Tag Archive for: Women and sleep

We know what sleep apnea looks like, right?

Middle-aged man, kind of stocky, looks tired and snores like a freight train? The truth is, that’s a common profile for Obstructive Sleep Apnea (OSA), but it’s far from the only one. OSA results from physical conditions that can affect people of any age, size or gender.

It often goes undiagnosed in women

Symptoms that point to OSA can be less pronounced in women than men, but studies suggest the consequences are just as damaging for women, if not worse. And it may be more common in women than we think; by some estimates, men are twice as likely to have sleep apnea, but are diagnosed with it 8 times more often. It’s been suggested that happens because women’s symptoms present differently from the typical male profile and therefore get missed.

Tired woman driving car

How does OSA work differently in women?

There are a number of factors that contribute to Obstructive Sleep Apnea in both men and women, but at the basic level what happens is the soft tissues at the back of the throat relax during sleep, sinking down and blocking the upper airway. This causes an interruption in breathing, which makes the brain alert the body to wake up slightly and re-open the airway. These micro-interruptions in sleep are rarely even noticed by the OSA sufferer, but they can happen many times an hour – meaning people not only lose sleep, but they’re often prevented from entering into deeper sleep phases, which makes for a groggy morning.

While a lot of men with OSA are loud snorers, and frequently report daytime sleepiness to the point of losing focus, women are less likely to report such symptoms. For whatever reason, women are less likely to report the feeling of “tiredness” unless the problem reaches extremes, at which point they are more likely to use words like “fatigued” or “exhausted.” In a woman who doesn’t fit the typical profile for OSA (overweight, male, loud snoring, etc.) a symptom like fatigue will often lead doctors to investigate thyroid issues or depression, and miss the possibility of sleep apnea.

Woman sleeping with mouth open

How does OSA in women get missed so often?

Doctors, like the rest of us, can fall victim to preconceived notions about what the condition looks like.

While a sleep study will often be ordered for a man who fits the profile and complains of related symptoms, those same symptoms may be overlooked or thought of as part of a different issue for a woman.

Male doctor with stethoscope

Some examples include

  • Snoring – women will often report lighter snoring, or none at all (because who wants to admit that?). On top of that, male partners are typically less likely to notice snoring. An almost comically frequent refrain from men who turn up for sleep studies is, “I’m here because my wife says I snore too much” – the same is more rarely true in the reverse.
  • Symptom overlap – symptoms that women do mention to their doctors are also associated with other conditions. Things like headache, fatigue, lack of energy or moodiness are often chalked up to menopause, depression, insomnia or other issues.
  • Low but present apnea events – women tend to have a lower apnea-hypopnea index (AHI) than men. That’s a measure of the number of breathing interruptions per hour, which means they (or their partners) are less likely to notice them.

snoring woman sleeping on her back

Getting missed doesn’t mean it doesn’t matter

Evidence shows that while OSA symptoms are typically less pronounced in women, the negative health effects are just as bad if not worse.

A 2013 UCLA study showed that normal autonomic responses to control things like blood pressure, heart rate and sweating are reduced in people with OSA, but the reduction is even more pronounced in women. They conducted a number of tests on men and women with OSA and their findings were concerning.

“The heart-rate results for these tests show that the impact of sleep apnea, while bad in men, is more severe in women,” said lead researcher Paul Macey. “This may mean that women are more likely to develop symptoms of heart disease, as well as other consequences of poor adaptation to daily physical tasks. Early detection and treatment may be needed to protect against damage to the brain and other organs.”

heart health woman

What to watch out for

Because it so often gets missed, it’s important to pay attention to symptoms that could mean you have OSA, in order to prevent further health complications down the road. Things you may notice that could point to sleep apnea include:

  • Your breathing stops and restarts while you sleep (noticed by a partner, perhaps)
  • You wake up a lot during the night (to use the washroom for example – under normal conditions you shouldn’t need to get up much at night)
  • You get a full night’s sleep but you feel tired anyway
  • You snore (even a little – no judgement!)
  • You have low energy or daytime fatigue
  • You’ve been told you have high blood pressure, or you have fibromyalgia
  • You get frequent morning headaches

OSA can be debilitating, and also comes with risks of more dangerous complications for overall health, but it can be effectively treated with CPAP. If you suspect you may have OSA, don’t hesitate to consult with us for more information.

tired woman rubbing temples

Risk factors for women

Even if you don’t have OSA or suffer from OSA symptoms now, there are certain factors that could put you more at risk of developing sleep apnea; if you have any of these, it’s a good idea to pay extra attention and act immediately if you notice symptoms appearing. There are also factors that can aggravate the negative health consequences of OSA.

