Sleep Apnoea in Men vs Women: What’s the Difference?

Sleep apnoea is often thought of as a “men’s condition,” but this misconception means many women remain undiagnosed or misdiagnosed for years. While both men and women can develop sleep apnoea, the way symptoms appear — and how the condition progresses — can be surprisingly different.

Understanding these differences is essential for accurate diagnosis and effective treatment.

How Common Is Sleep Apnoea in Men and Women?

Historically, sleep apnoea has been diagnosed more often in men. Studies suggest that men are two to three times more likely to be diagnosed with obstructive sleep apnoea (OSA).However, emerging research shows that women are significantly underdiagnosed.

Why?

• Women often present with less “classic” symptoms.

• Symptoms are sometimes attributed to anxiety, stress, or menopause.

• Sleep studies for women may under-report apnoea events because their breathing pattern disruptions can be subtler.

  
  

Different Symptoms: Men vs Women

Common Symptoms in Men

Men tend to show the traditional symptoms of sleep apnoea:

• Loud snoring

• Visible breathing pauses during sleep (often noticed by partners)

• Gasping or choking at night

• Excessive daytime sleepiness

• Morning headaches

These symptoms are usually obvious, making diagnosis more straightforward.

Common Symptoms in Women

Women often experience what we call atypical or subtler symptoms, such as:

• Insomnia or fragmented sleep

• Fatigue rather than sleepiness

• Morning headaches or migraines

• Mood changes: irritability, anxiety, or low mood

• Night sweats

• Restless legs

• Lower reported levels of snoring

Women may also describe “poor sleep” or “light sleep” rather than feeling outright sleepy, leading healthcare providers to overlook apnoea as a cause.

Why Are Symptoms Different?

1. Hormones

Oestrogen and progesterone influence airway muscle tone and breathing control:

• Before menopause, these hormones provide some protective effects.

• After menopause, the risk of sleep apnoea increases significantly, approaching rates seen in men.

2. Body Fat Distribution

• Men tend to gain upper-body and neck fat, increasing airway collapse.

• Women often accumulate fat around the hips and thighs, which doesn’t directly affect the airway.

• After menopause, however, fat distribution can shift to the upper body — increasing OSA risk.

3. Upper Airway Anatomy

Studies show subtle anatomical differences between men and women, influencing how and where airway obstruction occurs.

How Sleep Apnoea Affects Men and Women Differently

In Men

• Higher risk of high blood pressure

• Greater severity of oxygen desaturation

• More obvious snoring and obstructive events

In Women

• More likely to experience insomnia, depression, and anxiety related to fragmented sleep

• Strong association with metabolic complications, especially after menopause

• Higher likelihood of presenting with REM-related sleep apnoea, where events cluster during dreaming sleep

• 
  

Diagnosis Challenges for Women

Because women frequently show non-classic symptoms:

• Sleep apnoea may be misdiagnosed as stress, anxiety, chronic fatigue, menopausal changes, or insomnia.

• Home sleep tests may underestimate severity if REM-related events are not captured fully.

• Women often reach diagnosis later in the disease course, when symptoms become more pronounced.

This is why awareness is crucial — early diagnosis improves health outcomes, energy levels, and quality of life.

Does CPAP Therapy Work Differently for Men and Women?

Both men and women respond very well to CPAP therapy. However:

• Women may require lower pressure settings due to different airway characteristics.

• Mask fit is important — some women prefer smaller or “For Her” mask designs for comfort.

• Addressing insomnia, anxiety or fragmented sleep alongside CPAP can significantly improve adherence in women.

At Connect CPAP, we help customise therapy based on each patient’s unique sleep profile, ensuring comfort and long-term success.

Key Takeaways

• Sleep apnoea affects both men and women, but symptoms can appear differently.

• Women often present with subtler or non-traditional symptoms, leading to underdiagnosis.

• Hormonal changes, especially around menopause, play a major role.

• CPAP therapy is effective for everyone — with personalised adjustments.