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Men are more prone to sleep apnea than women, but that does not mean that treatment such as continuous positive airway pressure therapy (CPAP) can be neglected in women.

“This is very interesting because in the United States, women are less likely to use PAP therapy compared to men, but that is not the case everywhere in the world,” Dr. Jennifer Martin of UCLA told HCPLive at SLEEP 2024, the 38th annual meeting of the Associated Professional Sleep Societies. “In some other countries, the CPAP use rate is similar between men and women, and one of the reasons for this may be that there are differences in health care and access to health care.”

At SLEEP 2024, Martin presented that women with sleep apnea tend to be less likely to use positive airway pressure therapy compared to men and explained the reasons for this. She also discussed what a physician could do during an office visit to increase the likelihood that their patients with sleep apnea will receive treatment.

Martin explained that women in the U.S. have greater responsibilities for healthcare and supporting their families, so they may have to sacrifice their routine healthcare. As Martin said, women may find it a burden to also have to put on a CPAP mask after their children go to bed.

Other reasons women may be less inclined to use a CPAP mask are that, as Martin said, it may feel like “another challenge” to balance mental health issues or health behaviors like diet and exercise with wearing a mask. Women also experience depression more frequently than men, and depression can interfere with adherence to CPAP therapy.

Women also tend to suffer less from sleep apnea, so they may not feel that treatment is necessary because their condition is not as severe as it is in men.

“Another factor that may play a role is that I think there is more stigma attached to wearing a CPAP mask among women and therefore women may feel more uncomfortable in the presence of their partners than men, although that is just speculation,” Martin said.

In addition, some women have difficulty finding a CPAP mask that fits their face.

“There may indeed be technical challenges in fitting the mask due to the craniofacial structure, but again, there is not a lot of research data on that,” Martin said. “That’s likely considering that most masks were originally designed for male patients.”

Sleep apnea manifests itself differently in men and women. Men with sleep apnea tend to feel very sleepy, and CPAP reduces sleepiness. In contrast, women with sleep apnea tend to feel tired, but it is not yet confirmed whether CPAP relieves symptoms of fatigue.

Martin believes it’s important to examine how sleep apnea creates barriers in everyday life. Healthcare providers should talk to their patients about what’s important to them before starting treatment and assess the benefits of treatments in light of those values. For example, if a provider wants a patient to use CPAP to control their high blood pressure, but the patient’s relationship with their spouse is more important, the patient shouldn’t have to go through CPAP treatment.

“One of the really important things healthcare providers can do is take the time with people with sleep apnea to understand what their treatment goals are and how untreated sleep disorder impacts the things that are important to the person in their daily life,” Martin said.

References

Martin, J. CPAP adherence in women with sleep apnea. Paper presented at SLEEP 2024. Houston, TX. June 5, 2024.

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