Things to keep an eye on include:

  • Reaching a certain age – women aged 55-70 are 14% more likely to have OSA
  • Becoming pregnant – pregnancy can increase your chances of developing OSA, and if left untreated it can cause complications
  • Carrying extra weight – obese women in the 50-70 age range are 31% more likely to have OSA
  • Menopause can bring on sleep apnea
  • The chances of developing OSA for women with polycystic ovarian syndrome are up to 70%
  • A family history of sleep apnea increases the likelihood you’ll have it too
  • Chronic congestion, for any reason, can be linked to OSA
  • High blood pressure, diabetes and asthma all have strong associations with OSA

If you have concerns about any signs of Obstructive Sleep Apnea, book an appointment and get assessed:

tired woman eating pizza on couch

Obstructive sleep apnea (OSA) is one of the most common of the sleep disorders.

About 40% of Canadians will experience a sleep disorder during their lifetime.

Did you know that one in four Canadians is at high risk for having obstructive sleep apnea and most of those at risk are not screened for OSA? With an estimated 80% of cases going undiagnosed, many people are unaware that a sleep disorder is the underlying cause of their health problems.

So, what is apnea?

Sleep apnea is characterized by frequent breaks or pauses in breathing during sleep.

There are 3 forms of sleep apnea:

  1. Central sleep apnea (CSA) in which the pauses are due to the brain failing to signal the respiratory system to breathe;
  2. Obstructive sleep apnea (OSA) in which breathing is interrupted by a physical blockage in the upper airways, often caused by soft tissues of the throat and tongue collapsing into the airway
  3. And complex/mixed sleep apnea which is a combination of central sleep apnea and obstructive sleep apnea.

Warning Sign #1: Snoring

Loud, chronic snoring is one of the most frequently cited symptoms of sleep apnea. Snoring is the sound produced by vibrations in the upper respiratory airways during sleep. It is caused by partial blockage or obstructions as air is being restricted from moving easily through the airways.

Many people who snore may not even be aware that they do so and are only alerted to it by an annoyed bedpartner whose sleep is disturbed due to the loud noises coming from the other side of the bed. While snoring is a common symptom of sleep apnea, it doesn’t necessarily indicate that the person has the disorder. Many people who snore don’t have sleep apnea, and some people with sleep apnea don’t snore.

However, if your snoring is loud, disruptive, and occurs on a nightly basis, it could very well be a sign of sleep apnea.

At Apnea Health, we can help you. Sleep apnea is easily diagnosed with a home sleep test.

Snoring man in bed with his angry partner

Warning Sign #2: Frequent breaks or pauses in breathing

In obstructive sleep apnea, the fatty tissues of the throat or tongue become relaxed during sleep and fall back into your airways which restricts airflow and causes you to stop breathing for a few seconds. During an apnea event, the oxygen levels in your blood drop. This causes your brain to wake itself from sleep long enough jump start your respiratory system into working properly again and get air past the blockage.

While your brain partially wakes up to respond to the interruption in breathing, you still remain mostly asleep without realizing that you partially awoke. But while you may not realize that you frequently wake during sleep, the constant interruptions have a negative impact on the amount and quality of sleep you get which lead to many of the other symptoms on this list.

Apnea events can occur anywhere between 5 to 30 times in an hour lasting up to 10-20 seconds at a time. Those with severe obstructive sleep apnea can experience hundreds of apnea events a night. If you’ve been told that you frequently stop breathing in your sleep, it’s time to talk with your doctor or schedule an appointment with a sleep specialist.

man lying awake in bed

Warning Sign #3: You’re Tired all the Time

While you may think you got plenty of sleep during the night because you were in bed for 7-9 hours overnight, all of those pauses and interruptions to your sleep add up to a lot of lost time in quality and quantity of nightly sleep. One of the most common (but frequently overlooked) symptoms of sleep apnea is excessive daytime sleepiness (EDS). EDS is characterized by a chronic feeling of overwhelming daytime fatigue.

Common symptoms of EDS are: difficulty waking in the mornings, feeling excessively tired all day long, a general lack of energy, needing or taking frequent naps that only partially (or not at all) relieve symptoms, dozing off at inappropriate times, and difficulty concentrating among others.

