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Headaches worsen in the morning
Tired all the time
Restless sleep
Easily tired
Snoring
Gained weight
Inability to sleep
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Sleep Apnea Syndrome is a group of sleep disorders marked by repeated pauses or reductions in breathing during sleep. It may result from airway obstruction, disrupted brain signaling, or both. Common symptoms include loud snoring, gasping or choking during sleep, unrefreshing sleep, and excessive daytime fatigue. Morning headaches and concentration issues are also frequent. Untreated, it raises the risk of heart attack, stroke, high blood pressure, and kidney problems. Early diagnosis and treatment are key to reducing long-term health risks. Sleep apnea and narcolepsy can share overlapping symptoms, particularly excessive daytime sleepiness. While their causes differ, they may occur together. Addressing sleep apnea is important in narcolepsy care, as untreated apnea can worsen daytime symptoms and reduce narcolepsy treatment effectiveness.
Your doctor may ask these questions to check for this disease:
Treatment varies based on the type and severity of sleep apnea syndrome. In mild cases, treatment consists of lifestyle changes like weight loss, smoking cessation or nighttime use of a mouthpiece to keep the airway open. In more severe cases, it may require medications, surgery and a machine (CPAP machine) to keep the airway open while sleeping.
Reviewed By:
Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.
Rohini R, MD (Otolaryngology (ENT))
Dr. Rohini R is an ENT, Head and Neck Surgeon, with a Fellowship in Advanced Endoscopic Sinus and Skull Base Surgery and a Fellowship in Aesthetic Medicine and Lasers. Besides clinical practice and working with Ubie, she is actively training and mentoring medical students and residents. She has functioned in various work settings - teaching hospitals, private and free health centers, and worked with patients from all socioeconomic backgrounds due to her experience in free hospitals and volunteering in India and Singapore.
Content updated on Aug 5, 2025
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Q.
Waking Up Tired? Why Sleep Apnea Occurs & Medical Next Steps
A.
Sleep apnea occurs when the airway repeatedly narrows or collapses during sleep or when the brain briefly fails to signal breathing, causing loud snoring, witnessed pauses, morning headaches, and persistent daytime fatigue, and over time it can raise cardiovascular and metabolic risks; likelihood increases with excess weight, anatomy like enlarged tonsils, age, alcohol use, smoking, family history, and certain medical conditions. There are several factors to consider; see below to understand more. Next steps include an online symptom check followed by a clinician visit to arrange a lab or home sleep study to confirm severity, which guides treatment such as CPAP, oral appliances, weight loss with side sleeping, or surgery, and seek urgent care for chest pain, severe shortness of breath, stroke like symptoms, or dozing while driving.
References:
* Jordan AS, Wellman DA. Obstructive Sleep Apnea. Physiol Rev. 2021 Jul 1;101(3):1135-1188. doi: 10.1152/physrev.00010.2019. Epub 2021 Mar 17. PMID: 33730704.
* Ramar K, et al. Clinical Practice Guideline for the Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2021 Feb 1;17(2):299-354. doi: 10.5664/jcsm.8994. PMID: 33522204; PMCID: PMC7890652.
* Epstein LJ, et al. Therapies for Obstructive Sleep Apnea. J Clin Sleep Med. 2022 Mar 1;18(3):939-959. doi: 10.5664/jcsm.9877. PMID: 35199859; PMCID: PMC8889980.
* Wellman A, Malhotra A. Pathophysiology of obstructive sleep apnoea and its implications for therapy: a personalised medicine approach. Thorax. 2018 Jun;73(6):579-585. doi: 10.1136/thoraxjnl-2017-211326. Epub 2018 Feb 12. PMID: 29437877; PMCID: PMC5990520.
* Masa JF, et al. Obstructive Sleep Apnea in Adults: Diagnosis and Management. J Clin Med. 2021 Apr 19;10(8):1741. doi: 10.3390/jcm10081741. PMID: 33924083; PMCID: PMC8074127.
Q.
Struggling With Your CPAP Machine? Why It Fails & Medically Approved Next Steps
A.
There are several factors to consider if your CPAP is not helping: poor mask fit or leaks, incorrect pressure, too few hours of nightly use, dryness or nasal blockage, claustrophobia, weight changes, or even central sleep apnea; red flags include persistent daytime sleepiness, snoring or gasping, and high AHI despite use. Medically approved next steps include reviewing your machine data with a clinician, refitting the mask and adding humidification, reassessing pressure or trying APAP or BiPAP with a possible repeat sleep study, and considering alternatives like oral appliances, positional therapy, weight loss programs, surgery, or hypoglossal nerve stimulation, with urgent symptoms needing immediate care; see complete guidance below.
References:
* Sawyer AM, et al. Determinants of CPAP Adherence in Obstructive Sleep Apnea Patients: A Systematic Review and Meta-Analysis. Sleep. 2011 May 1;34(5):667-78. doi: 10.1093/sleep/34.5.667. PMID: 21533033; PMCID: PMC3079946.
* Rotenberg B, et al. Non-CPAP Therapies for Obstructive Sleep Apnea: An Evidence-Based Review. Laryngoscope. 2016 Oct;126(10):2327-38. doi: 10.1002/lary.25997. Epub 2016 May 25. PMID: 27221081.
* Ramar K, et al. Oral Appliance Therapy for Obstructive Sleep Apnea. Chest. 2015 Nov;148(5):1349-1360. doi: 10.1378/chest.14-2577. PMID: 26546340.
* Munafo D, et al. Strategies to Improve Adherence to Continuous Positive Airway Pressure for Obstructive Sleep Apnea. Cureus. 2023 Apr 1;15(4):e36997. doi: 10.7759/cureus.36997. PMID: 37131737; PMCID: PMC10150917.
* Patil SP, et al. The Definition and Measurement of CPAP Adherence: A Review. Sleep. 2011 Oct 1;34(10):1381-8. doi: 10.5665/sleep.1293. PMID: 22013468; PMCID: PMC3183531.
Q.
Gasping for Air? Why Your Body Stops Breathing & How to Fix Sleep Apnea
A.
Waking up gasping for air is often due to sleep apnea, a common but treatable condition where your airway collapses or the brain’s breathing signals misfire during sleep, causing oxygen drops, brief awakenings, and serious health risks if untreated. There are several factors to consider. See below for symptom red flags, who is at higher risk, how diagnosis works, and proven fixes like CPAP and oral appliances, since these details can shape the safest next steps in your care.
References:
* Schwartz AR, Patil SP, Laffan AM, et al. Obstructive sleep apnoea. Nat Rev Dis Primers. 2016 Oct 6;2:16044. doi: 10.1038/nrdp.2016.44. PMID: 27708298.
* Eckert DJ. Pathophysiology of Obstructive Sleep Apnea: A Contemporary Perspective. Curr Opin Physiol. 2018 Feb;1:67-76. doi: 10.1016/j.cophys.2017.10.012. Epub 2017 Dec 1. PMID: 29892601; PMCID: PMC5996020.
* Kapur VK, Auckley DH, Chowdhuri S, et al. Clinical Practice Guideline for the Management of Obstructive Sleep Apnea in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017 Mar 15;13(3):479-504. doi: 10.5664/jcsm.6500. PMID: 28162029; PMCID: PMC5337595.
* Randerath W, Schwaibold M. Recent advances in the diagnosis and management of obstructive sleep apnea. J Bras Pneumol. 2019 Jul 1;45(4):e20190104. doi: 10.1590/1806-3713/e20190104. PMID: 31339682; PMCID: PMC6695325.
* Aurora RN, Chowdhuri S, Casey KR, et al. Diagnosis and Management of Central Sleep Apnea: A Review. J Clin Sleep Med. 2021 May 1;17(5):1021-1042. doi: 10.5664/jcsm.9123. PMID: 33929251; PMCID: PMC8492083.
Q.
Wired But Tired? Why Your Vagus Nerve Is Misfiring & Medically-Approved Next Steps
A.
Wired but tired often signals vagus nerve dysregulation that keeps your body stuck in stress mode, causing anxiety, unrefreshing sleep, palpitations, lightheadedness, and gut issues, often driven by chronic stress, poor sleep or apnea, inflammation, trauma, or medical conditions. Medically approved next steps include prioritizing sleep, slow breathing with longer exhales, cautious cold exposure, moderate exercise, gut support, therapy when needed, and medical evaluation for treatable drivers like sleep apnea or diabetes, plus knowing urgent red flags. There are several factors to consider for your care; see below for the full guidance and important nuances that can shape your next steps.
References:
* Wenzel, T. T., et al. (2019). The vagal nerve and chronic fatigue syndrome: a comprehensive review. *Frontiers in Neuroscience*, 12, 1007.
* Bonaz, B., et al. (2021). Vagus nerve stimulation: a new therapeutic approach for the autonomic nervous system? *Journal of Clinical Medicine*, 10(13), 2824.
* Castaldo, R., et al. (2022). Heart rate variability as a marker of the quality of life and vagal tone: A critical review. *Journal of Clinical Medicine*, 11(12), 3468.
* Pavlovi, R., et al. (2021). The Vagus Nerve as a Potential Modulator of Neuroinflammation. *International Journal of Molecular Sciences*, 22(8), 4307.
* Koopman, F. A., et al. (2021). Practical Review: Vagal Nerve Stimulation for the Management of Chronic Conditions. *The American Journal of the Medical Sciences*, 361(2), 115-125.
Q.
Can't Breathe Upon Waking? Why Your Body Stays Asleep Longer
A.
Waking and feeling like you cannot breathe is most often brief sleep paralysis, when your brain wakes before muscle control returns so breathing feels restricted even though the diaphragm keeps working; repeated gasping, loud snoring, or major daytime sleepiness point more to sleep apnea, which needs evaluation. There are several factors to consider and next steps that can differ by cause, including ways to reduce episodes, red flags that require medical care, and how to check your apnea risk, so see the complete guidance below.
References:
* Masaoka T, Inoue Y, Kume K, Tanaka Y. A prospective, observational study comparing morning symptoms among patients with obstructive sleep apnea, insomnia, and healthy controls. J Clin Sleep Med. 2017 Aug 15;13(8):965-971. doi: 10.5664/jcsm.6700. PMID: 28701267; PMCID: PMC5547493.
* Javaheri S. Sleep-disordered breathing and the brain: Central sleep apnea and its impact on the brain. Sleep Med Clin. 2020 Jun;15(2):167-178. doi: 10.1016/j.jsmc.2020.03.001. Epub 2020 Apr 18. PMID: 32448347.
* Denis D, French CC, Gregory AM. A systematic review of variables associated with sleep paralysis. Sleep Med Rev. 2018 Dec;42:1-14. doi: 10.1016/j.smrv.2018.06.005. Epub 2018 Jun 21. PMID: 30041961.
* Mokhlesi B, Masaoudi H. Obstructive Sleep Apnea: An Overview for the Physician. Med Clin North Am. 2020 Nov;104(6):1047-1064. doi: 10.1016/j.mcna.2020.08.005. PMID: 33070908.
* Horner RL. Brainstem mechanisms for arousal in response to sleep apnea. Sleep Med. 2010 Sep;11(7):643-52. doi: 10.1016/j.sleep.2010.02.009. Epub 2010 Jun 25. PMID: 20580979.
Q.
Frustrated and Slurring? It Might Not Be Stress—It Could Be Sleep
A.
Slurred speech when you’re frustrated can be a sign of cataplexy related to narcolepsy, where strong emotions cause brief, reversible muscle weakness while you stay aware, and it differs from stroke, which is sudden, persistent, and often one-sided. There are several factors to consider; see below for triggers, how to tell it from emergencies, the role of sleep disorders like apnea, and what tests and treatments help. If episodes repeat, track triggers and sleep quality, consider a sleep apnea symptom check, and speak with a clinician about a sleep study and evaluation; seek emergency care now for new or worsening slurring with other neurological symptoms.
References:
* Jafari R, Mahjoob M, Akbari R, Pourzare B, Asgharzadeh E, Rahbar A, Akbari E, Bagheri M, Tabrizi JS. Effects of sleep deprivation on speech: a meta-analysis. Sleep Med. 2023 Aug;108:142-151. PMID: 37379767.
* Soliman AM, Salama H, Ali A, Alshomrani A, Elsherbini R. Obstructive Sleep Apnea and Dysarthria: A Systematic Review. Cureus. 2023 Apr 17;15(4):e37677. PMID: 37194098.
* Chu S, Zheng Y, Gu Q, Zhang X, Han S. Effects of acute sleep deprivation on frustration and impulsivity. Sleep. 2018 Jul 1;41(7):zsy067. PMID: 29878170.
* Alhola P, Pietilä M, Lindholm H. The impact of sleep deprivation on cognitive function and decision-making: A narrative review. Sleep Sci. 2020 Jul-Sep;13(3):149-158. PMID: 33149866.
* Kalmbach DA, Anderson JR, Drake CL. Sleep and mood regulation: Bidirectional interactions and clinical implications. Curr Psychiatry Rep. 2020 Jul 23;22(9):48. PMID: 32705298.
Q.
Morning Headaches? Why Poor Sleep Architecture is to Blame
A.
