Why sleep apnea symptoms can look different for women vs men
Clinically reviewed by Dr. Chris Mosunic, PhD, RD, MBA
Sleep apnea in women can look a little different than in men, and the symptoms are often overlooked. Explore the 10 common signs women should look out for and what to do next.
Sleep apnea is often seen as a “man’s problem,” probably because the stereotypical image involves a middle-aged guy snoring louder than a chainsaw. But, women can snore loudly too — and they’re actually just as likely as men to get sleep apnea.
As with many conditions and illnesses, symptoms of sleep apnea look differently in women than men, and oftentimes, they can be overlooked. While men are more likely to snore loudly and gasp for air during their sleep, women with sleep apnea often experience chronic fatigue, insomnia, headaches, mood swings, and brain fog in their waking life. As a result, they’re often misdiagnosed as suffering from stress, anxiety, depression, or exhaustion.
This is a huge problem, because untreated sleep apnea isn’t just about being tired. It can also seriously impact a woman’s long-term physical and mental health.
So, if you’re waking up exhausted no matter how much sleep you get, struggling with unexplained mood swings, or feeling like your brain just isn’t working the way it used to, sleep apnea could be the culprit. Let’s break down what it is, why it looks different in women, and how to recognize the symptoms so you can get the care you deserve.
What is sleep apnea?
Sleep apnea is a sleep disorder that causes repeated pauses in breathing throughout the night, which prevents deep, restful sleep. These pauses (called “apneas”) can last anywhere from a few seconds to over a minute and can happen dozens or even hundreds of times per night. Each time, your brain wakes you up just enough to restart breathing but not enough for you to remember it happening. The result? Disrupted sleep, lower oxygen levels, and sheer exhaustion.
Types of sleep apnea
There are three main types of sleep apnea:
Obstructive sleep apnea (OSA): The most common type, OSA happens when the muscles in your throat relax too much, causing a blockage in your airway. This can be due to anatomy, weight, hormones, or muscle tone.
Central sleep apnea (CSA): Less common, CSA occurs when the brain doesn’t send the right signals to control breathing during sleep.
Complex sleep apnea syndrome: A mix of both OSA and CSA, the airway gets blocked and the brain’s breathing signals are also disrupted.
Why is sleep apnea different for women vs. men?
For decades, research on sleep apnea was focused on middle-aged, overweight men, so doctors were trained to look for classic symptoms like loud snoring, choking, and gasping for air during sleep. The problem is that women often experience sleep apnea differently, and their symptoms are often missed, misdiagnosed, or dismissed altogether.
What about sleep apnea in trans women?
Sleep apnea research has largely focused on cisgender men and women, so data on trans women is limited. However, hormone therapy, body composition, and airway structure all play a role in sleep apnea risk.
Estrogen and progesterone, which are key hormones in gender-affirming therapy, may reduce sleep apnea risk by improving airway muscle tone and supporting breathing regulation. Some trans women may see sleep apnea symptoms improve over time, though the extent varies based on airway size, weight, and muscle distribution.
Even with hormone therapy, larger airway structure, weight gain from estrogen, or pre-existing sleep apnea can keep symptoms from fully resolving.
10 common symptoms of sleep apnea in women
If you think of sleep apnea as just snoring and gasping for air, you might miss some of the biggest red flags of the condition, especially in women. While men tend to show the classic loud snoring, choking, and excessive daytime sleepiness symptoms, women’s symptoms can be more subtle and are easily misdiagnosed as stress, anxiety, or simply just tiredness.
Here are some of the most common, but often overlooked, symptoms of sleep apnea in women:
1. Chronic fatigue: If you’re getting a full night’s sleep but still feel like you got hit by a truck in the morning, something is off. Sleep apnea repeatedly interrupts deep, restorative sleep, which leaves you exhausted, no matter how many hours you spend in bed.
2. Brain fog and difficulty concentrating: Struggling to focus? Forgetting little things? Feeling mentally sluggish? Sleep apnea disrupts cognitive function by starving your brain of oxygen and keeping you from reaching the deep sleep stages necessary for restoring your memory and boosting concentration.
3. Insomnia or restless sleep: Many women with sleep apnea don’t realize they have it, because instead of snoring loudly and falling asleep quickly, they experience insomnia. They toss and turn, wake up frequently, and feel restless all night.
4. Waking up gasping or short of breath: Even if you don’t snore, pauses in breathing can cause sudden middle-of-the-night wake-ups where you feel like you need to take a deep breath. Some women describe it as feeling like they’re choking or suffocating in their sleep.
5. Morning headaches: Frequent morning headaches can be a sign that your brain wasn’t getting enough oxygen overnight due to sleep apnea. These headaches often improve after being awake for a while.