Daytime drowsiness can even lead to serious accidents or even death especially if the sufferer is driving or working on or around heavy equipment or machines.

A woman yawning

Warning Sign #4: You frequently wake with headaches

Headaches are commonly reported by sufferers of sleep apnea. As you stop breathing frequently during the night, less oxygen is making its way to your brain. Low oxygen levels initiate the widening of blood vessels and can cause vascular headaches. Along with excessive daytime drowsiness, headaches are usually the symptoms that sleep apnea sufferers complain the most about as they may not be aware that they have symptoms of snoring or breaks in breathing.

Tired man lies in bed with insomnia, with alarm clock in foreground

Warning Sign #5: You Have High Blood Pressure

Hypertension is commonly linked to sleep apnea. For the same reasons you experience headaches due to frequent pauses during sleep, you can get high blood pressure. As your brain wakes from sleep as it realizes that its not receiving adequate oxygen levels in the blood it causes a spike in blood pressure as it restricts your blood vessels to kick starts your system into working again. When this happens repeatedly throughout the night to combat every apnea event, your body gets used to having to restrict its blood vessels and high blood pressure begins to persist even during the day when you are breathing normally.

Doctor using a blood pressure device on a patient

Warning Sign #6: You are overweight or obese

In many cases a person’s body weight is directly linked to having obstructive sleep apnea. People who are overweight or obese are more likely to have sleep apnea than those that maintain healthy weights. Sleep apnea can often be caused by excess fatty tissues that become built up in the neck and throat. The excess tissues can fall back into the airways during sleep causing obstructions to the airways and leading to apnea events. If your neck circumference is greater than 17 inches for men or 16 inches for women you have a higher risk of sleep apnea due to fatty tissue buildup surrounding your airways which can cause restrictions in breathing during sleep.

Woman looks at her weight while standing on a scale

Warning Sign #7: You are often irritable, depressed, or experience mood swings.

Lack of quality sleep can affect a person’s mood. Losing sleep nearly every night can make you more irritable, prone to anxiety, short-tempered, and over a long enough time even depressed. If you think your mood swings or depression may be caused by a lack of sleep contact your primary care physician to see if it’s related to a sleep disorder.

irritable man with frustrated wife

At Apnea Health We Can Help You

At Apnea Health, we diagnose and treat thousands of cases of sleep apnea every year.

Because treatment for sleep apnea through continuous positive airway pressure (CPAP) therapy or other alternative treatments is so effective, there’s no reason to have to live with apnea or any of its debilitating symptoms.

If you have experienced any of the previous symptoms it may be time to contact a sleep specialist to schedule a sleep study. Left untreated, sleep apnea can cause a whole slew of medical problems and can put you at an increased risk for many health issues including:

  • Heart failure
  • Arrhythmias
  • Gastroesophageal reflux disease
  • Diabetes
  • Stroke
  • Heart attacks

home sleep test

Have you ever thought about how snoring affects your relationship with your partner?

A prime symptom of OSA is snoring, plus frequent periods of gasping for air or tossing and turning. All that racket robs your partner of sleep, often leading to a shorter fuse the next day and heaps of resentment as well. “Heaps of resentment” – not a phrase you think of when picturing marital bliss.

Can we talk about sleeping together?

Patients commonly seek out first time help for their sleep apnea when a partner threatens to (or actually does) kick them out of bed. It’s incredibly common. A U.S. poll of a thousand adults by the National Sleep Foundation found that 31% of those who live with a partner will resort to earplugs or even separate bedrooms for relief from disruptive snoring. That’s almost a third of us.

woman with noise cancelling earphones

Maybe it’s time to pick up a marital aid…

Not that kind of marital aid! We’re not here to tell you how to handle intimacy, but the fact is the divorce rate for couples where one or both suffer from sleep apnea is frighteningly high. If loud snoring is driving a wedge between you and your partner, therapy with a Continuous Positive Airway Pressure (CPAP) machine may offer the aid you need. It’s the most proven and most prescribed treatment for sleep apnea, and your partner will thank you for making the leap.