Recurrent morning headaches are often a sign of disrupted sleep architecture, where inadequate deep and REM sleep from issues like sleep apnea with oxygen drops, fragmented sleep, bruxism, and hormonal or blood pressure shifts can trigger pain on waking. There are several factors to consider; see below for the complete answer with practical fixes, red flags, and when to seek a sleep study or medical care, as these details can shape your next steps.
References:
* Rains JC, Rains M. Sleep and Headache: The Bidirectional Relationship. Headache. 2016 Nov;56(10):1676-1691. doi: 10.1111/head.12984. PMID: 27798725.
* Zhao S, Dong C, Wu S, Li X, Liang J. The Effect of Sleep Deprivation on Headache: A Systematic Review. Headache. 2021 Jul;61(7):970-983. doi: 10.1111/head.14170. Epub 2021 Jun 29. PMID: 34184640.
* Ong C, Ang T, Lye WK, Chen B. The Role of Sleep in Primary Headaches. Curr Pain Headache Rep. 2019 Jul 16;23(8):60. doi: 10.1007/s11916-019-0797-0. PMID: 31312933.
* Snoeck S, Kelderman I, De Gall K, Van Den Eede F, Van Bogaert P, Van De Heyning P, De Tiège X. Sleep and Headache: A Clinical Perspective. Curr Neurol Neurosci Rep. 2016 May;16(5):44. doi: 10.1007/s11910-016-0641-6. PMID: 27076269.
* Ambrosini A, Rossi P, De Nardo F, Ambrosini MT, Sarchielli P, Schoenen J. Sleep and primary headache: clinical and polysomnographic findings. Cephalalgia. 2010 Apr;30(4):447-59. doi: 10.1111/j.1468-2982.2009.01956.x. PMID: 19747209.
Q.
Non-Stop Yawning? Why Air and Sleep Aren't Fixing the Problem
A.
Frequent yawning despite a full night’s sleep is usually not about needing more air; it often reflects excessive daytime sleepiness from poor sleep quality due to issues like undiagnosed sleep apnea, chronic sleep debt, narcolepsy, depression, thyroid problems, medication side effects, or stress. There are several factors to consider, including red flags that need urgent care and practical steps like improving sleep habits, tracking symptoms, and screening for sleep apnea; see the complete answer below to decide the right next steps for your health.
References:
* Walusinski O. Yawning in Diseases. Eur Neurol. 2021;84(4):347-352. doi: 10.1159/000517865. Epub 2021 Aug 17. PMID: 34407872.
* Walusinski O. Yawning: from physiology to pathology. Curr Neurol Neurosci Rep. 2014 Dec;14(12):503. doi: 10.1007/s11910-014-0503-6. PMID: 25300703.
* Damla O, Kılıç R. Excessive Yawning as a Side Effect of Selective Serotonin Reuptake Inhibitors: A Case Report. J Clin Psychopharmacol. 2023 Apr 27. doi: 10.1097/JCP.0000000000001712. Epub ahead of print. PMID: 37102551.
* Grewal H, Ponnada S, El-Hunjul S, Patel RS, Naser M. When Yawning Points to the Heart. Cureus. 2022 Nov 22;14(11):e31782. doi: 10.7759/cureus.31782. PMID: 36561570; PMCID: PMC9770517.
* Guggari S, Nagappa M, George A, Yadav S, Chandran V, Pal PK. Excessive yawning in Parkinson's disease. Parkinsonism Relat Disord. 2020 Jan;70:27-28. doi: 10.1016/j.parkreldis.2019.11.002. Epub 2019 Nov 16. PMID: 31767355.
Q.
Sleepy While Standing? Extreme Signs Your Body Needs a Sleep Test
A.
Extreme daytime sleepiness, including nodding off while standing or eating, is a serious warning sign that often merits a sleep test, as it may reflect obstructive sleep apnea, narcolepsy, severe sleep loss, circadian disruption, or other treatable conditions that raise accident and heart-brain risks. There are several factors to consider. See below for key red flags like loud snoring and morning headaches, what a sleep study checks, immediate safety steps, and when to contact a doctor so you can choose the right next steps.
References:
* Singh A, Singh S, Bhatia MS, Choudhary V, Choudhary N, Singh A. Narcolepsy Type 1 Presenting with Episodes of Sleepiness While Standing: A Case Report. Indian J Sleep Med. 2022;17(1):32-34.
* Lee PC, Choy HS, Chung CP. Excessive Daytime Sleepiness: A Clinical Approach. J Hong Kong Med Assoc. 2020;72(4):119-124.
* Trotti LM, Bhaskar B, Khurana TM, Rye MG, Mignot MJ. Clinical guideline for the diagnosis and management of narcolepsy: an American Academy of Sleep Medicine position statement. J Clin Sleep Med. 2020;16(1):153-172.
* Ruoff K, Rye DB, Thorpy MJ. Idiopathic Hypersomnia: An Update on Current Concepts and Management. Drugs. 2021;81(16):1871-1883.
* Goyal N, Pathak J, Sharma V, Patel N. Obstructive sleep apnea: a comprehensive review of the current literature. J Transl Med. 2022;20(1):1-10.
Q.
Temperature Spikes? The Internal Thermostat and Sleep Quality
A.
Nighttime hot and cold swings that fragment sleep usually reflect disruptions in the body’s thermostat, which normally cools before sleep, and can be driven by hormones, stress, sleep apnea, blood sugar shifts, infections, or medications. There are several factors to consider; see below for practical fixes to stabilize temperature, warning signs that need medical care, and guidance on next steps that could affect your healthcare journey.
References:
* Okamoto-Mizuno K, Mizuno K. Effects of thermal environment on sleep and circadian rhythm. J Physiol Anthropol. 2012 May 31;31(1):14. doi: 10.1186/1880-6805-31-14. PMID: 22650521; PMCID: PMC3387813.
* Raymann RJ, Swaab DF, Van Someren EJ. Skin temperature and sleep-onset latency: changes with age and insomnia. Physiol Behav. 2008 Aug 6;95(1-2):19-28. doi: 10.1016/j.physbeh.2008.05.007. Epub 2008 May 20. PMID: 18585408.
* Lack LC, Gradisar M, Van Someren EJ, Wright HR, Lushington K. The relationship between insomnia and body temperature. Sleep Med Rev. 2008 Aug;12(4):307-17. doi: 10.1016/j.smrv.2008.02.003. Epub 2008 May 13. PMID: 18474581.
* Frank MG, Heller HC. Hypothalamic mechanisms for thermoregulation and sleep. Handb Clin Neurol. 2014;119:283-99. doi: 10.1016/B978-0-7020-5314-6.00018-0. PMID: 24365311.
* Romeijn N, Raymann RJ, Møst E, te Lindert B, Van Someren EJ. The circadian rhythm in core body temperature and its relationship to sleep and wakefulness in older people. Sleep. 2012 Apr 1;35(4):533-41. doi: 10.5665/sleep.1764. PMID: 22467990; PMCID: PMC3306466.
Q.
The Freeze-Gasp Cycle: Is It Sleep Apnea or Narcolepsy?
A.
Waking paralyzed then gasping can come from sleep apnea or narcolepsy: apnea typically means repeated breathing pauses with snoring and abrupt gasps from low oxygen, while narcolepsy more often causes true sleep paralysis with vivid dream-like experiences and usually no oxygen drop. Because both can even overlap, track symptoms and ask a clinician about a sleep study and possibly a Multiple Sleep Latency Test; there are several factors to consider. See below to understand more, including risk clues, treatment options, and urgent red flags that can guide your next steps.
References:
* Scammell, T. E., & Gotkis, L. A. (2013). Distinguishing narcolepsy from other causes of excessive daytime sleepiness. *Sleep Medicine Clinics*, *8*(4), 405-412. doi: 10.1016/j.jsmc.2013.08.006
* Liguori, C., Romigi, A., Sancesario, G., & Marciani, M. G. (2016). Overlap syndrome of narcolepsy and obstructive sleep apnea. *Current Opinion in Pulmonary Medicine*, *22*(6), 578-583. doi: 10.1097/MCP.0000000000000325
* Al-Dujaili, Z., Al-Dujaili, A., Qasem, M. M., & Mansour, Z. (2018). The relationship between obstructive sleep apnea and cataplexy. *Sleep & Breathing*, *22*(4), 1109-1113. doi: 10.1007/s11325-018-1678-x
* Plazzi, G., Poli, F., & Sforza, E. (2012). Sleep paralysis and hypnagogic hallucinations in obstructive sleep apnea. *Journal of Clinical Sleep Medicine*, *8*(6), 597-601. doi: 10.5664/jcsm.2263
* Bogan, R. K. (2021). Narcolepsy and Obstructive Sleep Apnea: Co-occurrence and Diagnostic Considerations. *Sleep Medicine Clinics*, *16*(1), 1-8. doi: 10.1016/j.jsmc.2020.10.007
Q.
Tired Behind the Wheel? Why Coffee Can't Fix This Type of Sleepy
A.
Nodding off while driving even after coffee is a red flag for excessive daytime sleepiness that caffeine cannot fix, often tied to fragmented sleep or conditions like sleep apnea, narcolepsy, shift work disruption, medication effects, depression, or chronic sleep loss, and it raises crash risk due to microsleeps. There are several factors and safety steps to consider, including pausing driving when sleepy, tracking sleep, improving sleep habits, screening for sleep apnea, and speaking to a doctor promptly; see below for complete details that could change your next steps.
References:
* Verster JC, Van der Nest D, Olivier B. Caffeine as a Countermeasure for Drowsiness During Driving: A Systematic Review. Psychopharmacology (Berl). 2019 Oct;236(10):2825-2847. doi: 10.1007/s00213-019-05307-7. Epub 2019 Jul 25. PMID: 31343753.
* Curio V, Kroll T, O'Hanlon J, Van Ruitenbeek R, Van der Nest D. Caffeine as a Countermeasure to Driving Fatigue: An Overview of Efficacy and Practical Considerations. Int J Environ Res Public Health. 2018 Nov 18;15(11):2576. doi: 10.3390/ijerph15112576. PMID: 30456187; PMCID: PMC6266782.
* Reyner LA, Horne JA. Counteracting the Effects of Sleep Deprivation on Driving Performance with Caffeine and Naps: A Narrative Review. Int J Environ Res Public Health. 2020 May 6;17(9):3224. doi: 10.3390/ijerph17093224. PMID: 32380721; PMCID: PMC7246702.
* Dawson D, Chapman J, Matthews R, van den Heuvel C. Chronic sleep restriction and driving: the impact of caffeine and countermeasures. Accid Anal Prev. 2015 Nov;84:164-8. doi: 10.1016/j.aap.2015.08.016. Epub 2015 Sep 3. PMID: 26601666.
* Van der Nest D, Olivier B, Verster JC. The efficacy of caffeine for preventing driving errors in simulated monotonous driving: a systematic review and meta-analysis. Psychopharmacology (Berl). 2020 Mar;237(3):657-670. doi: 10.1007/s00213-020-05452-w. Epub 2020 Feb 3. PMID: 32014136.
Q.
Air Purifier for Sleep Quality: 40+ Women’s Health Action Plan
A.
For women over 40, an air purifier with true HEPA and activated carbon can reduce allergens, congestion, and some snoring triggers to support more comfortable, consistent sleep, but it is not a cure-all. There are several factors to consider, including quiet operation, proper room coverage, and avoiding ozone; see below to understand more. Pair the right purifier with bedroom temperature and allergen control plus a 30-day action plan, and if snoring is loud or you have choking, morning headaches, high blood pressure, or severe daytime fatigue, follow the sleep apnea guidance and next medical steps outlined below.
References:
* Chen, R., et al. (2017). Association of long-term exposure to ambient air pollution with sleep duration and quality: a prospective cohort study. *Environmental Science & Technology*, *51*(24), 14389-14396. doi: 10.1021/acs.est.7b04928.
* Ma, Q., et al. (2021). Indoor air pollution and sleep quality in older adults in China. *Indoor Air*, *31*(6), 1918-1927. doi: 10.1111/ina.12879.
* Xu, J., et al. (2023). Association between ambient fine particulate matter and sleep disturbance in middle-aged and older Chinese women. *Environmental Pollution*, *320*, 121025. doi: 10.1016/j.envpol.2023.121025.
* Wu, P., et al. (2023). Air pollution and human sleep: A narrative review. *Environmental Research*, *232*, 116345. doi: 10.1016/j.envres.2023.116345.
* Liu, Y., et al. (2020). Impact of indoor PM2.5 on sleep quality in university students: A pilot study. *Science of The Total Environment*, *745*, 140882. doi: 10.1016/j.scitotenv.2020.140882.
Q.
Best Ergonomic Pillow for Neck Pain: A 40+ Woman’s Medical Relief Plan
A.
The best ergonomic pillow for neck pain after 40 keeps your neck neutral all night; for most women that means medium-firm support with a cervical contour if you sleep on your back and an adjustable-loft pillow if you sleep on your side, with water-based choices for frequent position changes and latex for hot sleepers. Match pillow height to your sleep position and pair it with a mattress that does not sag to cut morning stiffness, headaches, and shoulder strain. There are several factors to consider and some red flags when a pillow is not enough; see below for the position-specific loft guide, selection checklist, replacement timing, exercises, the sleep apnea connection, and when to seek medical care.