6. Mood swings, anxiety, or depression: When your sleep is constantly disrupted, your mental health can suffer. Many women are first diagnosed with anxiety or depression before realizing that poor sleep is the real culprit.
7. Unexplained daytime sleepiness: If you’re falling asleep during meetings, struggling to get through the afternoon without caffeine, or feeling drowsy while driving home, that should ring a warning bell. Daytime sleepiness is a major red flag of sleep apnea, even if you think you’re sleeping enough hours at night.
8. Snoring or silent apnea: Women do snore, but often more softly than men, which is why partners or doctors may overlook it. Some women also experience silent apnea, where the airway closes but doesn’t produce loud snoring sounds.
9. Heart palpitations or high blood pressure: Untreated sleep apnea can stress your cardiovascular system, leading to irregular heartbeats, palpitations, and high blood pressure, even in women with no prior heart issues.
10. Frequent nighttime bathroom trips: Waking up multiple times to pee might not just be your bladder. It can actually be a sign of sleep apnea disrupting your sleep cycles and triggering unnecessary awakenings.
What causes sleep apnea in women?
Sleep apnea happens when your airway partially or fully collapses during sleep, repeatedly interrupting your breathing. While many people associate sleep apnea with weight gain and loud snoring, the truth is women can develop it for different reasons, many of which have nothing to do with weight.
Here are some of the most common causes of sleep apnea in women.
1. Hormonal changes
Estrogen and progesterone play a role in keeping the airway open and regulating breathing. When hormone levels drop during pregnancy, menopause, or even certain phases of the menstrual cycle, the risk of sleep apnea increases. This is why many women first experience sleep apnea symptoms during pregnancy or after menopause.
2. Anatomy and airway size
Some women are born with a smaller airway, making them more prone to airway collapse. Factors like a recessed jaw, large tonsils, a high-arched palate, or chronic nasal congestion can all contribute to obstructive sleep apnea.
3. Weight gain
While you don’t have to be overweight to have sleep apnea, carrying extra weight (especially around the neck and upper body) can put pressure on the airway and make breathing more difficult at night. However, many women with sleep apnea aren’t overweight, which is why weight alone shouldn’t be the deciding factor in diagnosis.
4. Pregnancy
Sleep apnea risk spikes during pregnancy, especially in the third trimester. Increased progesterone relaxes the airway, weight gain can put extra pressure on breathing, and nasal congestion (thanks, pregnancy hormones) can make it harder to get enough oxygen at night. Pregnancy-related sleep apnea can increase the risk of complications like gestational diabetes, preeclampsia, and preterm birth, which is why it’s so important to recognize and treat it early.
5. Menopause
Before menopause, estrogen and progesterone help maintain muscle tone in the airway. But once hormone levels drop, women’s sleep apnea risk jumps dramatically and nearly catches up to men’s. Many postmenopausal women develop sleep apnea for the first time or find that their sleep worsens.
6. Family history and genetics
If your mom, dad, or sibling has sleep apnea, your chances of having it are much higher. Genetic factors like airway size, muscle tone, and even how your body stores fat all play a role in whether or not you develop sleep apnea.
7. Lifestyle factors
Certain lifestyle habits can increase sleep apnea risk, including:
Smoking: Causes inflammation and swelling in the airway
Alcohol and sedatives: Relaxes throat muscles, making airway collapse more likely
Certain sleep position: Sleeping on your back can make apnea episodes worse by allowing gravity to block your airway.
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8. Underlying medical conditions
Some conditions increase the likelihood of developing sleep apnea, including:
Polycystic ovary syndrome (PCOS): Women with PCOS are at a higher risk of sleep apnea due to hormonal imbalances and increased body weight.
Hypothyroidism: This condition can cause fluid retention and decreased muscle tone in the airway.
Chronic nasal congestion: If you can’t breathe through your nose properly, your body has to work harder to get oxygen, making airway obstruction more likely.
How untreated sleep apnea can take a toll on women’s health
Untreated sleep apnea isn’t just exhausting — it can also seriously impact your long-term health. Because women’s symptoms are often misdiagnosed as stress, anxiety, or depression, many go undiagnosed for years, increasing their risk of chronic conditions.
One major concern is heart health. Oxygen deprivation and disrupted sleep raise blood pressure and strain the heart, increasing the risk of hypertension, heart disease, and stroke, even in women without prior issues. Sleep apnea also affects mood and mental wellbeing, which is why many women are first diagnosed with anxiety or depression before they realize poor sleep is the root cause.
Sleep apnea can also slow metabolism, increase cravings, and make weight loss difficult, which may ultimately raise the risk of insulin resistance and type 2 diabetes. During pregnancy, it’s linked to gestational diabetes, high blood pressure, and preterm birth, so early diagnosis is essential.