Airsense, Dreamstation and Sleepstyle CPAP machines

Save your marriage with CPAP

The sneaky thing with OSA is that many who have it have no idea what’s going on. They feel tired, sure, and over time the effects pile up. But the little stoppages in breathing that cause them to lose sleep are usually not enough to fully wake them up, so they spend a whole night in bed, snoring away, and wondering why they’re so tired the next day. Their spouses, on the other hand, know exactly what’s making them tired – getting woken half the night by all that snoring! Study after study has been done on the subject. Researchers at The Sleep Disorders Center at Rush University Medical Center found clinical evidence that sleep deprivation in partners of people with sleep apnea put a strain on marriages – in one case study a woman was woken up over eight times an hour by her husband’s snoring. Okay, maybe it doesn’t take a research scientist to figure out how that could drive people apart… What’s encouraging from the study though, is that when the snoring partner started CPAP treatment, their spouse’s quality of life shot up remarkably. They reported reductions in daytime sleepiness, and great gains in nighttime sleep efficiency and marital satisfaction.

people affectionate e1607981386462

Want to get back in your bed?

If you’re thinking it’s time to get serious about snoring – if you’re looking to get back in your own bed or address the problem before you find you’re no longer welcome there – Apnée Santé is here to help.

arms hugging

And where does the solution start? In bed!

To find out if CPAP treatment is right for you, you can do a home sleep test in the comfort of your own, well, wherever you’re sleeping. Reach out to any of our clinics and we’ll give you an initial consultation within 48 hours, then set you up with a simple, easy-to-use home sleep test to confirm if you have sleep apnea. If you do, we’ll enlist the help of a compact, whisper-quiet CPAP machine to stop your snoring, improve your sleep and get you on the path to brighter days and a happier marriage. From personal experience, since the snoring stops immediately with CPAP, your spouse might start to feel the benefits of your treatment even before you do! What’s more, once you’re set up, our care for life program means we’ll stick with you, give you tips to make the most of your CPAP therapy, and be there if you have questions or need help with your equipment.

Man in bed adjusting the home sleep test monitor around his chest

Fallen off the sleep wagon?

Have you tried CPAP therapy but fallen off the wagon? Not to worry! If you had success with CPAP in the past but later found it wasn’t really working for you, it probably isn’t your fault. Patients’ needs can change over time, and equipment wears out and becomes less effective. Since these things happen gradually, you aren’t likely to notice the subtle changes night by night until eventually you just feel like CPAP isn’t really doing the trick anymore. Ill-fitting or poorly functioning equipment can actually make your sleep worse, so without checking in with the experts from time to time, it’s easy to feel like your therapy used to work but now somehow just doesn’t, and decide to pack it in. But that doesn’t mean your sleep apnea has packed it in too.

Man looking at a ESON 2 mask

If the snoring is back, and the exhaustion is back, it’s time to get yourself back on track.

Whether your equipment originally came from us or you got it somewhere else a long time ago, our respiratory therapists will be happy to consult with you and help get your therapy working again. If your shoulders are getting sore from all the “Roll over and be quiet!” shoving at night, or you’ve dropped off your CPAP and are feeling the old tired feelings coming back, we can help.

Apnée Santé Team

Related links:

Tossing and turning in her bed for the third time that week, Sylvie sat up and glanced at her alarm clock in frustration.

3:37 AM, it read – which meant she had been awake for more than two hours. Again.

Although she’d gone to bed at a decent hour and fallen asleep right away, here she was wide awake, knowing that in a few short hours she’d have to get up, make her way to work, and somehow find the energy to get through that big presentation to the new client that her boss was counting on her to bring in.

Sylvie flopped down on the bed. She was so tired – so why couldn’t she fall asleep?

Sylvie’s experience is not uncommon.

Here in Canada, insomnia is on the rise.  A new study conducted by Dr. Charles M. Morin at Université Laval revealed that 40% of Canadians had experienced one or more symptoms of insomnia at least three times a week in the preceding month and only 13% said they had consulted their doctor about it.

“Many people who suffer from insomnia try to treat the problem themselves rather than consulting a healthcare professional,” said Dr. Morin. His survey revealed that Canadians use prescription medicine (10%), natural products (9%), over-the-counter drugs (7%), or alcohol (5%) to treat their sleep problems. “This is not a good idea because we don’t know the risks and benefits of products that have not been approved by government health agencies,” he explained.

pie chart showing a tired man in 40% and a sleeping one in the remaining 60%

What is Insomnia?