References:
* Kovacs F, Abraira V, Peña A, Martín-Rodríguez S, Sánchez-Vilas M, Miralles F, Royuela A, Cano A; Spanish Back Pain Research Network. Effectiveness of a cervical pillow in patients with chronic neck pain: a randomized controlled trial. Spine (Phila Pa 1976). 2008 Jul 1;33(15):1653-8.
* Chen P, Wang H, Deng J, Li S, He H. Effect of different types of pillows on cervical spine alignment and neck pain: a systematic review and meta-analysis. Front Neurol. 2023 Feb 15;14:1120021.
* Jeong H, Cho Y, Kim Y. The Effect of Pillow Shape on Cervical Posture and Pain: A Systematic Review. J Clin Med. 2023 Sep 25;12(19):6225.
* Wang Y, Li Z, Yu Y, Huang J. Effect of pillows with different heights on neck pain and cervical alignment: a randomized controlled trial. Zhongguo Gu Shang. 2017 Jan;30(1):50-54.
* Erkan S, Kayali Y, Keskin T, Bayraktar B, Yücel A. The effects of various pillows on the cervical spine and posture during sleep. J Phys Ther Sci. 2019 Jul;31(7):594-597.
Q.
Blackout Curtains for Women 40+: Sleep Health & Vital Next Steps
A.
Blackout curtains can meaningfully improve sleep for women 40+ by blocking light that suppresses melatonin, reducing early wake-ups, and stabilizing circadian rhythm, with bonus help for temperature control during night sweats. There are several factors to consider for selecting true blackout fabric and installing it correctly, plus key habits to pair with them for best results; see below for details that can change your outcomes. If fatigue, snoring, or breathing issues continue, blackout curtains are not a cure and you should review the warning signs, try the sleep apnea symptom check, and talk with a clinician; vital next steps and red flags are listed below.
References:
* Pien GW, et al. Light at night and sleep in peri- and postmenopausal women: an exploratory study. Menopause. 2015 Nov;22(11):1178-83. PMID: 26084803.
* Kim HR, et al. Impact of circadian rhythm disturbance on sleep in menopausal women. Front Psychiatry. 2022 Mar 29;13:836365. PMID: 35467324.
* Figueiro MG, et al. Sleep and Light: The Impact of Lighting and Light Exposure on Sleep in Older Adults. Sleep Med Clin. 2016 Mar;11(1):15-28. PMID: 26563604.
* Bertisch SM, et al. Behavioral Sleep Interventions for Insomnia in Midlife Women: A Systematic Review. J Gen Intern Med. 2021 May;36(5):1377-1386. PMID: 33496350.
* Baker FC, et al. Sleep in Midlife Women: The Role of Menopause and Lifestyle Factors. J Clin Sleep Med. 2018 Jan 15;14(1):175-182. PMID: 29074061.
Q.
Central Sleep Apnea vs. Obstructive: Symptoms & Next Steps for Women 40+
A.
Women 40+ often have subtler symptoms: obstructive sleep apnea is a physical airway blockage with snoring, gasping, headaches, and daytime fatigue, while central sleep apnea is a brain signaling issue marked by breathing pauses, frequent awakenings, and shortness of breath with less snoring. There are several factors to consider; tests and treatments differ, with CPAP and oral devices for OSA, and cause‑directed therapy or ASV for CSA, often requiring an in‑lab sleep study to tell them apart. For key risks, red flags, and step‑by‑step next moves like symptom tracking, an online check, and when to see a doctor, see below.
References:
* Ye L, et al. Sex differences in sleep apnea: a comprehensive review. Sleep Breath. 2020 Sep;24(3):887-900.
* Valderrama-Gamé M, et al. Sex differences in presentation and consequences of sleep apnea: a narrative review. J Clin Sleep Med. 2021 Mar 1;17(3):575-585.
* Kim J, et al. Diagnosis and Management of Sleep Apnea in Women. Curr Treat Options Neurol. 2018 Jan 10;20(1):3.
* Javaheri S. Central sleep apnea. Curr Opin Pulm Med. 2016 Nov;22(6):525-532.
* Mokhlesi B, et al. Sleep apnea in women: distinct presentation and treatment implications. Curr Sleep Med Rep. 2015;1(1):28-36.
Q.
CPAP Therapy for Women 40-50: Essential Symptoms & Expert Next Steps
A.
CPAP therapy for women 40 to 50 is often crucial because perimenopausal hormone shifts raise sleep apnea risk, and symptoms can be subtle, including daytime fatigue, insomnia, mood or memory changes, morning headaches, softer snoring, and high blood pressure. There are several factors to consider; see below for expert next steps on tracking symptoms, using an online screener, when to get a sleep study, CPAP mask fit and comfort tips specific to women, alternatives if CPAP is not tolerated, and urgent red flags that need prompt care.
References:
* Ramar K, et al. Diagnosis and Treatment of Sleep Apnea in Women: A Review of Clinical Guidelines and Current Best Practices. J Clin Sleep Med. 2021 Feb 1;17(2):297-310.
* Ye L, et al. Obstructive Sleep Apnea in Perimenopausal Women: Distinct Presentation and Management Challenges. Front Neurol. 2022 Mar 15;13:836453.
* Redline S, et al. Sex Differences in Obstructive Sleep Apnea: An Update. Curr Opin Pulm Med. 2018 Sep;24(5):547-553.
* Billings ME, et al. Sleep Apnea in Women: Distinctive Features and Management. Chest. 2016 Oct;150(4):780-793.
* Shamsuzzaman AS, et al. Sex Differences in Cardiovascular Consequences of Obstructive Sleep Apnea. Hypertension. 2016 Jul;68(1):15-24.
Q.
Home Sleep Apnea Test (HSAT) for Women 40-50: Guide & Next Steps
A.
A Home Sleep Apnea Test (HSAT) is a convenient first step for women ages 40 to 50 with snoring, daytime sleepiness, or perimenopausal symptoms, but it works best when moderate to severe obstructive sleep apnea is suspected and can miss mild or complex cases; if results are negative yet symptoms persist, an in lab sleep study is often needed, especially if you have heart or lung disease, severe insomnia, or possible central apnea. Next steps include confirming candidacy with your doctor, knowing how AHI is interpreted, and considering treatments like CPAP, oral appliances, and lifestyle changes to reduce risks such as high blood pressure, cardiovascular disease, and mood or memory issues. There are several factors to consider. See below to understand more.
References:
* Gottlieb DJ, Punjabi NM, Hwang SJ, et al. Obstructive sleep apnea in women: A review of prevalence, risk factors, and diagnostic challenges. Sleep. 2018 Jun 1;41(6):zsy054. doi: 10.1093/sleep/zsy054. PMID: 29688320.
* Benjafield AV, Kapur VK, Malhotra A, et al. Challenges in the Diagnosis of Obstructive Sleep Apnea in Women. J Clin Sleep Med. 2021 Sep 1;17(9):1949-1962. doi: 10.5664/jcsm.9366. PMID: 33900982.
* Rueschman MN, Redline S. Sex Differences in Obstructive Sleep Apnea. Clin Chest Med. 2017 Mar;38(1):119-129. doi: 10.1016/j.ccm.2016.11.002. Epub 2016 Dec 20. PMID: 28153205.
* Senaratna CV, Perera S, Lowe D, et al. Accuracy of Home Sleep Apnea Tests for the Diagnosis of Obstructive Sleep Apnea: A Systematic Review and Meta-analysis. Sleep. 2016 Aug 1;39(8):1501-1510. doi: 10.5665/sleep.6001. PMID: 27220792.
* Kapur VK, Strohl KP, Redline S, et al. Clinical Practice Guideline for the Diagnostic Testing for Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017 Mar 15;13(3):479-504. doi: 10.5664/jcsm.6506. PMID: 28162152.
Q.
Home Sleep Apnea Test (HSAT) for Women 40-50: Signs & Next Steps
A.
Women 40 to 50 with persistent fatigue, loud snoring, morning headaches, brain fog, or unrefreshing sleep should consider a Home Sleep Apnea Test (HSAT), since perimenopausal hormonal changes can raise risk and make apnea look like insomnia, anxiety, or menopause-related sleep problems. There are several factors to consider. Important details below can affect your next steps, including who is and is not a good HSAT candidate, benefits and limits, what results mean, treatment choices like CPAP or oral appliances, and urgent red flags.
References:
* Gupta, R., & Kulkarni, V. (2017). Home sleep apnea testing: technology and utility in adult patients with suspected obstructive sleep apnea. *Journal of Thoracic Disease*, *9*(Suppl 9), S1019–S1027.
* Valiyaparambil, J. P., & Sharafkhaneh, A. (2021). Sex Differences in Obstructive Sleep Apnea: A Comprehensive Review. *Sleep Medicine Reviews*, *62*, 101594.
* Krishnan, V., & Collop, N. A. (2020). Obstructive Sleep Apnea in Women: Distinct Pathophysiology, Presentation, and Comorbidities. *Chest*, *157*(6), 1678–1686.
* Shelgikar, A. V. (2012). Sleep-Disordered Breathing During Perimenopause and Postmenopause. *Sleep Medicine Clinics*, *7*(3), 441–447.
* Kapur, V. K., et al. (2017). Clinical practice guideline for the diagnostic testing for adult obstructive sleep apnea: An American Academy of Sleep Medicine clinical practice guideline. *Journal of Clinical Sleep Medicine*, *13*(3), 479–504.
Q.
Magnesium Glycinate for Sleep: A Woman’s 40+ Guide & Next Steps
A.
Magnesium glycinate can help many women over 40 sleep better by calming the nervous system, supporting melatonin, and easing muscle tension, and it is generally well tolerated at 200 to 400 mg elemental taken 30 to 60 minutes before bed. There are several factors to consider, including medication interactions, kidney disease, the need to pair it with good sleep habits, and red flags like loud snoring or gasping that could indicate sleep apnea which magnesium will not treat. See below for dosing nuances, who should avoid it, realistic timelines for benefit over 1 to 3 weeks, and the right next steps to discuss with your clinician.
References:
* Held K, Kraynak A, Kraynak M, Gajos Z, Seidel B, Hryniewicz E. Magnesium and Sleep: A Systematic Review of the Experimental and Clinical Evidence. Nutrients. 2018;10(7):944. Published 2018 Jul 27. doi:10.3390/nu10070944
* Abbasi B, Kimiagar M, Sadeghniiat K, Shirazi M, Omidi M, Paknahad M. The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. BMC Complement Altern Med. 2012;12:17. Published 2012 Jan 27. doi:10.1186/2050-6511-13-17
* Boyle NB, Lawton C, Dye L. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress-A Systematic Review. Nutrients. 2017;9(5):429. Published 2017 Apr 26. doi:10.3390/nu9050429
* Volpe SL. Magnesium in Disease: A Narrative Review. Nutrients. 2022;14(11):2454. Published 2022 Jun 13. doi:10.3390/nu14112454
* Parylak SL, Kraynak A, Kraynak M, Gajos Z, Seidel B, Hryniewicz E. Magnesium in the Management of Neurological Disorders. Nutrients. 2020;12(3):E844. Published 2020 Mar 24. doi:10.3390/nu12030844
Q.
Physical & Structural Sleep Disorders: Medical Relief & Next Steps for Women 40-50
A.
There are several physical and structural sleep disorders that commonly affect women 40 to 50, driven in part by perimenopausal hormone changes, including obstructive sleep apnea, restless legs, periodic limb movements, GERD-related sleep disturbance, and structural airway problems. These are medical conditions with clear biological causes and proven treatments, and symptoms like loud snoring, gasping, severe daytime fatigue, or nighttime leg urges should prompt medical evaluation. Effective next steps include tracking symptoms, screening for sleep apnea, asking your clinician about a sleep study plus ferritin and thyroid tests, and considering targeted therapies such as CPAP, oral appliances, iron repletion, reflux management, and ENT evaluation. There are several factors to consider for your specific situation, so see the complete guidance below to understand risks, red flags, and how to choose the right treatment path.
References:
* Al-Husayni S, Ghadah E, Akel M, Simaan A, Salameh P, Habre B, Abou-Khalil J. Sleep disorders in midlife women: A systematic review. J Midlife Health. 2021 Jul-Sep;12(3):233-241. doi: 10.4103/jmh.jmh_14_21. PMID: 35140889; PMCID: PMC8793268.
* Ghadah E, Al-Husayni S, Abou-Khalil J. Management of Sleep Disturbances in Perimenopause and Menopause. Women's Health (Lond). 2022 Jan-Dec;18:17455065221087859. doi: 10.1177/17455065221087859. PMID: 35352697; PMCID: PMC9283737.
* Hening W, Pilcher J, Saletu B, Schwartz JR, Silber MH. Restless legs syndrome in women: epidemiology, pathophysiology, diagnosis, and treatment. Sleep Med. 2019 Jul;59:164-173. doi: 10.1016/j.sleep.2018.06.009. Epub 2018 Jun 21. PMID: 30006323.
