Obstructive Sleep Apnea and PCOS


Women with Polycystic Ovary Syndrome (PCOS) are at a higher risk for obstructive sleep apnea (OSA) according to findings presented at the 9th Annual Meeting of the Androgen Excess & PCOS Society.

One report suggests PCOS women are 30 times more likely to have OSA (characterized by slow wave activity, sleep loss, oxygen deficiency) than compared with controls. Another study published in Steroids showed the risk for OSA is at least 5- to 10-fold higher in women with PCOS compared to the risk in similarly weight matched women without PCOS.

Obstructive sleep apnea is an under recognized yet significant factor in the development of metabolic complications seen in women with PCOS. In fact, the more severe the apnea, the higher prevalence of impaired glucose tolerance, non-alcoholic fatty liver disease (NASH), and high blood pressure. OSA contributes to weight gain and difficulties losing weight as it affects the sympathetic nervous system and hypothalamic adrenal axis.

What Is Obstructive Sleep Apnea?

According to the National Heart Lung and Blood Institute, OSA is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. They often occur 5 to 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.

Sleep apnea often goes undiagnosed as there are no blood tests for the condition and doctors can’t recognize it at office visits because you are awake. Often times a family member and/or bed partner may be the first notice the signs.

Signs and Symptoms of OSA

  • Loud and chronic (ongoing) snoring.

  • Pauses may occur in the snoring. Choking or gasping may follow the pauses.

  • The snoring usually is loudest when you sleep on your back.

  • Snoring may not happen every night. Over time, the snoring may happen more often and get louder.

  • Sleepiness during the day, at work, or while driving.

  • Morning headaches

  • Memory or learning problems and not being able to concentrate

  • Feeling irritable, depressed, or having mood swings or personality changes

  • A dry throat when you wake up

The Link Between Sleep Apnea and PCOS

So why do so many people with PCOS have sleep apnea? It’s most likely androgens that are to blame.

High androgens contribute to sleep apnea which may explain why so many women with PCOS have it.

Testosterone has been found to influence sleep receptors in the brain that control breathing. Obesity or excessive body fat can also increase the risk. One study published in Endocrine Practice found that  androgen levels and the prevalence of NAFLD (83.3% vs. 26.9%) were higher in patients with sleep apnea than those without it.

Even young women with PCOS have been shown to be at an increased risk for sleep apnea. Compared to girls of the same weight, those with PCOS had higher prevalence of sleep apnea and metabolic dysfunction. The prevalence of cardiometabolic dysfunction in girls with PCOS and sleep apnea was higher compared to girls with PCOS without apnea.

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Treatment Of Sleep Apnea

The goal is to keep the airway open so that breathing does not stop during sleep. Continuous positive airway pressure (CPAP) is now the first treatment for obstructive sleep apnea in most people. CPAP is delivered by a machine with a tight-fitting face mask. Good follow-up and support from a sleep center can often help overcome any problems in using CPAP.

The good news for women with PCOS: Blood pressure, metabolic function and insulin can improve with number of hours of CPAP use.

Bottom line:
Sleep apnea should not be overlooked in PCOS. Treatment with CPAP can improve blood pressure, insulin and reduce the risk for diabetes and metabolic syndrome. It may also help shed those unwanted pounds. If you think you have OSA, talk to your doctor about getting a sleep study done to test for sleep apnea.


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Comments (2)
  • Katherine Dilworth

    September 19, 2016 at 5:46 am

    Fantastic post on OSA and PCOS! I really enjoyed reading your article…Thanks for sharing your knowledge..

  • petty

    April 9, 2017 at 7:04 pm

    Very interesting and helpful.thanks a lot!

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