Insomnia is a sleep disorder whereby you can’t fall asleep, even though you want to, or you can’t stay asleep long enough. It is generally defined as taking more than 15 minutes to fall asleep, being awake and unable to fall back asleep from periods of 30 minutes or more during the night, and/or sleeping less than five hours per night. Acute insomnia can afflict you for just a few days, or it can become a chronic condition, depriving you of rest for months or even years.

It can also make a person exhausted, moody, irritable, accident-prone, anxious, and less able to think straight or remember things. Over the long term, insomnia is also linked to conditions like obesity, high blood pressure, diabetes, and heart disease.

woman staring at her alarm clock in the middle of the night

Insomnia Rates in Canada

Insomnia affects all segments of the population, including children and the elderly. According to a recent survey1, half of Canadian adults have trouble going to sleep or staying asleep. One in five adults do not find their sleep refreshing, and one in 3 have difficulty staying awake during waking hours. Younger adults are more likely to report problems falling asleep, whereas middle-aged and older adults find it harder to stay asleep throughout the night.

Insomnia is more prevalent among women, middle-aged and older adults, and individuals who say they are in poor physical or mental health. It’s also more common among lower-income Canadians. And insomnia is on the rise – the report notes an increase of 42% in insufficient sleep among Canadians from 2007 to 2015.

tired woman rubbing temples

Insomnia Costs Us All

A recent study2 estimated the total annual cost of insomnia in the province of Quebec alone to be $6.6 billion. This total includes direct costs associated with healthcare consultations and products used to promote sleep (including medications and self-administered aids such as alcohol), as well as indirect costs arising from lost resources (absenteeism and reduced productivity) associated with insomnia.

The study also found that insomnia costs those who suffer from it in particular, both directly and indirectly. The average cost to someone suffering from insomnia is $5,010 annually, which includes indirect costs such as reduced productivity and lost revenue as well as direct costs like medications.

a pile of money

What causes insomnia?

Stress and Worry

Stress and worry are two of the most common disruptors to the sleep cycle – more than half of insomnia cases are caused by a troubled mind. If you are dreading an upcoming event, it can be difficult to put it out of your mind at bedtime. Our dependence on devices such as smartphones may lead us to check work emails right before bed, causing job-related stress that contributes to worry as you try to fall asleep.

Ongoing stress, such as worry about work, school, money or a relationship, can intrude on your sleep on a regular basis. And major life events, such as a job loss, divorce, or the death of a loved one often cause insomnia. People with depression, anxiety, dementia, or mental disorders are far more likely to have sleep problems, including insomnia.

In Sylvie’s case, a recent round of layoffs at work and a new, abrasive boss had her worrying about her job security and financial stability. She was working later hours to demonstrate her worth – and skipping regular exercise, which could have helped her manage the stress better.

stressed out man, rubbing temples

Substances and Medications

Sylvie had started having an extra cup or two of coffee in the morning, to shake off the brain fog she got out of bed with most days. To relax after a hard day at the office, she regularly had a few glasses of wine in the evenings as well. Both caffeine and alcohol, however, can affect the ability to fall asleep, stay asleep, and enjoy a restful night.

Caffeine is well-known as a stimulant, but its effects can last for several hours, so the chances of it affecting sleep are significant. Caffeine not only makes it hard to fall asleep, but can also cause you to wake up during the night. Alcohol may have a sedative effect for a few hours, but as it is metabolized by the body it can rouse you from sleep and affect sleep quality as well.

Many medications, such as decongestants or asthma inhalers, are also stimulants and can disrupt sleep. Other drugs that might cause insomnia include allergy medications and those for heart disease, hypertension, thyroid problems, and depression.

a pile of pills spilling out of a container

Irregular Schedule

On nights when she worked late, Sylvie ordered pizza and ate it in front of the TV before falling into bed. Eating a late dinner or snacking before bed can activate the digestive system and keep you up, and fatty foods can contribute to acid reflux problems or heartburn, especially when you’re lying down in bed. Even drinking water or herbal tea just before bed can require you to wake up and visit the bathroom during the night, disturbing your sleep.

An irregular sleep schedule also contributes to insomnia, as your body becomes accustomed to sleeping and waking at regular intervals. Sylvie would tell herself that she would “catch up” by sleeping in on weekends, and while she did get some much-needed rest, inconsistent sleep patterns made it hard to fall asleep once she was back on her weekday schedule.

broken clock


To make matters worse, Sylvie was suffering from the shifting balance of hormones caused by menopause. Occasionally, hot flashes — surges of adrenaline that raise body temperature – would make her so uncomfortable that she would wake up drenched in sweat, sometimes several times a night.