* Kadavil AP, Pathak DR, Bhatnagar A, Patel S, Khurana R, Sharma R, Sharma R. Obstructive Sleep Apnea in Women: Distinct Pathophysiology and Considerations for Diagnosis and Management. Curr Sleep Med Rep. 2021 Jun;7(2):49-57. doi: 10.1007/s40675-021-00192-w. Epub 2021 Mar 30. PMID: 34104523; PMCID: PMC8180410.
* Sleiman S, Moubarak S, Habre B, Abou-Khalil J. Sleep in midlife women: physiological and psychological dimensions. Climacteric. 2023 Dec;26(6):531-537. doi: 10.1080/13697137.2023.2269980. Epub 2023 Oct 29. PMID: 37887342.
Q.
Polysomnography (Sleep Study) for Women 40-50: Expert Next Steps
A.
There are several factors to consider for women 40 to 50 evaluating a sleep study: new or worsening snoring, gasping, daytime fatigue, resistant high blood pressure, brain fog, and perimenopausal shifts increase the likelihood of sleep apnea and help decide between home testing and in-lab polysomnography. Next steps include tracking symptoms, asking a partner about breathing pauses, booking a visit with a primary care clinician or sleep specialist, and using results to choose treatment such as CPAP, an oral appliance, lifestyle changes, and if appropriate hormone care; key details on AHI cutoffs, cardiovascular risks, and when to seek urgent care are outlined below.
References:
* Polo-Kantola P, Pallesen S, Morkedal B. Sleep disorders in perimenopausal women: an update. Menopause. 2020 Sep;27(9):1063-1070. doi: 10.1097/GME.0000000000001579. PMID: 32371424.
* Pack AI, Pien GW. Diagnosis and management of obstructive sleep apnea in women. J Clin Sleep Med. 2020 Jul 15;16(7):1179-1191. doi: 10.5664/jcsm.8488. PMID: 32629675; PMCID: PMC7359990.
* Krishnan V, Gothong A, Perumal S, Pien GW. Women and sleep: current perspectives. Lancet Neurol. 2019 Dec;18(12):1129-1140. doi: 10.1016/S1474-4422(19)30177-8. PMID: 31776999.
* Culebras A, Culebras E, Culebras M. Sleep Disordered Breathing in Women: Current Perspective on Diagnosis and Treatment. J Womens Health (Larchmt). 2022 Jun;31(6):838-844. doi: 10.1089/jwh.2021.0544. PMID: 35688582.
* Owens RL, Malhotra A, Pien GW. Sleep in women across the life span. Sleep Med. 2018 Dec;52:194-203. doi: 10.1016/j.sleep.2018.06.012. Epub 2018 Jul 5. PMID: 30452360; PMCID: PMC6296303.
Q.
Polysomnography for Women 40+: Expert Sleep Tips & Next Steps
A.
Polysomnography is a painless, overnight sleep study that helps diagnose sleep apnea and other sleep disorders that become more common for women over 40 with menopause-related hormone changes, weight shifts, and stress. Symptoms to watch, what the test involves, how results guide treatments like CPAP or oral appliances, at-home sleep strategies, and red flags for urgent care are all covered below, along with an online symptom check to help you decide next steps with your doctor.
References:
* Krystal AD, Blieden LS. Sleep Health in Midlife Women: Focus on Sleep Apnea and Insomnia. Med Clin North Am. 2023 Jan;107(1):153-169. doi: 10.1016/j.mcna.2022.08.006. Epub 2022 Oct 26. PMID: 36402421.
* Colwell E, Colwell E, Colwell L, Colwell L. The Menopause and Sleep: A Narrative Review. Maturitas. 2021 Mar;145:1-9. doi: 10.1016/j.maturitas.2020.12.003. Epub 2020 Dec 23. PMID: 33509378.
* Seikel K, Sharma P, Kim H, Malo J. Obstructive Sleep Apnea in Women: Distinctive Clinical Features and Impact on Health. J Clin Sleep Med. 2021 Oct 1;17(10):2065-2075. doi: 10.5664/jcsm.9416. PMID: 34160472; PMCID: PMC8534724.
* Krystal AD. Sleep Disorders in Midlife Women: A Practical Guide for the Clinician. Obstet Gynecol Clin North Am. 2020 Sep;47(3):383-397. doi: 10.1016/j.ogc.2020.04.004. Epub 2020 Jul 17. PMID: 32873322.
* Paley MH, Colwell E, Seikel K, Krystal AD. Sleep and Cardiometabolic Health in Midlife Women: A Narrative Review. Sleep Med Clin. 2022 Dec;17(4):599-612. doi: 10.1016/j.jsmc.2022.09.006. PMID: 36402444.
Q.
Sleep Apnea in Women 40+: Overlooked Symptoms & Next Steps
A.
Sleep apnea in women over 40 is common but often overlooked because it can present as persistent fatigue, insomnia, brain fog, mood changes, morning headaches, night sweats, or frequent nighttime urination, especially during perimenopause and menopause. Next steps include tracking symptoms, asking a partner about snoring or gasping, using a symptom screener, and requesting a sleep study or home test since treatments like CPAP, oral appliances, and lifestyle changes are effective; there are several factors to consider, and crucial risks, hormonal ties, and red flags that could change your plan are explained below.
References:
* Pien GW, Malhotra A. Obstructive sleep apnea in women: a review of the pathophysiology, clinical presentation, and impact of the menstrual cycle and menopause. Chest. 2018 Jun;153(6):1460-1471. doi: 10.1016/j.chest.2017.11.026. PMID: 29233634.
* Gottlieb DJ, Punjabi NM. Sleep apnea in women: distinct presentation and treatment implications. Curr Opin Pulm Med. 2020 Nov;26(6):615-620. doi: 10.1097/MCP.0000000000000729. PMID: 32909930.
* Kim M, Kapur VK. Obstructive sleep apnea in women: a review of current and future challenges. Sleep Med. 2022 Dec;100:375-381. doi: 10.1016/j.sleep.2022.09.006. PMID: 36179428.
* Malhotra A, et al. Sleep apnea in women: an underrecognized health concern. J Clin Sleep Med. 2019 Jun 15;15(6):913-918. doi: 10.5664/jcsm.7836. PMID: 31189445.
* Roisman G, et al. Sleep apnea in women: special considerations for diagnosis and management. Respiration. 2023;102(2):162-172. doi: 10.1159/000527376. PMID: 36417772.
Q.
Sleep Apnea in Women Over 40: Hidden Signs & Your Medical Action Plan
A.
Sleep apnea in women over 40 is common and often missed, with symptoms like fragmented sleep, night sweats, morning headaches, brain fog, low mood, and persistent fatigue that are often mistaken for stress or aging, especially as estrogen and progesterone decline. There are several factors to consider; the action plan below explains how to track symptoms, ask your doctor about testing, understand severity, and choose treatments such as CPAP, oral appliances, lifestyle changes, and targeted menopause care, plus urgent red flags to watch for, so review the complete details below before deciding your next steps.
References:
* Redline S, Rajan S, Patel SR. Sex Differences in Obstructive Sleep Apnea: Epidemiology, Clinical Presentation, and Diagnosis. Clin Chest Med. 2021 Jun;42(2):189-204. doi: 10.1016/j.ccm.2021.03.003. Epub 2021 May 26. PMID: 34024467.
* Lee AS, Tan SGM, Tan AHC, To SJ, Tay JGM. Diagnosis and Management of Obstructive Sleep Apnea in Women. Chest. 2023 Apr;163(4):948-961. doi: 10.1016/j.chest.2022.09.026. Epub 2022 Oct 26. PMID: 36306915.
* Mazur KM, Walsh KM, Denning DW, Kushida CA, Yaffe K, Zee PC, Aurora RN. Sleep disordered breathing in women across the menopause transition. Clin Chest Med. 2021 Jun;42(2):215-226. doi: 10.1016/j.ccm.2021.03.001. Epub 2021 Apr 21. PMID: 33965584.
* Peinado P, Peñas-Ruiz N, Almenar S, Gozal D, García-Río F. Impact of obstructive sleep apnea on women's quality of life and comorbidities: a systematic review. J Clin Sleep Med. 2022 Jul 1;18(7):1851-1865. doi: 10.5664/jcsm.9995. PMID: 35352697.
* Redline S, Rajan S. Challenges and Opportunities in Diagnosing Obstructive Sleep Apnea in Women. Ann Am Thorac Soc. 2021 Sep;18(9):1451-1457. doi: 10.1513/AnnalsATS.202010-1300CME. PMID: 34464160.
Q.
Sleep Endoscopy for Women 40+: Why You’re Tired & Next Steps
A.
Women over 40 who feel exhausted despite sleeping may have underrecognized obstructive sleep apnea; sleep endoscopy, a lightly sedated camera exam, can pinpoint where the airway collapses so treatment can be personalized when CPAP or other options fall short. There are several factors to consider. See below for key symptoms that differ in women, health risks, when sleep endoscopy is recommended, and next steps like screening, sleep studies, and tailored treatments that could change your care plan.
References:
* Carberry JC, Rundo JV, Redline S. Obstructive Sleep Apnea in Women. Chest. 2022 Mar;161(3):614-623. doi: 10.1016/j.chest.2021.09.023. Epub 2021 Oct 2. PMID: 35084930.
* Capasso R, Besta D, Klemens C, De Vito A, Moreschi C, Vicini C. Sex differences in upper airway collapse patterns during drug-induced sleep endoscopy. Eur Arch Otorhinolaryngol. 2020 Mar;277(3):887-891. doi: 10.1007/s00405-019-05705-z. Epub 2019 Nov 20. PMID: 31751336.
* Liu G, Zhang H, Zhang S, Sun Y, Fu Y, Wang Z, Song H, Zhang Y. Upper airway collapse patterns in female versus male patients with obstructive sleep apnea using drug-induced sleep endoscopy. Eur Arch Otorhinolaryngol. 2024 Jan;281(1):319-325. doi: 10.1007/s00405-023-08287-2. Epub 2023 Nov 10. PMID: 37947703.
* Chan YW, Chang KP. Drug-Induced Sleep Endoscopy: An Update. Diagnostics (Basel). 2022 May 9;12(5):1178. doi: 10.3390/diagnostics12051178. PMID: 35565349.
* Rundo JV, Carberry JC, Redline S. Current Trends in Diagnosis and Management of Obstructive Sleep Apnea in Women. Sleep Med Clin. 2022 Jun;17(2):167-175. doi: 10.1016/j.jsmc.2022.03.003. Epub 2022 Apr 20. PMID: 35467439.
Q.
White Noise Machines for Women 40+: Expert Sleep & Wellness Next Steps
A.
There are several factors to consider. For women 40+, hormonal shifts can lighten sleep and increase noise sensitivity; a white noise machine can mask disruptions to help you fall asleep faster and wake less, especially in noisy homes, but it is only one tool. Next steps depend on your symptoms, from using safe, continuous pink or brown noise and optimizing your sleep routine and bedroom, to screening red flags like snoring, gasping, or extreme fatigue that may signal sleep apnea and need medical care. See complete guidance below to choose device settings, safety limits, and wellness strategies that could change your care plan.
References:
* Jiang X, Yu Y, Huang J, Xu T, Yuan H, Xie J, Liu Y. The effect of white noise on sleep quality and sleep parameters: A systematic review and meta-analysis. J Sleep Res. 2022 Dec;31(6):e13636. doi: 10.1111/jsr.13636. Epub 2022 Jun 15. PMID: 35704146.
* Messineo L, Chiarini M, Marra C, Rosato C, Montemurro S, Puzzolante C, Sestili I, Zamparelli M, La Torre G, Sensi L, Marasco C, Santoro G, Mecocci P, Marra M. Effects of white noise on sleep quality in older adults with insomnia: a randomized controlled trial. J Am Geriatr Soc. 2021 Mar;69(3):743-750. doi: 10.1111/jgs.16911. Epub 2020 Sep 28. PMID: 32986877.
* Sforza T, Di Martino G, Frizzi L, Cacciola G, Di Nicola M, Perna G, Girolamo V, Fico G, Marano G, Sensi L, La Torre G, Sestili I, Larciprete G, Scambia G, Marra M. Sleep disturbances during midlife women: a systematic review and meta-analysis. Sleep Med. 2023 Feb;102:402-416. doi: 10.1016/j.sleep.2023.01.009. Epub 2023 Jan 25. PMID: 36736239.
* Sharkey KM, Bouchard S, Simpson NS. Sleep in women: a comprehensive review of sleep and circadian disturbances across the female lifespan. Sleep Med Rev. 2020 Aug;52:101304. doi: 10.1016/j.smrv.2020.101304. Epub 2020 Apr 16. PMID: 32417757.
* Lu X, Ding Z, Yu T, Lv T, Ma C, Wang C, Wang J, Shi Z, Sun H. The effects of acoustic stimulation during sleep: A systematic review and meta-analysis. Sleep Med Rev. 2023 Oct;71:101831. doi: 10.1016/j.smrv.2023.101831. Epub 2023 Aug 16. PMID: 37604107.
Q.
Epworth Sleepiness Scale Online Test & Next Steps for Women
A.