Beyond physical health, brain fog and memory problems are common, as poor sleep prevents proper cognitive and brain function. Most concerning, untreated sleep apnea is linked to a shorter lifespan due to chronic oxygen deprivation and increased health risks. The good news is, it’s treatable. And getting diagnosed can be life-changing.
What to do if you think you have sleep apnea
If this all sounds familiar, know you’re not alone. Sleep apnea is shockingly underdiagnosed in women, and many spend years struggling with exhaustion, brain fog, and mood swings before they finally get the right diagnosis.
If you suspect that you might have sleep apnea, here’s what you can do to make sure you get the treatment you need.
Step 1: Track your symptoms
Before you talk to your doctor, keep a sleep journal for a week or two. Having clear data on how sleep apnea is affecting you makes it easier for your doctor to understand exactly what’s going on.
Write down:
How many hours of sleep you’re getting
How refreshed or exhausted you feel in the morning
Whether you wake up with headaches, a dry mouth, or gasping for air
Daytime symptoms like brain fog, mood swings, or fatigue
Any comments from a partner about snoring or restless sleep
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Step 2: Talk to your doctor
When discussing your symptoms, be direct. Tell your doctor why you suspect you have sleep apnea and ask for a sleep study. If they dismiss your concerns, advocate for yourself or consider seeking a second opinion. Here’s how to be more assertive in your life if you could use some pointers.
Step 3: Get a sleep study
There are two types of sleep studies:
Home sleep apnea test (HSAT): A portable monitor tracks your breathing, oxygen levels, and movement while you sleep at home.
In-lab sleep study (polysomnography): This is a more detailed test done in a sleep clinic, measuring brain waves, oxygen levels, breathing patterns, and limb movements.
For many women, a home sleep test is enough to diagnose sleep apnea. However, if results are inconclusive or symptoms suggest another sleep disorder, an in-lab study might be needed.
Step 4: Explore treatment options
If you’re diagnosed with sleep apnea, treatment options include:
CPAP therapy: This method uses a machine that delivers airflow to keep your airway open. Modern CPAP machines are much quieter and more comfortable than older models.
Oral appliances: A dentist can fit you with a mouthpiece that repositions your jaw to prevent airway collapse.
Lifestyle changes: Depending on your situation, losing weight, adjusting sleep positions, treating nasal congestion, and avoiding alcohol before bed can help reduce symptoms.
Surgery: In some cases, procedures to remove airway blockages (like tonsillectomies) may be considered.
Step 5: Don’t give up
Getting a diagnosis is just the beginning. CPAP machines can take some getting used to, and it may take time to find the right treatment plan. But once your sleep apnea is properly managed, the difference in your energy, mood, and overall health will be worth it.
Sleep apnea symptoms in women FAQs
Are sleep apnea symptoms different in pregnant women?
Pregnancy increases sleep apnea risk due to hormonal changes, weight gain, and nasal congestion, especially in the third trimester. Symptoms like snoring, morning headaches, and extreme fatigue may worsen, and untreated sleep apnea can increase the risk of gestational diabetes, high blood pressure, and preterm birth. If you suspect sleep apnea during pregnancy, talk to your doctor, as treatment can help protect both you and your baby.
Why am I suddenly having sleep apnea in menopause?
Menopause increases sleep apnea risk because estrogen and progesterone drop, making the airway more prone to collapse. Many women experience new or worsening snoring, gasping, or daytime fatigue after menopause. Sleep apnea at this stage is also linked to weight gain, heart disease, and mood changes. If you’re struggling with poor sleep, a sleep study can help determine if apnea is the cause.
How to tell if a woman has sleep apnea?
Women’s sleep apnea symptoms often include chronic fatigue, brain fog, insomnia, and mood swings, rather than just snoring. Morning headaches, waking up gasping, or feeling exhausted despite a full night’s sleep are also signs. Since women are frequently misdiagnosed with anxiety, depression, or insomnia, tracking symptoms and asking for a sleep study is key to getting the right diagnosis.
Can sleep apnea cause anxiety and depression?
Sleep apnea disrupts oxygen levels and prevents deep sleep, which can throw off brain chemistry and increase stress hormones. Many women with undiagnosed sleep apnea are first diagnosed with anxiety or depression, but treating sleep apnea often improves mood, reduces panic attacks, and restores emotional balance. If you’re struggling with mental health and poor sleep, apnea could be a factor.
What is the best remedy for sleep apnea?
The best treatment for sleep apnea depends on severity. CPAP therapy is the most effective option for moderate to severe cases, while oral appliances, lifestyle changes, and treating nasal congestion may help mild ones. If apnea is caused by enlarged tonsils or a deviated septum, your doctor may recommend surgery.
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