A study set to be presented at the SLEEP 2026 annual meeting has found that women with moderate-to-severe obstructive sleep apnea experience a higher overall symptom burden than men, even when objective measures of apnea severity are comparable. The apnea-hypopnea index for women averaged 36 events per hour, while for men it was 40.
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Despite similar severity metrics, women reported significantly worse scores on various symptoms including nocturia, headaches, nightmares, and overall sleep disturbances. Additionally, they experienced more daytime impairment, anxiety, anger, fatigue, depression, and cognitive issues, alongside greater dissatisfaction with social roles. However, no notable differences were found regarding snoring, nocturnal gasping, nasal congestion, acid reflux, or scores on the Epworth Sleepiness Scale.
Lead researcher Stuti Vaidya from the University of Pittsburgh stated that while women initiating CPAP treatment exhibit similar traditional symptoms of obstructive sleep apnea as men, they consistently report a broader range of atypical symptoms that indicate a greater overall burden. Vaidya emphasized that current diagnostic algorithms may not fully address these atypical symptoms experienced by women, potentially leading to delays in proper diagnosis and treatment.
Obstructive sleep apnea is a prevalent sleep disorder characterized by repeated upper airway collapse during sleep, disrupting breathing. Currently, an estimated 54 million adults in the U.S. suffer from this disorder, with about 24 million facing moderate to severe cases.
The study involved 502 adults—287 men and 202 women—diagnosed with moderate-to-severe obstructive sleep apnea and beginning continuous positive airway pressure therapy at two clinical sites. The average age was 50 for women and 48 for men. Participants completed online questionnaires gauging symptoms and satisfaction before starting treatment.
Vaidya noted that these findings may explain the often delayed diagnosis for women, stating that they might not be recognized or treated for obstructive sleep apnea until developing symptoms akin to those experienced by men at similar severities.
This research was supported by a grant from the American Academy of Sleep Medicine Foundation and is part of ongoing discourse in the field as presented during the annual SLEEP meeting. The abstract will be presented on June 15 in Baltimore.