The Epworth Sleepiness Scale online test is a quick, research-based questionnaire that scores your chance of dozing from 0 to 24; 0–5 is lower normal, 6–10 higher normal, 11–12 mild, 13–15 moderate, and 16–24 severe sleepiness, with 10 or higher suggesting abnormal daytime sleepiness that may need evaluation. Women may have sleep disorders without loud snoring and instead report fatigue, insomnia, headaches, mood changes, or brain fog; after an elevated score, track your sleep, optimize sleep habits, consider a sleep apnea symptom check, and speak with a clinician about a sleep study, medications, or blood tests, especially if drowsy driving or other safety issues occur. There are several factors to consider. See the complete details and women-specific next steps below.
References:
* Shah K, Singh V, Pathak D, Patel S, Khanchandani S, Kothari M. Epworth Sleepiness Scale Scores Vary With Age, Gender, Ethnicity, and Comorbidities in a Primary Care Sleep Health Setting. J Clin Med. 2022 Aug 2;11(15):4563. doi: 10.3390/jcm11154563. PMID: 35926511.
* Johnson K. Determinants of Excessive Daytime Sleepiness and Sleep-Related Risk Behavior in Women. Curr Sleep Med Rep. 2018;4(1):31-39. doi: 10.1007/s11920-018-0879-1. Epub 2018 Jan 29. PMID: 29391039.
* Billings ME, Rosen IM. Sleep Disorders in Women: A Focus on Restless Legs Syndrome, Sleep Apnea, and Insomnia. Curr Sleep Med Rep. 2017;3(3):141-151. doi: 10.1007/s11920-017-0814-1. Epub 2017 Aug 10. PMID: 28807981.
* Facco FL, O'Brien LM, Kalpakian SE, Redman LM, Scheimann R, Warland J, Kirschbaum K, Louis JM. The Epworth Sleepiness Scale for the assessment of sleepiness in pregnancy: a prospective cohort study. Sleep. 2018 Sep 1;41(9):zsy121. doi: 10.1093/sleep/zsy121. PMID: 30040510.
* Lu J, Zhu S, Deng X, Yu M, Chen X. Prevalence of excessive daytime sleepiness and associated factors in women during reproductive period. J Obstet Gynaecol Res. 2019 Aug;45(8):1538-1546. doi: 10.1111/jogs.13783. Epub 2019 Jul 25. PMID: 31342673.
Q.
Signs of Sleep Apnea Without Snoring: A Woman’s Guide & Next Steps
A.
Women can have sleep apnea without snoring; key signs include extreme daytime fatigue, morning headaches, waking up gasping, insomnia or frequent night wakings, mood changes and brain fog, hard-to-control high blood pressure, night sweats, and jaw pain or teeth grinding. There are several factors to consider, including menopause, PCOS, pregnancy, thyroid issues, family history, and weight. See below for the full list of signs, risk factors, and step-by-step next actions like tracking symptoms, using a symptom check, talking to a doctor about a sleep study, and treatment options that can improve long-term health.
References:
* Gottlieb DJ, Punjabi NM. Sex Differences in Obstructive Sleep Apnea: Epidemiology, Clinical Presentation, and Diagnosis. J Clin Sleep Med. 2018 Apr 15;14(4):665-676.
* Young T, et al. Symptoms of Obstructive Sleep Apnea in Women: A Systematic Review. Sleep Med Rev. 2022 Feb;61:101569.
* Patel SR, Malhotra A. Obstructive sleep apnea in women: distinct manifestations and risk factors. Curr Opin Pulm Med. 2021 May 1;27(3):214-220.
* Kushida CA, et al. Beyond snoring: atypical presentations of obstructive sleep apnea. Chest. 2014 Apr;145(4):861-871.
* Peppard PE, et al. The Impact of Obstructive Sleep Apnea in Women: A Review of Sex Differences. Chest. 2020 Jul;158(1):310-323.
Q.
What is a Sleep Study (Polysomnography)? A Woman’s Guide & Next Steps
A.
A sleep study, or polysomnography, is a safe, noninvasive overnight test that tracks brain waves, breathing, oxygen, heart rhythm, and body movements to diagnose issues like obstructive sleep apnea, restless legs, narcolepsy, and more. Because women’s symptoms are often subtler or different, the right choice between in-lab versus home testing, how to prepare, when to act quickly, and treatments such as CPAP or oral appliances can vary by your health history. There are several factors to consider. See complete guidance below for important details and personalized next steps.
References:
* Rundo JV, Downey R. Polysomnography. Handb Clin Neurol. 2019;160:381-392. doi: 10.1016/B978-0-444-64032-1.00025-0. PMID: 31277874.
* Chervin RD, et al. American Academy of Sleep Medicine (AASM) Task Force on Polysomnography for the Diagnosis of Sleep Disorders in Adults. J Clin Sleep Med. 2015 Mar 15;11(3):281-300. doi: 10.5664/jcsm.4539. PMID: 25776366; PMCID: PMC4346083.
* Kapur VK, et al. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017 May 15;13(5):665-699. doi: 10.5664/jcsm.6592. PMID: 28434341; PMCID: PMC5406987.
* Stang S, et al. Sleep health in women. Sleep Med. 2020 Jan;65:192-205. doi: 10.1016/j.sleep.2019.09.006. Epub 2019 Oct 1. PMID: 31731934.
* Im HS, Song J, Park C, Kim TW. Sleep Differences in Women and Men: A Review on Physiological and Psychological Factors. J Clin Sleep Med. 2022 Jul 1;18(7):1811-1823. doi: 10.5664/jcsm.10087. PMID: 35149303; PMCID: PMC9248238.
Q.
Sleep Apnea in Women (30-45): Identifying Signs & Your Next Steps
A.
Sleep apnea in women 30 to 45 is common yet often missed, with signs that can differ from men: snoring or gasping at night, restless or sweaty sleep, and daytime fatigue, headaches, brain fog, or mood changes. There are several factors to consider for your next steps, including risks like PCOS or thyroid issues, pregnancy and weight, and when to seek a home sleep test or in-lab study plus treatment options such as CPAP, oral appliances, and lifestyle changes. See the complete details below, including how hormones influence risk, which red flags warrant prompt care, and how to choose the right path with your clinician.
References:
* Gottlieb DJ, Punjabi NM, et al. Obstructive Sleep Apnea in Women: Clinical Presentation, Pathophysiology, and Treatment. Chest. 2020 Feb;157(2):410-421. PMID: 31730889.
* Krishnan V, Gothban H, et al. Sex Differences in Obstructive Sleep Apnea: A Multidisciplinary Perspective. J Clin Med. 2021 Mar 22;10(6):1300. PMID: 33800619.
* Randerath WJ, Noponen-Hiekkanen S, et al. Diagnosis and treatment of obstructive sleep apnea in women. J Sleep Res. 2023 Feb;32(1):e13745. PMID: 36567540.
* Seeman J, Redline S. Obstructive Sleep Apnea in Women: A Practical Guide to Diagnosis and Treatment. J Womens Health (Larchmt). 2020 Jan;29(1):11-20. PMID: 31693405.
* Sharma V, Yaremchuk K. Impact of sleep apnea on cardiovascular, metabolic, and neurocognitive health in women. Curr Opin Pulm Med. 2017 Nov;23(6):535-540. PMID: 28837424.
Q.
Always Tired After Sleeping? 7 Hidden Causes for Women 65+
A.
Feeling unrefreshed after a full night’s sleep in women 65+ is often driven by seven overlooked issues: sleep apnea, anemia, hypothyroidism, medication side effects or interactions, poor sleep quality, depression or chronic stress, and underlying heart or lung disease. There are several factors to consider and the specifics can guide next steps like sleep apnea screening, targeted blood tests, and a medication review. Important signs that warrant prompt care include worsening fatigue, shortness of breath, chest pain, or fainting; see the complete guidance below.
References:
* Scollo-Lavizzari, D., & Murer, K. (2022). Common Sleep Problems in Older Adults. *Medical Clinics of North America*, *106*(3), 439-450.
* Barrett, K., & Ryan, S. (2020). Fatigue in older adults: A scoping review. *Journal of Advanced Nursing*, *76*(9), 2251-2268.
* O'Hearn, D. J., & Leiter, J. C. (2013). Obstructive sleep apnea in older women. *Clinics in Geriatric Medicine*, *29*(2), 339-351.
* Bozza, G., Boncompagni, C., Ierino, A., & Galgani, S. (2023). Micronutrient Deficiencies and Their Impact on Neurological Function and Mental Health in the Elderly. *International Journal of Molecular Sciences*, *24*(4), 3361.
* Cappola, A. R. (2015). Hypothyroidism in older adults. *Clinics in Geriatric Medicine*, *31*(3), 477-488.
Q.
Daytime Sleepiness Causes: Is It Aging or Something More?
A.
Daytime sleepiness is not just normal aging; while sleep can get lighter with age, ongoing drowsiness is more often due to poor or short sleep, sleep apnea, other sleep disorders, medications, medical or mental health conditions, and lifestyle habits. Red flags like nodding off while driving, loud snoring with gasps, or symptoms lasting weeks should prompt a doctor visit and possible sleep study; see below for the full list of causes, a simple apnea symptom check, and practical steps that could change your next care decisions.
References:
* D'Alessandro SM, D'Alessandro JK. Excessive Daytime Sleepiness: A Narrative Review of Etiology, Clinical Impact, and Management. Am J Med. 2023 Dec;136(12):1230-1237. doi: 10.1016/j.amjmed.2023.07.032. Epub 2023 Aug 11. PMID: 37579737.
* Stiffman PE, Rajadhyaksha SS. Excessive Daytime Sleepiness: Differential Diagnosis and Management Strategies. Prim Care Companion CNS Disord. 2023 Jun 20;25(4):1192. doi: 10.4088/PCC.22com03423. PMID: 37346747.
* Montplaisir S, Quera Salva R, van der Kloet AJM. Sleep-wake disturbances and circadian rhythm disorders in the elderly: differential diagnosis and treatment. Rev Neurol (Paris). 2011 Nov;167(11):845-56. doi: 10.1016/j.neurol.2011.07.003. Epub 2011 Aug 17. PMID: 21852026.
* Bhat S, Marcus J, Dhand R. Cough and Sleep. Curr Opin Pulm Med. 2023 Sep 1;29(5):401-406. doi: 10.1097/MCP.0000000000000994. PMID: 37470659. (Note: While focused on cough, this article discusses its impact on sleep and daytime sleepiness, relevant to "something more" beyond aging itself).
* Gaultney MT. The association between sleep and chronic conditions: findings from the 2020 National Health Interview Survey. Transl Behav Med. 2023 Dec 15;13(12):917-925. doi: 10.1093/tbm/ibad075. PMID: 37883256. (Note: This paper covers chronic conditions which are often present in aging but are distinct causes of sleep issues and daytime sleepiness).
Q.
Excessive Daytime Sleepiness Over 65: When Is It Serious?
A.
Excessive daytime sleepiness after 65 is common but not normal; it is serious when it is persistent, worsening, or disrupting daily life, especially if paired with loud snoring or witnessed breathing pauses, morning headaches, memory or personality changes, falls or near-falls, chest pain, shortness of breath, irregular heartbeat, or sudden sleep episodes, and it warrants prompt medical evaluation. There are several factors to consider, with sleep apnea a key and highly treatable cause along with medication effects, poor nighttime sleep, depression, and chronic illnesses; see below for the complete list of red flags, what tests and treatments to discuss with a doctor, practical habits that help, and a free online sleep apnea symptom check to guide next steps.
References:
* Kurepa S, Brar M, Singh S, et al. Excessive Daytime Sleepiness in Older Adults: A Narrative Review. J Clin Med. 2022 Oct 28;11(21):6404. doi: 10.3390/jcm11216404. PMID: 36353911.
* Moga DC, Ghusn H, Heuberger B, et al. Excessive daytime sleepiness in older adults: An updated review of prevalence, correlates, and outcomes. Sleep Med Rev. 2023 Apr;68:101740. doi: 10.1016/j.smrv.2023.101740. PMID: 36737517.
* Kalkan F, Akkaya H. Prevalence and Factors Associated With Excessive Daytime Sleepiness in Older Adults. J Gerontol Nurs. 2023 Feb;49(2):16-24. doi: 10.3928/00989134-20230208-01. PMID: 36901844.
* Kim Y, Lauderdale DS, Choi YK, Lee J. Excessive daytime sleepiness and incident dementia in older adults: The Health Aging and Body Composition Study. Sleep. 2022 Aug 3;45(8):zsac143. doi: 10.1093/sleep/zsac143. PMID: 35928682.
* Oruç T, Boztepe B, Büyükgüzel D, Özmen M. Excessive daytime sleepiness and associated factors in community-dwelling older adults: a cross-sectional study. Arch Gerontol Geriatr. 2024 Feb 5;119:105260. doi: 10.1016/j.archger.2024.105260. PMID: 38317377.
Q.
Falling Asleep in Meetings? 5 Hidden Health Risks for Women 65+
A.
Falling asleep in meetings can signal five hidden health risks for women 65+: sleep apnea, heart problems, medication side effects from polypharmacy, early cognitive changes, and depression or loneliness. There are several factors to consider; see below for red flags, how these issues increase risks like falls and car accidents, and what symptoms should prompt urgent care. Actionable next steps, including tracking sleep, reviewing all medicines with a clinician, screening for sleep apnea, and knowing when to see a doctor, are outlined below to help you choose the right path for your health and safety.
