Sleep apnea in females, a diagnostic masquerade:
Conventional wisdom tells us that sleep apnea and snoring are mostly a disease of older males. This misconception commonly causes the underdiagnosis of sleep disorders in females. Why? Snoring can be a smaller part of the picture, and the disease can manifest with a different pattern. In females, it presents as nasal congestion, headache, fatigue and dry mouth and for some reason, instead of a sleep apnea diagnosis, many females (and males) end up with a diagnosis of migraines, chronic fatigue or fibromyalgia, and sinusitus or a slew of other symptoms that require expensive treatments and trips to many specialists like neurologists, ent’s and rheumatologists. Many, in my experience become frustrated with the lack of improvement from he treatments which are sometimes exotic.
In many cases, the sleep apnea is due to two causes. The earliest cause is septal deviation and nostril collapse seen in petit noses or poorly structured noses. This requires people to become mouth breathers during sleep and exercise. Mouth breathing causes tongue collapse during sleep, dry mouth, and the collapse causes headaches and fatigue from reduced brain oxygenation during sleep. The treatment is nasal repair and / or CPAP (continuous positive airway pressure). The other cause of mouthbreathing with weight gain, and elevated BMI (body mass index) that affects the chin, neck and chest and causes to mouth to spring open at night, permitting the tongue to collapse into the airway. This is exacerbated by menopause which relaxes some of the supportive tissues of the face, neck and chin, causing facial aging, and decreased muscle tone, and worsening of the mouth opening and tongue collapse at night. As mentioned above, this mouthbreathing causes headache, nasal obstruction, loss of energy and fatigue, symptoms that are usually ascribed to other conditions. Conventional medicine tends to split these conditions into other diagnosis and specialties, and sleep apnea masquerades literally as a whole host of other entities like migraine and chronic fatigue syndrome.
Why does a facial plastic surgeon like me care about this? Two reasons. Many of the women who have these conditions can be helped with a functional rhinoplasty and weight loss, but don’t realize it! Also, chronic sleep apnea and mouth breathing causes reversible aging face changes that can be treated as well, but are better managed by treating the underlying cause of sleep apnea! Next time you get individual symptoms treated as individual diagnosis by individual specialists, remember that there may be one underlying cause (concept known in Medicine as Occam’s Razor).
For more research info see fairfieldcountyrhinoplasty.com