Sleep apnea, a disease in which a person stops breathing during sleep many times each night, can vary from mild to severe and life-threatening, and most experts have believed that it affects men two or three times as often as women.
So it was very surprising that on August 16 in the European Respiratory Journal, a research study out of Sweden reported that in 400 women aged 20 to 70 years who were studied, 50% of them had a diagnosis of sleep apnea!
This high of an incidence has never been reported. Other studies have found a sleep apnea (SA) incidence in women from four to nine percent, so this 50% figure is shockingly high. In cases like this—when a new study shows a result way out of line from the expected—other scientists in the same discipline first look to see if there was some problems in the design or execution of the study, or in the evaluation of the data.
We will see what happens with this Swedish study. Maybe the results will be validated by different researchers, in a different medical center, maybe not. But there is one thing that all sleep researchers agree on: sleep apnea, especially in women, is under diagnosed.
The best estimates are that 80% of men, and 92% of women with SA are never diagnosed! The disease also occurs in children, usually as a result of enlarged tonsils and adenoids. In children, often the only symptom is hyperactivity.
Patients rarely walk into a doctor’s office and say: “I think I have sleep apnea”. Doctors cannot look at someone and say they have SA. Doctors need to ask questions, and often the answers can only come from someone who actually sleeps with the patient, rather than the patient himself.
To make a definite diagnosis, a person needs to have what is called a “polysomnography” test. This can be done overnight in a clinic setting or sometimes at home, and the patient wears small monitors on their nose and chest that check for apnea (breath holding), the amount of snoring, the oxygen level in the blood, heart rate, and sometimes other data is collected.
The person with SA holds their breath many times during the night, for ten seconds and sometimes for more than a minute at a time, and this can happen hundreds of times during one night. The typical SA sufferer is also a loud snorer, and because they did not get a restful sleep, they are often sleepy during the daytime. Usually they they have no idea that the underlying problem is sleep apnea.
Sleep apnea occurs more commonly in obese individuals, and the incidence increases with age. This apnea is stressful on the body, and many SA sufferers develop hypertension and premature heart disease. Since they are often restless sleepers (as well as snorers), the bed partners of people with sleep apnea are often sleep deprived as well.
In the next weeks in Mais Saúde we will tell you what to look for in yourself and your bed partners to help detect SA, and about the treatment options. In the meantime, pay attention to your partner’s sleep, man or woman! Unlike what many doctors think, it is an equal opportunity disease!
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