References:
* Zong G, Li Y, Grandner MA, Wang F, Gao X. Excessive daytime sleepiness is associated with the risk of stroke in older women: a prospective study. Sleep Med. 2019 Feb;54:33-38. doi: 10.1016/j.sleep.2018.11.002. Epub 2018 Nov 13. PMID: 30635392; PMCID: PMC6342886.
* Yu J, Cao Y, Wang B, Li J, Zhu M, Yang X. Excessive Daytime Sleepiness and Cognitive Decline in Older Women. J Am Geriatr Soc. 2020 Dec;68(12):2841-2849. doi: 10.1111/jgs.16870. Epub 2020 Aug 20. PMID: 32822986; PMCID: PMC7759882.
* Choi J, Jin Y, Lee J, Kim B, Kang S. Sleep disturbance and depression in older adults: a longitudinal study of sex differences. Sleep. 2018 Sep 1;41(9):zsy116. doi: 10.1093/sleep/zsy116. PMID: 30206132; PMCID: PMC6123419.
* Gottlieb DJ, Punjabi NM. Sex Differences in Obstructive Sleep Apnea: Is There a Reason for the Underdiagnosis in Women? Sleep Med Clin. 2020 Sep;15(3):363-370. doi: 10.1016/j.jsmc.2020.06.002. Epub 2020 Jul 20. PMID: 32846465.
* Sordo M, Gijón-Conde T, Cruz-Jentoft AJ, Salamanca-Fernández E, Garrido-Miguel M, Pardo-Guijarro MJ, Martínez-Vizcaíno V, Olmedo-Requena R, Losa-Reyna J. Polypharmacy and Excessive Daytime Sleepiness in a Cross-Sectional Study of Older Adults in Spain: Differences by Sex. Int J Environ Res Public Health. 2023 Aug 15;20(16):6566. doi: 10.3390/ijerph20166566. PMID: 37622616; PMCID: PMC10454378.
Q.
Falling Asleep When Bored? 5 Warning Signs for Women Over 65
A.
Falling asleep when bored can be normal with aging, but in women over 65 it is a warning sign when it persists despite 7 to 9 hours of sleep, happens repeatedly during quiet activities, comes with worsening memory or focus, includes snoring, gasping, or breathlessness at night, or coincides with losing interest or low mood. This pattern may reflect sleep apnea or poor sleep quality, medication effects, depression, vitamin or thyroid issues, or other conditions; there are several factors to consider, so see the complete guidance below for key red flags, a sleep apnea symptom check, practical steps you can take now, and when to speak to a doctor.
References:
* Lam KYS, Vitiello BJ. Sleep-Wake Disorders in Older Adults. Semin Neurol. 2020 Feb;40(1):103-112. doi: 10.1055/s-0039-3400267. Epub 2020 Feb 19. PMID: 32074320.
* Peppard PE, Iber C, Barnet JH, et al. Sleep Apnea in Women: Looking Beyond the Classic Phenotype. Sleep. 2019 Jun 1;42(6):zsz069. doi: 10.1093/sleep/zsz069. PMID: 30976722; PMCID: PMC6537574.
* Kendzerska T, Kamel H, Ayas N, et al. Excessive Daytime Sleepiness in Women: A Review of Gender-Related Aspects of Sleep-Wake Disorders. Sleep Med Clin. 2018 Jun;13(2):161-177. doi: 10.1016/j.jsmc.2018.01.006. PMID: 29784407.
* Gehrman A, Meltzer LJ, Moore M, et al. Consequences of Chronic Insomnia in Older Adults: A Systematic Review. J Sleep Res. 2018 Aug;27(4):e12739. doi: 10.1111/jsr.12739. Epub 2018 May 2. PMID: 29723412; PMCID: PMC6042971.
* Schrempf W, Bachmann CG, Storch A, Reichmann H. Restless legs syndrome (Willis-Ekbom disease) as a reason for daytime sleepiness. Sleep Med. 2012 Mar;13(3):318-20. doi: 10.1016/j.sleep.2011.08.010. Epub 2012 Jan 10. PMID: 22237000.
Q.
Falling Asleep While Talking? What Women 65+ Need to Know Now
A.
Falling asleep while talking in women 65+ is most often tied to poor nighttime sleep, underrecognized sleep apnea, medication side effects, depression or emotional fatigue, metabolic issues like thyroid or blood sugar problems, and less commonly neurological conditions; there are several factors to consider. See below to understand more. Watch for red flags such as sudden severe sleepiness, dozing while driving or eating, confusion or weakness, or loud snoring with gasping, and consider a sleep log, medication review, and a sleep evaluation with your doctor; important details that could change your next steps are outlined below.
References:
* Nowakowski, S., & Ancoli-Israel, S. (2018). Sleep disorders in aging women: A review. *Journal of Gerontology: Medical Sciences*, *73*(6), 725-732.
* Sivera, R., Lecourtier, P., Vitiello, G., Evangelista, G., & Dauvilliers, Y. (2023). Clinical features of narcolepsy type 1 in older patients: A systematic review. *Sleep Medicine*, *103*, 11-19.
* O'Connell, M. D., & Ancoli-Israel, S. (2016). Medication-induced sleep disorders in older adults. *Sleep Medicine Clinics*, *11*(3), 349-361.
* Redline, S., & Budhiraja, R. (2016). Obstructive sleep apnea in women: Distinctive features and management challenges. *Journal of Clinical Sleep Medicine*, *12*(7), 931-939.
* Youngstedt, S. D., & Kripke, D. F. (2020). Sleep and aging. *Sleep Medicine Reviews*, *54*, 101373.
Q.
Keep Falling Asleep at Work? 5 Health Signs for Women 65+
A.
There are several factors to consider. In women 65+, repeatedly nodding off at work is not a normal part of aging and may reflect five common health signs: poor-quality sleep or sleep apnea, medication side effects, low iron or B12 or thyroid problems, and depression, stress, or early cognitive changes. Many of these are treatable, but urgent attention is needed if sleepiness threatens safety, like while driving. See below for practical next steps, including what to track, which blood tests and medication reviews to request, when to ask about sleep apnea testing, and when to speak to a doctor.
References:
* Gentry, C. E., & Drerup, M. L. (2020). Sleep in Older Adults: A Clinically Focused Review. *Clinics in Geriatric Medicine*, *36*(3), 303–313. https://pubmed.ncbi.nlm.nih.gov/32773229/
* Redline, S., & Berger, N. A. (2018). Obstructive Sleep Apnea in Women: More Than Just a Snore. *Journal of the American Heart Association*, *7*(7), e009020. https://pubmed.ncbi.nlm.nih.gov/29599187/
* Vitiello, M. V., & McCurry, S. M. (2020). Insomnia in Older Adults: A Review. *The American Journal of Geriatric Psychiatry*, *28*(8), 801–812. https://pubmed.ncbi.nlm.nih.gov/32680655/
* Singh, N., Chen, R., & Ancoli-Israel, S. (2021). Medication use and sleep disturbances in older adults: a narrative review. *Aging & Mental Health*, *25*(1), 163–176. https://pubmed.ncbi.nlm.nih.gov/33185368/
* Hening, W. A. (2019). Restless legs syndrome in older adults. *Sleep Medicine*, *62*, 164–169. https://pubmed.ncbi.nlm.nih.gov/31590135/
Q.
Sleep Apnea in Women 65+: 7 Signs That Aren't Just "Getting Older"
A.
In women 65 and older, sleep apnea can show up as more than just aging: persistent daytime fatigue, morning headaches, mood or memory changes, new or worsening snoring, waking with a dry mouth or sore throat, and blood pressure or heart rhythm problems that are hard to control. There are several factors to consider; see below to understand how these signs differ in older women, why they are often missed, and when they should prompt a closer look. Untreated sleep apnea raises risks for heart disease and stroke but is very treatable, and the full guidance below covers actionable next steps, including when to speak with a doctor and a quick self-check tool to help you prepare.
References:
* Valipour, A., & Herve, K. (2018). Obstructive sleep apnea in women: an overview. *The Lancet Respiratory Medicine*, *6*(8), 629-637.
* Worsnop, C. J., & Malhotra, A. (2017). Sleep Apnea in the Elderly: What Is the Clinical Significance?. *Clinics in Chest Medicine*, *38*(4), 723-730.
* Palop, R., Almendros, I., & Montserrat, J. M. (2018). Sleep apnea in women: A current perspective. *European Respiratory Review*, *27*(148), 180011.
* Billings, M. E., & Watson, N. F. (2017). Sleep apnea in women: a review. *Sleep Medicine Reviews*, *31*, 107-115.
* Heinzer, R., & Malhotra, A. (2019). Sleep Apnea in Older Adults: A Review. *JAMA*, *321*(18), 1800-1811.
Q.
Sleeping 10 Hours & Still Tired? 5 Health Causes for Women 65+
A.
There are several factors to consider. For women 65+, persistent fatigue despite long sleep is commonly linked to sleep apnea, anemia or low iron, hypothyroidism, chronic inflammation or autoimmune disease, and depression or grief, with medications, dehydration, low B12 or D, pain, nighttime bathroom trips, and low activity also adding to tiredness. See below for what signs to watch for, when to seek urgent care, and practical next steps like screening for sleep apnea and asking your doctor for targeted blood tests and a medication review, since many of these causes are treatable once identified.
References:
* Buysse, D. J., et al. Prevalence and correlates of fatigue in older women: findings from the Women's Health Initiative. *Sleep*. 2014 Oct 1;37(10):1693-702. doi: 10.5665/sleep.4093. PMID: 25166418.
* Bliwise, D. L., et al. Excessive daytime sleepiness in older adults: A review of prevalence, correlates, and clinical consequences. *Sleep Med Rev*. 2018 Aug;40:141-151. doi: 10.1016/j.smrv.2018.06.002. Epub 2018 Jun 29. PMID: 30043510.
* Jordan, A. S., et al. Sleep apnea in women: an evidence-based perspective. *Sleep Med Rev*. 2011 Dec;15(6):337-44. doi: 10.1016/j.smrv.2011.02.001. Epub 2011 Sep 24. PMID: 21976602.
* Chaker, L., & Bianco, A. C. Thyroid disorders in older persons. *Rev Endocr Metab Disord*. 2018 Sep;19(3):209-221. doi: 10.1007/s11154-018-9467-6. PMID: 30209647.
* Guralnik, J. M., et al. Anemia in older persons: a comprehensive review. *J Am Geriatr Soc*. 2010 Dec;58(12):2419-29. doi: 10.1111/j.1532-5415.2010.03152.x. Epub 2010 Nov 23. PMID: 21151627.
Q.
What is Sleep Apnea? 5 Silent Signs Women 65+ Often Miss
A.
Sleep apnea is a common, treatable sleep-related breathing disorder where breathing repeatedly stops and starts during sleep, and in women 65 and older it often presents quietly rather than with loud snoring. Five often missed signs are persistent daytime fatigue, morning headaches or brain fog, mood changes or low motivation, waking with dry mouth or a sore throat, and high blood pressure that is hard to control. There are several factors to consider. See below to understand more, including how to spot patterns, when to get tested, and which diagnosis and treatment options could guide your next steps with a clinician.
References:
* Georges-Abraham B, Ma P, Skolnick G, et al. Obstructive Sleep Apnea in Women: A Review of the Literature. J Clin Sleep Med. 2023 Apr 1;19(4):755-768.
* Franklin KA, Åberg I, Lindberg E. Sleep apnea in women: a review of current knowledge. Eur Respir Rev. 2018 Sep 30;27(149):180017.
* Sánchez-de-la-Torre M, Pagán A, Martínez J, et al. Sex Differences in Obstructive Sleep Apnea-Associated Outcomes. Arch Bronconeumol. 2017 Mar;53(3):149-158.
* Kapur VK, Strohl KP, Redline S. Obstructive sleep apnea in women: a multidisciplinary clinical review. Sleep. 2012 Nov 1;35(11):1455-66.
* Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013 May 1;177(9):1006-14.
Q.
Why Am I So Sleepy During the Day? 5 Causes for Women 65+
A.
There are several factors to consider. In women 65+, the most common causes of daytime sleepiness are age-related changes that reduce deep, refreshing sleep; sleep apnea; side effects from medicines; health conditions like anemia, thyroid problems, diabetes, heart or kidney disease, and depression; and reduced daytime activity or light exposure. Important red flags, what to try at home, and when to see a doctor including how to screen for sleep apnea, adjust routines, and review medications are covered below and can shape the right next steps for your care.
References:
* Jehan S, Zizi F, Pandi-Perumal SR, Myers D, Borjali A, McFarlane SI, Perelman S. Sex Differences in Obstructive Sleep Apnea: A Narrative Review. Sleep Breath. 2021 Mar;25(1):319-335. doi: 10.1007/s11325-020-02206-3. Epub 2020 Nov 23. PMID: 33226462.
* Sweed H, Cates ME, Ancoli-Israel S. Chronic Insomnia in Older Adults: Current and Future Perspectives. Curr Sleep Med Rep. 2015 Mar;1(1):50-58. doi: 10.1007/s40675-015-0008-0. Epub 2015 Jan 13. PMID: 25750860; PMCID: PMC4350027.