Menopause is another contributor to insomnia, which may help explain why insomnia affects middle-aged women more than any other age group.

confused woman trying to remember something

Breathing Problems

Sylvie had noticed that she woke up more when she was on her back – a position in which she had been told she sometimes snored in her sleep. Snoring is associated with sleep apnea, a condition where the normal breathing cycle is interrupted, waking you up several times every night.

You may not realize it’s happening, but you feel tired the next day. Fortunately, sleep apnea can be diagnosed with a simple test. Sufferers of sleep apnea report great improvement in sleep after treatment.

snoring woman sleeping on her back

What Can I Do to Beat Insomnia?

At Apnea Health, we can help.

After yet another sleepless night, Sylvie came to see us for a sleep test. It turned out that she stopped breathing 18 times per hour. One of our respirologists (sleep doctors) met with her to explain that she suffered from moderate sleep apnea and the treatment options available to her.

Sylvie did a trial of CPAP for 3 months where our team was able to eliminate her sleep apnea so that she no longer stopped breathing 18 times per hour. However, after 3 months she was still waking up at night or too early in the morning unrefreshed.  After consultations with our therapists and our sleep doctor, we determined that Sylvie also suffered from insomnia. She joined a 4-week cognitive behaviour workshop for insomnia.

Today, Sylvie wakes up refreshed and with more energy. And on weekend mornings, when she used to sleep late, she now spends time exercising or outdoors with her family.

If you are one of the 40% of Canadians suffering from insomnia, contact one of our sleep specialists today to set up a sleep test.

Apnée Santé Team

  1. Chaput JP, Yau ,J, Rau DP and Morin CM, Prevalence of insomnia for Canadians aged 6 to 79, Statistics Canada, December 19, 2018.
  2. Daley M, Morin CM, LeBlanc M, Grégoire JP, Savard J. The economic burden of insomnia: Direct and indirect costs for individuals with insomnia syndrome, insomnia symptoms, and good sleepers. Sleep. 2009;32(1):55-64.

October is Menopause Awareness Month.

Menopause is a time of major hormonal, physical and psychological change for women, although menopausal symptoms vary from one woman to another.
Women enter menopause around the age of 50, and during the transition they can encounter a multitude of different symptoms such as hot flashes, headaches, fatigue, and mood swings and surprisingly, even sleep apnea.

Menopause can cause sleepless nights

During the perimenopause, or transition phase, a woman’s ovaries gradually (over several years) decrease production of estrogen and progesterone. One year after menstrual periods have stopped, a woman is considered to have reached menopause – and from peri-menopause to post-menopause, women report an increased rate of symptoms that interfere with sleep. Most notably, these include hot flashes, which are unexpected feelings of heat all over the body accompanied by sweating. They usually begin near the face and spread to the chest, affecting 75-85% of women around menopause.

Hot flashes can interrupt sleep and last on average three minutes, leading to less sleep efficiency. Most women experience these for a year, but about 25% have hot flashes for five years. While total sleep time may not suffer, sleep quality does. Interrupted sleep and frequent awakenings cause next-day fatigue.

Other symptoms of menopause include mood disorders, insomnia, and sleep-disordered breathing; sleep problems are often accompanied by depression and anxiety. Generally, post-menopausal women are less satisfied with their sleep and as many as 61% report insomnia symptoms. Snoring has also been found to be more common and severe in post-menopausal women. Snoring, along with pauses or gasps in breathing are signs of a more serious sleep disorder, obstructive sleep apnea (OSA).

woman staring at her alarm clock in the middle of the night

What’s OSA?

  • In obstructive sleep apnea the airway becomes blocked (obstructed) during sleep, which causes a pause in breathing.
  • When we stop breathing our oxygen levels drop, which triggers the brain to tell us to wake up and breathe.
  • However, we don’t wake up completely (these sleep interruptions are called “micro-arousals”).
  • It’s these micro-arousals that disrupt our sleep architecture and cause us to wake up in the morning feeling as if we haven’t slept a wink.

Woman sleeping with mouth open

Sleep apnea and menopause: What’s the connection?

