

Sex differences within symptom subtypes of mild obstructive sleep apnea. Sleep Med
Who: Community-based Sleep Heart Health Study adults aged 39-90 with mild OSA (AHI 5-14.9): 921 men and 797 women, mean age 64.9, primarily white and overweight
PMID 34182353

other primary study · 2016

“Females indeed were more likely to report depression, insomnia, and use of sleep medication; however, these factors were not associated with HSAT outcomes.”

Sex differences in sleep apnea predictors and outcomes from home sleep apnea testing. Nat Sci Sleep
Who: 272,705 adult patients deemed at risk for sleep apnea who completed home sleep apnea testing (ARES) from 2009 to 2013, 57% male; not a random sample
PMID 27418861

Disagree 0· none of the studies we read

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