Women may suffer from sleep apnoea during menopause

Feeling exhausted no matter how much you sleep? Waking up foggy, irritable, or struggling to concentrate?

Many women assume it’s stress, burnout, or menopause. But it could actually be sleep apnea.

Obstructive Sleep Apnea in women is often hiding in plain sight because the symptoms don’t always look the way people expect. Most people picture loud snoring and obvious breathing pauses during sleep — but for women, the signs can be much more subtle.

Instead, women often experience:

• Constant fatigue

• Brain fog

• Anxiety or low mood

• Insomnia

• Morning headaches

• Night sweats

• Poor concentration

• Restless sleep

• Low energy and reduced motivation

Because these symptoms overlap heavily with menopause, many women are told it’s “just hormones” — while the real issue goes untreated for years.

The statistics are eye-opening:

• Up to 75% of obstructive sleep apnea cases in women may go unrecognised or undiagnosed

• Studies show sleep apnea prevalence increases dramatically after menopause

• One major study found sleep apnea affected approximately 47% of postmenopausal women, compared with 21% of premenopausal women

• Research also suggests postmenopausal women not using hormone replacement therapy had significantly higher rates of sleep apnea than premenopausal women

• Women are far more likely than men to present with symptoms like insomnia, fatigue, anxiety, depression, and morning headaches instead of classic loud snoring.

This is one of the reasons sleep apnea is so commonly confused with menopause.

Both conditions can cause:

• Poor sleep quality

• Night sweats

• Mood changes

• Irritability

• Memory problems

• Difficulty concentrating

• Daytime exhaustion

As a result, many women spend years trying to manage symptoms without ever investigating the underlying sleep disorder contributing to them.

The hormonal changes that occur during menopause may also directly increase the risk of sleep apnea. Estrogen and progesterone help support breathing stability and muscle tone in the airway during sleep. As these hormone levels decline, the airway becomes more likely to collapse during the night, increasing breathing disturbances and reducing sleep quality. And it’s not just about feeling tired.

Untreated sleep apnea has been associated with:

• High blood pressure

• Increased cardiovascular risk

• Type 2 diabetes

• Anxiety and depression

• Cognitive decline and memory issues

• Increased risk of accidents due to fatigue

Many women with sleep apnea:

• Don’t realise they stop breathing

• May not snore loudly

• Wake multiple times overnight without knowing why

• Simply feel drained every day despite getting “enough” sleep

The good news is that sleep apnea is highly treatable, and many women notice significant improvements in energy, mood, mental clarity, and overall wellbeing once diagnosed and treated appropriately.

Awareness is key. Recognising that sleep apnea in women often presents differently — and is frequently mistaken for menopause, stress, anxiety, or insomnia — can help more women receive the support and treatment they need sooner.

Medical References

• Dancey DR et al. (Chest Journal) found sleep apnea prevalence was significantly higher in postmenopausal women (47%) compared with premenopausal women (21%).

• Research published in the American Journal of Respiratory and Critical Care Medicine showed postmenopausal women had substantially higher sleep apnea rates than premenopausal women.

• Recent reviews report that up to 75% of women with sleep apnea may remain undiagnosed due to differences in symptom presentation.

• Studies also show women are more likely to present with fatigue, insomnia, anxiety, and depression rather than the “classic” symptoms traditionally associated with sleep apnea.