According to The National Sleep Foundation, “During menopause, levels of the hormones estrogen and progesterone decrease in women’s bodies. These hormones act as stimulants and play a role in keeping airways open by maintaining muscle tone in the throat. As they decrease, the chances of obstructed breathing rise. What’s more, hormonal changes can lead to weight gain and a redistribution of body fat, sending more fat to the throat area, which can cause disrupted breathing.”

This weight gain can also cause snoring.  According to statistics, snoring affects 3% of women before menopause and 11% after menopause1. An American study examined 2,852 post menopausal women to asses whether sleep apnea was more common in women who were not treated with Menopausal Hormonal Therapy (MHT) than those who did. In this study, MHT is associated with a significant decrease in the frequency of sleep apnea.  Researchers found that patients receiving replacement therapy were able to reduce the severity of their apnea; however, it did not eliminate it.2

Sleep apnea is a risk factor in cardiovascular disease.  In women, its frequency increases at the time of menopause.  A study published in France in 2017 studied obstructive sleep apnea (OSA) in postmenopausal women with a high risk of cardiovascular disease.  The 2 year study included 91 menopausal patients hospitalized at Lille University Hospital for cardiovascular disease.  All these patients had a screening test for OSA and 73% of them had sleep apnea.3

Tired woman driving car

So what should you do if you’re past menopause, you snore, and you suspect sleep apnea?

The first step is to get tested for sleep apnea. If you have OSA symptoms and feel that your sleep is not restful, it’s important to talk to your doctor about it. Apnea Health offers simple, fast and effective home testing. You can also contact us for a free evaluation to see if sleep testing is right for you.

If the test shows you have sleep apnea, you’ll most likely be prescribed a continuous positive air pressure (CPAP) device. CPAP is the most effective treatment for OSA. Thousands of Canadians use it every time they sleep. CPAP consists of a gentle stream of air that is directed through the airway during sleep, allowing the airway to remain open, and therefore preventing apnea.

Treating your sleep apnea can reduce other health risks, too, from impaired memory to weight gain.

Respiratory therapist with smiling patient

Additional tips for restful sleep

  • Eat healthy. Avoid large meals, especially before bedtime. Maintain a regular, normal weight. Some foods that are spicy or acidic may trigger hot flashes. Try foods rich in soy as they might minimize hot flashes.
  • Avoid nicotine, caffeine and alcohol, especially before bedtime.
  • Dress in lightweight clothes to improve sleep efficiency. Avoid heavy, insulating blankets and consider using a fan or air conditioning to cool the air and increase circulation.
  • Reduce stress and worry as much as possible. Try relaxation techniques, massage and exercise. Talk to a behavioral health professional if you are depressed, anxious or having problems.
  • Create a schedule and avoid naps. Establishing a schedule will make it easier to fall asleep the same time every night, and napping could make it harder to get to sleep.
  • Create a controlled sleeping environment. Your bedroom should be cool and dark to promote the bed sleep possible, invest in a fan or sleep mask if necessary.
  • Don’t exercise before bed. It is important to maintain a healthy lifestyle through exercise, but try to fit your workout in earlier in the day.

Woman stretching to get ready to exercise

Better sleep, better life

Women are underdiagnosed for sleep apnea across the country and around the world.  To improve your sleep and your life, call Apnea Health today!  Proper diagnosis and treatment can make you more successful at home, at work or wherever your life’s focus is.

woman sleeping peacefully


  1. Menopausal status and sleep-disordered breathing in the Wisconsin Sleep Cohort Study. American journal of respiratory and critical care medicine. Young. 2003. 1;167(9):1181-5  S,
  2. Hormone replacement therapy and sleep-disordered breathing. Shahar. American journal of respiratory and critical care medicine. Mai 2003. 1;167(9):1186-92
  3. Souad Sedir,Claire Mounier Vehier Christelle CharleyMonaca: Science direct, Médecine du sommeil, Volume 14, Issue, Mars 2017, page 21, https://www.sciencedirect.com/science/article/pii/S1769449317300109

Have you ever noticed that when you are tired you eat more?

You may even feel ravenous and spend your day grazing the office freebies in the kitchenette. Your portions may be getting larger and the number of times you eat during the day may be increasing in an attempt to get more energy and combat fatigue.

Rest assured this is not your fault! It is not a lack of willpower. The answer may lie in your sleep and sleep apnea may be the culprit responsible for your weight gain.

Why do we pack on the pounds when we are sleep deprived?

When we’re sleep deprived, the hormones that control hunger and appetite start sending out faulty messages.