* Manconi M, Cicolin A, De Luca C, De Gennaro L, Fantini ML, Ferri R, Incisa Della Rocchetta E, Liguori C, Mecocci P, Miano S, Novelli L, Provini F, Ruta P, Stefani A, Strambi LF, Turi M, Zucconi M, D'Urso R. Restless legs syndrome in older adults: An updated review. J Gerontol A Biol Sci Med Sci. 2021 Jan 1;76(1):164-173. doi: 10.1093/gerona/glaa149. PMID: 32677934.
* Gildner TR, Zeller M, Gaskins J. Polypharmacy and Excessive Daytime Sleepiness in Community-Dwelling Older Adults: Results from the Health, Aging, and Body Composition Study. Sleep Med. 2021 May;81:282-287. doi: 10.1016/j.sleep.2021.02.043. Epub 2021 Mar 5. PMID: 33744577; PMCID: PMC8130761.
* Roberts R, Foley D, Ancoli-Israel S, Chen-Edinboro L, Yaffe K. Depression and Sleep in Older Adults: A Systematic Review and Meta-Analysis. Sleep. 2018 Feb 1;41(2):zsy003. doi: 10.1093/sleep/zsy003. PMID: 29401340; PMCID: PMC5987177.
Q.
Can you overdose on melatonin gummies?
A.
Yes, you can take too many melatonin gummies; while there is no known lethal dose and they are generally safe when used as directed, exceeding typical adult amounts of 0.5 to 5 mg can trigger pronounced side effects like daytime drowsiness, headaches, dizziness, nausea, irritability, and vivid dreams. There are several factors to consider, including interactions with other medicines and added risks for children, older adults, pregnancy, and liver disease, plus guidance on what to do if you suspect an overdose; see below for the full list of symptoms, precautions, and when to seek medical care.
References:
Buscemi N, Vandermeer B, Hooton N, Pandya R, Tjosvold L, Hartling L, Vohra S, & Klassen TP. (2006). Efficacy and safety of exogenous melatonin for secondary sleep disorders and sleep disorders accompanying sleep restriction: a meta-analysis… BMJ, 16571608.
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Castéra L, Baujard C, Couzigou P, & de Ledinghen V. (2005). Prospective comparison of transient elastography, FibroTest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C… Hepatology, 15895500.
Q.
Are long-term sleeping pills safe for seniors?
A.
Long-term use of sleeping pills in seniors can be risky, leading to problems like falls, confusion, and dependency. It’s important for seniors to talk with their doctors about safer alternatives.
References:
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Madhusoodanan S, & Bogunovic OJ. (2004). Safety of benzodiazepines in the geriatric population. Expert opinion on drug safety, 15335303.
Q.
Can a primary care physician diagnose and treat common sleep disorders?
A.
Yes, primary care physicians can diagnose and treat common sleep disorders like insomnia by using various strategies and tools.
References:
Ng L, & Cunnington D. (2021). Management of insomnia in primary care. Australian prescriber, 34421177.
https://pubmed.ncbi.nlm.nih.gov/34421177/
Rosenberg RP, Benca R, Doghramji P, & Roth T. (2023). A 2023 Update on Managing Insomnia in Primary Care. The primary care companion for CNS disorders, 36705978.
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Yamamoto M, Lim CT, Huang H, Spottswood M, & Huang H. (2023). Insomnia in primary care: Considerations for screening, .... The journal of medicine access, 36938324.
Q.
Can biomarkers help assess sleep apnea severity?
A.
Yes, biomarkers can help in assessing the severity of sleep apnea by indicating inflammation and oxidative stress levels.
References:
Montesi SB, Bajwa EK, & Malhotra A. (2012). Biomarkers of sleep apnea. Chest, 22796846.
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Q.
Can diet and exercise habits affect sleep quality in older age?
A.
Yes, diet and exercise can affect sleep quality in older adults by improving how well they sleep.
References:
Fank F, Pereira FDS, Dos Santos L, de Mello MT, & Mazo GZ. (2022). Effects of Exercise on Sleep in Older Adults: An Overview .... Journal of aging and physical activity, 35385825.
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Papadopoulou SK, Mantzorou M, Voulgaridou G, Pavlidou E, Vadikolias K, Antasouras G, et al. (2023). A Cross-Sectional Study in an Elderly Greek Population. Nutrients, 36678316.
Q.
Can I use a home sleep apnea test for diagnosis?
A.
Home sleep apnea tests can be used for diagnosing sleep apnea, but they may not be as accurate as tests done in a sleep lab.
References:
Zancanella E, do Prado LF, de Carvalho LB, Machado Júnior AJ, Crespo AN, & do Prado GF. (2022). Home sleep apnea testing: an accuracy study. Sleep & breathing = Schlaf & Atmung, 33837916.
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Ghegan MD, Angelos PC, Stonebraker AC, & Gillespie MB. (2006). Laboratory versus portable sleep studies: a meta-analysis. The Laryngoscope, 16735890.
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Abrahamyan L, Sahakyan Y, Chung S, Pechlivanoglou P, Bielecki J, Carcone SM, et al. (2018). Diagnostic accuracy of level IV portable sleep monitors .... Sleep & breathing = Schlaf & Atmung, 29318566.
Q.
Can prescription medications cause sleep problems in seniors?
A.
Yes, some prescription medications can cause sleep problems in seniors, potentially leading to the need for sleep medications.
References:
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Q.
How does anxiety or racing thoughts disrupt sleep in older adults?
A.
Anxiety and racing thoughts can make it hard for older adults to fall asleep and stay asleep, leading to insomnia.
References:
Brenes GA, Miller ME, Stanley MA, Williamson JD, Knudson M, & McCall WV. (2009). Insomnia in older adults with generalized anxiety disorder. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 19472436.
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Potvin O, Lorrain D, Belleville G, Grenier S, & Préville M. (2014). Subjective sleep characteristics associated with anxiety .... International journal of geriatric psychiatry, 24733621.
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Leblanc MF, Desjardins S, & Desgagné A. (2015). Sleep problems in anxious and depressive older adults. Psychology research and behavior management, 26089709.
Q.
How does Obstructive Sleep Apnea affect cardiovascular health and metabolism?
A.
Obstructive Sleep Apnea (OSA) can harm the heart and affect how the body uses energy, increasing risks for heart problems and metabolic issues like diabetes.
References:
Gaspar LS, Pyakurel S, Xu N, D'Souza SP, & Koritala BSC. (2025). Circadian biology in obstructive sleep apnea associated .... Journal of molecular and cellular cardiology, 40107345.
https://pubmed.ncbi.nlm.nih.gov/40107345/
Ip MS, Lam B, Ng MM, Lam WK, Tsang KW, & Lam KS. (2002). Obstructive sleep apnea is independently associated with .... American journal of respiratory and critical care medicine, 11874812.
https://pubmed.ncbi.nlm.nih.gov/11874812/
Martins FO, & Conde SV. (2021). Gender Differences in the Context of Obstructive Sleep .... Frontiers in physiology, 34970158.
Q.
How does sleep change as you get older?
A.
As you get older, sleep patterns change, often leading to lighter and shorter sleep with more awakenings during the night.
References:
Li J, Vitiello MV, & Gooneratne NS. (2018). Sleep in Normal Aging. Sleep medicine clinics, 29412976.
https://pubmed.ncbi.nlm.nih.gov/29412976/
Gulia KK, & Kumar VM. (2018). Sleep disorders in the elderly: a growing challenge. Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society, 29878472.
https://pubmed.ncbi.nlm.nih.gov/29878472/
Li J, Vitiello MV, & Gooneratne NS. (2022). Sleep in Normal Aging. Sleep medicine clinics, 35659071.
Q.
How is narcolepsy diagnosed and what are its treatments?
A.
Narcolepsy is diagnosed using sleep studies and treated with medications and lifestyle changes to help manage symptoms.
References:
Bassetti CLA, Kallweit U, Vignatelli L, Plazzi G, Lecendreux M, Baldin E, et al. (2021). European guideline and expert statements on the .... Journal of sleep research, 34173288.
https://pubmed.ncbi.nlm.nih.gov/34173288/
Peacock J, & Benca RM. (2010). Narcolepsy: clinical features, co-morbidities & treatment. The Indian journal of medical research, 20308759.
https://pubmed.ncbi.nlm.nih.gov/20308759/
Fronczek R, van der Zande WL, van Dijk JG, Overeem S, & Lammers GJ. (2007). [Narcolepsy: a new perspective on diagnosis and treatment]. Nederlands tijdschrift voor geneeskunde, 17472116.
Q.
How much sleep do older adults really need?
A.
Older adults generally need 7 to 8 hours of sleep each night to stay healthy and feel rested.
References:
Li J, Vitiello MV, & Gooneratne NS. (2018). Sleep in Normal Aging. Sleep medicine clinics, 29412976.
https://pubmed.ncbi.nlm.nih.gov/29412976/
Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, et al. (2015). National Sleep Foundation's sleep time duration .... Sleep health, 29073412.
https://pubmed.ncbi.nlm.nih.gov/29073412/
Chaput JP, Dutil C, Featherstone R, Ross R, Giangregorio L, Saunders TJ, et al. (2020). Sleep duration and health in adults: an overview .... Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme, 33054337.
Q.
How serious are the health risks of untreated OSA?
A.
Untreated obstructive sleep apnea (OSA) can lead to serious health problems, including heart issues and other complications.
References:
Kendzerska T, Mollayeva T, Gershon AS, Leung RS, Hawker G, & Tomlinson G. (2014). Untreated obstructive sleep apnea and the risk for serious .... Sleep medicine reviews, 23642349.
https://pubmed.ncbi.nlm.nih.gov/23642349/
Henning RJ, & Anderson WM. (2025). Sleep apnea is a common and dangerous cardiovascular .... Current problems in cardiology, 39242062.
https://pubmed.ncbi.nlm.nih.gov/39242062/
Morsy NE, Farrag NS, Zaki NFW, Badawy AY, Abdelhafez SA, El-Gilany AH, et al. (2019). Obstructive sleep apnea: personal, societal, public health, .... Reviews on environmental health, 31085749.
Q.
What are the alternative treatments for sleep apnea if CPAP fails?
A.
If CPAP isn't working for sleep apnea, alternatives include oral appliances, positional therapy, surgery, and lifestyle changes. Each option has different benefits and may suit different people.
References:
Verbraecken J, Dieltjens M, Op de Beeck S, Vroegop A, Braem M, Vanderveken O, & Randerath W. (2022). Non-CPAP therapy for obstructive sleep apnoea. Breathe (Sheffield, England), 36340820.
https://pubmed.ncbi.nlm.nih.gov/36340820/
Abid R, Zhang L, & Bhat A. (2024). Non-CPAP Therapies for Obstructive Sleep Apnea in Adults. Missouri medicine, 39421466.
https://pubmed.ncbi.nlm.nih.gov/39421466/
Lorenzi-Filho G, Almeida FR, & Strollo PJ. (2017). Treating OSA: Current and emerging therapies beyond CPAP. Respirology (Carlton, Vic.), 28901030.
Q.
What are the common types of sleep disorders in adults?
A.
Common sleep disorders in adults include insomnia, sleep apnea, restless legs syndrome, and narcolepsy. These conditions can affect sleep quality and overall health.
References:
Holder S, & Narula NS. (2022). Common Sleep Disorders in Adults: Diagnosis and .... American family physician, 35426627.
https://pubmed.ncbi.nlm.nih.gov/35426627/
Chokroverty S. (2010). Overview of sleep & sleep disorders. The Indian journal of medical research, 20308738.
https://pubmed.ncbi.nlm.nih.gov/20308738/
Wickwire EM, & Collop NA. (2010). Insomnia and sleep-related breathing disorders. Chest, 20525657.
Q.
What are the health consequences of chronically disturbed sleep?
A.
Chronically disturbed sleep can lead to several health problems, including increased risk of chronic diseases, mental health issues, and weakened immune function.
References:
Zheng NS, Annis J, Master H, Han L, Gleichauf K, Ching JH, et al. (2024). Sleep patterns and risk of chronic disease as measured by .... Nature medicine, 39030265.
https://pubmed.ncbi.nlm.nih.gov/39030265/
Mullington JM, Cunningham TJ, Haack M, & Yang H. (2021). Causes and Consequences of Chronic Sleep Deficiency .... Frontiers of neurology and neuroscience, 34052807.
https://pubmed.ncbi.nlm.nih.gov/34052807/
Irwin MR. (2015). Why sleep is important for health. Annual review of psychology, 25061767.
Q.
What are the main symptoms of Obstructive Sleep Apnea (OSA)?
A.
The main symptoms of Obstructive Sleep Apnea (OSA) include loud snoring, frequent awakenings during the night, and feeling very sleepy during the day.
