Can perimenopause or weight gain cause sleep apnea?

Question

Hello doctor,

I am a 45-year-old woman who often wakes up feeling tired even after getting seven to eight hours of sleep. My partner has mentioned that I snore loudly and sometimes seem to stop breathing during the night. I used to think sleep apnea mainly affected men, but I am starting to wonder if I might have obstructive sleep apnea (OSA).

Could factors like perimenopause or weight gain contribute to this in women? I also experience daytime fatigue, brain fog, and frequent headaches. If I am diagnosed with OSA, does every woman need to use a CPAP machine, or are there effective alternatives such as oral appliances?

Lastly, I am concerned about whether untreated sleep apnea increases the risk of heart problems in women.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

The symptoms you have described strongly suggest the possibility of sleep apnea. You are absolutely right, while it is often discussed more in men, sleep apnea is quite common in women as well, particularly around perimenopause. Hormonal changes during this stage can affect the muscles that support your airway, and weight gain can further narrow the airway during sleep.

The next important step would be to have a sleep study. This will help confirm whether you are experiencing pauses in breathing during sleep and determine how severe it is. Once we have those results, we can discuss the most suitable treatment options.

Regarding CPAP therapy, it remains the most effective treatment, with strong evidence for improving sleep quality, lowering blood pressure, and reducing strain on the heart. However, not every woman needs a CPAP machine. For mild cases, custom-made oral appliances (similar to dental mouthguards) can help by gently repositioning the jaw forward to keep the airway open. Some women also benefit from positional therapy (sleeping on the side), weight management, or nasal breathing exercises if their sleep apnea is mild. The best approach depends on your sleep study findings.

It is also important to know that untreated sleep apnea can increase the risk of cardiovascular problems over time, including high blood pressure, irregular heart rhythms, and a higher risk of heart attack or stroke. The encouraging news is that with proper treatment, these risks drop significantly, and most people notice a meaningful improvement in their energy, focus, and mood within just a few weeks.

I hope this helps.

Kindly revert if there are any queries.

Thank you.