There are four hormones that control hunger and appetite:

  • Ghrelin tells the body to eat
  • Leptin tells it to stop eating
  • Cortisol makes us crave sugary foods when we’re stressed
  • Insulin stores calories

When we’re short on sleep, we produce more ghrelin (making us want to eat) and less leptin (the hormone that tells us to stop). On top of that, we produce more cortisol due to the stress caused by lack of sleep, so we crave sugary foods. And we produce extra insulin, which leads the body to store glucose in fat cells . . . so we gain weight.

It’s no wonder that as much as we might try, if we’re lacking sleep, we will invariably turn to food. We simply cannot combat the signals our bodies are sending us. Moreover, with an increasing amount of cortisol, we’re likely to give in to junk food cravings.

tired woman eating pizza on couch

Sleep apnea and weight gain: a vicious cycle

Here’s what happens:

  • In obstructive sleep apnea the airway becomes blocked (obstructed) during sleep, which causes a pause in breathing.
  • When we stop breathing our oxygen levels drop, which triggers the brain to tell us to wake up and breathe.
  • However, we don’t wake up completely (these sleep interruptions are called “micro-arousals”).
  • It’s these micro-arousals that disrupt our sleep architecture and cause us to wake up in the morning feeling as if we haven’t slept a wink.

Gaining weight can cause us to sleep less and sleeping less can make us eat more! This vicious cycle can turn into a nightmare.

But there is hope: The cycle can be broken, starting with a proper night’s sleep. And the good news is Apnea Health can help you achieve a good night’s rest.

A continual cycle that shows that sleep apnea leads to poor sleep which leads to increased hunger hormones which weight gain. After that, the process repeats.

How to break the cycle

The first step is to get tested for sleep apnea.

If you have OSA symptoms and feel that your sleep is not restful, it’s important to talk to your doctor about it.

Apnea Health offers simple, fast and effective home testing. You can also contact us for a free evaluation to see if sleep testing is right for you.

Here’s a checklist to review with your doctor for signs of sleep apnea.

  • Loud snoring
  • Occasionally waking up during the night feeling that you’re choking or gasping
  • Restless sleep
  • Having a sore or dry throat in the morning
  • Having a headache in the morning
  • Sleepiness, low energy or fatigue during the day
  • Feeling sleepy behind the wheel
  • Weight gain
  • Erectile dysfunction
  • Forgetfulness, mood changes, and a decreased interest in sex

a checklist

Will CPAP treatment help with weight loss?

Yes! A three-month study of CPAP users published in the New England Journal of Medicine showed a marked reduction in body mass index, as well as a mild to moderate decrease in blood pressure and cholesterol levels 1.

That’s three good reasons for people with sleep apnea to use their CPAP device every night!


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Is it okay to stop CPAP treatment after losing weight?

Treating sleep apnea and restoring sleep will obviously have an impact on your health and weight. You’ll stop feeling drowsy and fatigued. You’ll want to be more active, and with your new energy you might take up exercise, which will support your weight loss. And, of course, your hunger hormones will work normally.

Still, even if you snore less and feel you no longer suffer from sleep apnea, you should never stop CPAP without checking with a sleep medicine specialist first. That’s because there is no 100% guarantee that your sleep apnea will be completely eliminated.

Although being overweight is a cause of sleep apnea, sometimes other factors are present too – such as ear, nose and throat abnormalities (including nasal obstruction, tonsillar hypertrophy, large tongue base, elongated uvula or palate), or facial abnormalities. If these factors are present, sleep apnea will not necessarily disappear with weight loss.

man holding cpap e1610479937791


So you’ve lost that extra weight. What next?

After you’ve lost weight, it’s a good idea to visit your sleep clinic. It’s possible that the pressure setting on your CPAP machine will need adjustment because your airway has become less restricted.

After that, start thinking about other healthy lifestyle changes! With cravings under control, you can take the time to make nutritious meals. The extra energy you get from being well-rested can help you get a good workout, either outdoors or in the gym. You’ll find that with the help of Apnea Health, a whole new outlook begins with a good night’s sleep!

weight loss


1 Rishi, Muhammad Adeel MD et al. Effect of Positive Airway Pressure Therapy on Body Mass Index in Obese Patients With Obstructive Sleep Apnea Syndrome: A Prospective Study. American Journal of Therapeutics: March/April 2016 – Volume 23 – Issue 2 – p 422–428