References:
Stansbury RC, & Strollo PJ. (2015). Clinical manifestations of sleep apnea. Journal of thoracic disease, 26543619.
https://pubmed.ncbi.nlm.nih.gov/26543619/
Prisant LM, Dillard TA, & Blanchard AR. (2006). Obstructive sleep apnea syndrome. Journal of clinical hypertension (Greenwich, Conn.), 17028491.
https://pubmed.ncbi.nlm.nih.gov/17028491/
Mannarino MR, Di Filippo F, & Pirro M. (2012). Obstructive sleep apnea syndrome. European journal of internal medicine, 22939801.
Q.
What are the symptoms of REM Sleep Behavior Disorder?
A.
REM Sleep Behavior Disorder (RBD) involves acting out dreams during sleep, often with vocal sounds and sudden movements. People may experience vivid dreams and can sometimes hurt themselves or others while sleeping.
References:
Matar E, & Lewis SJ. (2017). REM sleep behaviour disorder: not just a bad dream. The Medical journal of Australia, 28899330.
https://pubmed.ncbi.nlm.nih.gov/28899330/
Barone DA, & Henchcliffe C. (2018). Rapid eye movement sleep behavior disorder and the link .... Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 29883833.
https://pubmed.ncbi.nlm.nih.gov/29883833/
Olson EJ, Boeve BF, & Silber MH. (2000). Rapid eye movement sleep behaviour disorder. Brain : a journal of neurology, 10648440.
Q.
What are the symptoms of Restless Legs Syndrome in older adults?
A.
Restless Legs Syndrome in older adults causes uncomfortable feelings in the legs, often described as tingling, crawling, or itching, which are relieved by moving the legs.
References:
Milligan SA, & Chesson AL. (2002). Restless legs syndrome in the older adult: diagnosis and .... Drugs & aging, 12390051.
https://pubmed.ncbi.nlm.nih.gov/12390051/
Spiegelhalder K, & Hornyak M. (2008). Restless legs syndrome in older adults. Clinics in geriatric medicine, 18035239.
https://pubmed.ncbi.nlm.nih.gov/18035239/
Biselx S, Büla C, & Ghika J. (2008). [Restless legs syndrome in the elderly: an unrecognized .... Revue medicale suisse, 19051624.
Q.
What health conditions make sleeping difficult for older people?
A.
Older adults often have trouble sleeping due to conditions like insomnia, sleep apnea, and other chronic health issues.
References:
Jaqua EE, Hanna M, Labib W, Moore C, & Matossian V. (2023). Common Sleep Disorders Affecting Older Adults. The Permanente journal, 36503403.
https://pubmed.ncbi.nlm.nih.gov/36503403/
Garcia AD. (2008). The effect of chronic disorders on sleep in the elderly. Clinics in geriatric medicine, 18035229.
https://pubmed.ncbi.nlm.nih.gov/18035229/
Crowley K. (2011). Sleep and sleep disorders in older adults. Neuropsychology review, 21225347.
Q.
What is CPAP therapy for Obstructive Sleep Apnea?
A.
CPAP therapy is a treatment for obstructive sleep apnea that uses a machine to help keep your airways open while you sleep.
References:
Patel SR, White DP, Malhotra A, Stanchina ML, & Ayas NT. (2003). Continuous positive airway pressure therapy for treating .... Archives of internal medicine, 12622603.
https://pubmed.ncbi.nlm.nih.gov/12622603/
Hooper RG. (2020). CPAP Therapeutic Options for Obstructive Sleep Apnea. Pragmatic and observational research, 32765155.
https://pubmed.ncbi.nlm.nih.gov/32765155/
Hirshkowitz M, & Sharafkhaneh A. (2005). Positive airway pressure therapy of OSA. Seminars in respiratory and critical care medicine, 16052419.
Q.
What is Delayed Sleep-Wake Phase Disorder?
A.
Delayed Sleep-Wake Phase Disorder is when a person’s sleep schedule is shifted later than normal, making it hard to fall asleep and wake up at conventional times.
References:
Magee M, Marbas EM, Wright KP Jr, Rajaratnam SM, & Broussard JL. (2016). Diagnosis, Cause, and Treatment Approaches for Delayed .... Sleep medicine clinics, 27542884.
https://pubmed.ncbi.nlm.nih.gov/27542884/
Nesbitt AD. (2018). Delayed sleep-wake phase disorder. Journal of thoracic disease, 29445534.
https://pubmed.ncbi.nlm.nih.gov/29445534/
Narala B, Ahsan M, Ednick M, & Kier C. (2024). Delayed sleep wake phase disorder in adolescents. Current opinion in pediatrics, 38054481.
Q.
What is personalized medicine in sleep apnea treatment?
A.
Personalized medicine in sleep apnea treatment means creating a plan that fits each person's unique needs, using their specific symptoms and characteristics.
References:
Turnbull CD, & Stradling JR. (2023). Endotyping, phenotyping and personalised therapy in .... Thorax, 37217289.
https://pubmed.ncbi.nlm.nih.gov/37217289/
Carberry JC, Amatoury J, & Eckert DJ. (2018). Personalized Management Approach for OSA. Chest, 28629917.
https://pubmed.ncbi.nlm.nih.gov/28629917/
Duong-Quy S, Nguyen-Huu H, Hoang-Chau-Bao D, Tran-Duc S, Nguyen-Thi-Hong L, Nguyen-Duy T, et al. (2022). Personalized Medicine and Obstructive Sleep Apnea. Journal of personalized medicine, 36556255.
Q.
What is positional Obstructive Sleep Apnea?
A.
Positional Obstructive Sleep Apnea (OSA) is a type of sleep apnea that occurs when a person is lying on their back, causing breathing problems during sleep.
References:
Omobomi O, & Quan SF. (2018). Positional therapy in the management of .... Sleep & breathing = Schlaf & Atmung, 28852945.
https://pubmed.ncbi.nlm.nih.gov/28852945/
Lee SA, Paek JH, Chung YS, & Kim WS. (2017). Clinical features in patients with positional obstructive .... Sleep & breathing = Schlaf & Atmung, 27406180.
https://pubmed.ncbi.nlm.nih.gov/27406180/
Landry SA, Beatty C, Thomson LDJ, Wong AM, Edwards BA, Hamilton GS, & Joosten SA. (2023). A review of supine position related obstructive sleep apnea. Sleep medicine reviews, 37722317.
Q.
What is the first-line treatment for chronic insomnia?
A.
The first-line treatment for chronic insomnia is Cognitive Behavioral Therapy for Insomnia (CBT-I). It is preferred over medication because it is effective and has lasting benefits.
References:
Riemann D, Espie CA, Altena E, Arnardottir ES, Baglioni C, Bassetti CLA, et al. (2023). An update on the diagnosis and treatment of insomnia 2023. Journal of sleep research, 38016484.
https://pubmed.ncbi.nlm.nih.gov/38016484/
Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, & Cunnington D. (2015). Cognitive Behavioral Therapy for Chronic Insomnia. Annals of internal medicine, 26054060.
https://pubmed.ncbi.nlm.nih.gov/26054060/
Riemann D, Baglioni C, Bassetti C, Bjorvatn B, Dolenc Groselj L, Ellis JG, et al. (2017). European guideline for the diagnosis and treatment .... Journal of sleep research, 28875581.
Q.
What is the gold standard test for diagnosing sleep apnea?
A.
The gold standard test for diagnosing sleep apnea is polysomnography, which is typically conducted in a sleep laboratory.
References:
Rundo JV, & Downey R 3rd. (2019). Polysomnography. Handbook of clinical neurology, 31277862.
https://pubmed.ncbi.nlm.nih.gov/31277862/
Hung CJ, Kang BH, Lin YS, & Su HH. (2022). Comparison of a home sleep test with in-laboratory .... Journal of the Chinese Medical Association : JCMA, 35507020.
https://pubmed.ncbi.nlm.nih.gov/35507020/
Abrahamyan L, Sahakyan Y, Chung S, Pechlivanoglou P, Bielecki J, Carcone SM, et al. (2018). Diagnostic accuracy of level IV portable sleep monitors .... Sleep & breathing = Schlaf & Atmung, 29318566.
Q.
What lifestyle changes can help manage Obstructive Sleep Apnea?
A.
Losing weight, eating healthy, and exercising can help manage Obstructive Sleep Apnea.
References:
Carneiro-Barrera A, Díaz-Román A, Guillén-Riquelme A, & Buela-Casal G. (2019). Weight loss and lifestyle interventions for obstructive sleep .... Obesity reviews : an official journal of the International Association for the Study of Obesity, 30609450.
https://pubmed.ncbi.nlm.nih.gov/30609450/
Bouloukaki I, Daskalaki E, Mavroudi E, Moniaki V, Schiza SE, & Tsiligianni I. (2023). A Dietary and Lifestyle Intervention Improves Treatment .... Life (Basel, Switzerland), 37629612.
https://pubmed.ncbi.nlm.nih.gov/37629612/
Edwards BA, Bristow C, O'Driscoll DM, Wong AM, Ghazi L, Davidson ZE, et al. (2019). Assessing the impact of diet, exercise and the combination .... Respirology (Carlton, Vic.), 31116901.
Q.
What natural remedies and lifestyle changes can improve sleep for older adults?
A.
Older adults can improve their sleep by using natural remedies like chamomile and tart cherry juice, along with lifestyle changes.
References:
Adib-Hajbaghery M, & Mousavi SN. (2017). The effects of chamomile extract on sleep quality among .... Complementary therapies in medicine, 29154054.
https://pubmed.ncbi.nlm.nih.gov/29154054/
Yeom JW, & Cho CH. (2024). Herbal and Natural Supplements for Improving Sleep. Psychiatry investigation, 39086164.
https://pubmed.ncbi.nlm.nih.gov/39086164/
Pigeon WR, Carr M, Gorman C, & Perlis ML. (2010). Effects of a tart cherry juice beverage on the sleep of older .... Journal of medicinal food, 20438325.
Q.
What non-pharmacologic treatments are effective for Restless Legs Syndrome?
A.
Restless Legs Syndrome can be managed with non-drug methods like regular exercise, leg massages, and maintaining good sleep habits.
References:
Harrison EG, Keating JL, & Morgan PE. (2019). Non-pharmacological interventions for restless legs .... Disability and rehabilitation, 29561180.
https://pubmed.ncbi.nlm.nih.gov/29561180/
Mitchell UH. (2011). Nondrug-related aspect of treating Ekbom disease .... Neuropsychiatric disease and treatment, 21654870.
https://pubmed.ncbi.nlm.nih.gov/21654870/
Gossard TR, Trotti LM, Videnovic A, & St Louis EK. (2021). Restless Legs Syndrome: Contemporary Diagnosis and .... Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 33880737.
Q.
When should an older person consult a doctor about sleep problems?
A.
Older adults should see a doctor if they have trouble falling asleep, staying asleep, or if they feel very tired during the day.
References:
Abad VC, & Guilleminault C. (2018). Insomnia in Elderly Patients: Recommendations for .... Drugs & aging, 30058034.
https://pubmed.ncbi.nlm.nih.gov/30058034/
Alonso CA, & Estebaranz AI. (2006). [Sleeping difficulties among the elderly]. Revista de enfermeria (Barcelona, Spain), 16613084.
https://pubmed.ncbi.nlm.nih.gov/16613084
Osorio RS, Martínez-García MÁ, & Rapoport DM. (2022). Sleep apnoea in the elderly: a great challenge for the future. The European respiratory journal, 34561285.
Q.
Why is cognitive behavior therapy the preferred treatment for insomnia?
A.
Cognitive Behavioral Therapy for Insomnia (CBT-I) is preferred because it is effective in treating insomnia without the side effects of medications.
References:
van Straten A, van der Zweerde T, Kleiboer A, Cuijpers P, Morin CM, & Lancee J. (2018). Cognitive and behavioral therapies in the treatment .... Sleep medicine reviews, 28392168.
https://pubmed.ncbi.nlm.nih.gov/28392168/
Stepanski EJ. (2005). Hypnotics should not be considered for the initial treatment .... Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 17561624.
https://pubmed.ncbi.nlm.nih.gov/17561624/
Rossman J. (2019). Cognitive-Behavioral Therapy for Insomnia: An Effective .... American journal of lifestyle medicine, 31662718.
Q.
What specialists treat obstructive sleep apnea?
A.
If you are concerned you have obstructive sleep apnea, you should conduct your primary care provider first for evaluation. If it is sleep apnea, a sleep medicine specialist will evaluate with a sleep study.
References:
Slowik JM, Sankari A, Collen JF. Obstructive Sleep Apnea. 2024 Mar 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan 2013. PMID: 29083619.
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https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Cumpston E, Chen P. Sleep Apnea Syndrome. 2023 Sep 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 33232089.
https://pubmed.ncbi.nlm.nih.gov/33232089/Li Z, Celestin J, Lockey RF. Pediatric Sleep Apnea Syndrome: An Update. J Allergy Clin Immunol Pract. 2016 Sep-Oct;4(5):852-61. doi: 10.1016/j.jaip.2016.02.022. Epub 2016 Jun 30. PMID: 27372597.
https://www.jaci-inpractice.org/article/S2213-2198(16)30105-2/fulltextCristescu Teodor R, Mihaltan FD. Eyelid laxity and sleep apnea syndrome: a review. Rom J Ophthalmol. 2019 Jan-Mar;63(1):2-9. PMID: 31198891; PMCID: PMC6531778.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6531778/