DARIEN, IL – A new study to be presented at the SLEEP 2026 annual meeting found that women with moderate-to-severe obstructive sleep apnea reported a greater overall symptom burden than men, even though their objective measures of sleep apnea severity were similar.
Results show that despite having a similar mean apnea-hypopnea index as men (36 vs. 40 events/hour), women reported significantly higher scores for nocturia, headache, and nightmares, as well as worse scores for sleep disturbance, sleep-related daytime impairment, anxiety, anger, fatigue, depression, and cognitive function. Women also reported greater dissatisfaction with social roles. No sex differences were observed for snoring, nocturnal gasping, nasal congestion, acid reflux, or Epworth Sleepiness Scale scores.
"Women with moderate-to-severe obstructive sleep apnea initiating CPAP treatment have similar sleep apnea severity and classical symptoms including snoring, nocturnal gasping, and sleepiness assessed by the Epworth Sleepiness Scale compared to men. However, across a broad range of atypical symptoms, women uniformly report a greater symptom burden," said lead author Stuti Vaidya, a researcher at the University of Pittsburgh. "Our results suggest that current algorithms used by clinicians to diagnose and treat patients with obstructive sleep apnea continue to focus on classical symptoms and do not consider the broader range of symptoms women may experience."
Obstructive sleep apnea is a common and serious sleep disorder in which the upper airway repeatedly collapses during sleep, causing disruptions in breathing. It is estimated that 54 million adults in the U.S. have sleep apnea, and 24 million adults have moderate to severe obstructive sleep apnea nationwide.
The study recruited 502 adults (287 men, 202 women) diagnosed with moderate-to-severe obstructive sleep apnea who were initiating continuous positive airway pressure therapy across two clinical sites. The mean age of participants was 50 years in women and 48 years in men. Participants completed online questionnaires before beginning treatment. Visual analog scales assessed snoring, nocturnal gasping, nasal congestion, nocturia, headaches, nightmares, and acid reflux, while validated instruments assessed sleep disturbance, sleep-related impairment, cognitive function, depression, anxiety, anger, fatigue, and satisfaction with social roles.
Vaidya noted that the findings help explain why there might be a delay in the diagnosis of sleep apnea in women.
"Our results suggest that women may not be diagnosed and treated for obstructive sleep apnea until they develop classical symptoms of a severity similar to that seen in men, which may contribute to delays in diagnosis," Vaidya said.
This study was supported by a grant from the American Academy of Sleep Medicine Foundation. The research abstract was published recently in an online supplement of the journal Sleep and will be presented June 15 during SLEEP 2026 in Baltimore. SLEEP is the annual meeting of the Associated Professional Sleep Societies, a joint venture of the AASM and the Sleep Research Society.
