Women with sleep apnea face misdiagnosis and delayed treatment due to a lack of knowledge by physicians of the differentiated ways OSA symptoms arise and present in women. Traditional exams overlook the hormonal and other crucial health aspects that make OSA unique in women. Vivos Therapeutics is addressing this issue with better diagnostics, professional clinical education, and a non-invasive treatment that targets the root cause and is preferred by women over 2 to 1.
LITTLETON, Colo., March 26, 2025 /PRNewswire-PRWeb/ -- Sleep is essential to physical and mental well-being, yet for millions of women, undiagnosed obstructive sleep apnea (OSA) is quietly undermining their health. Up to 15% of women in North America have OSA, and their risk increases after menopause, but their symptoms—ranging from chronic fatigue and mood disturbances to disrupted sleep—are frequently dismissed or misdiagnosed. (1) "This is a critical gap in healthcare," points out Susie McCullough, EVP Operations and Co-founder of . "Women deserve access to accurate diagnoses and effective treatments. We must rethink how we approach sleep health to ensure no one is left behind."
The Hidden Epidemic: Why Women Are Overlooked
OSA in women is often missed or misdiagnosed because it presents with symptoms that differ from those commonly seen in men. While men typically experience loud snoring and noticeable pauses in breathing, women are more likely to report persistent fatigue, headaches, mood swings, and difficulty sleeping—symptoms that are frequently mistaken for anxiety, depression, or even menopause-related changes. This leads to delayed diagnosis and prolonged suffering, leaving many women without the critical treatment they need to protect their long-term health. (1)
Key reasons why OSA uniquely affects women include:
- Hormonal Influences on Breathing: Estrogen and progesterone help keep airways stable, reducing the risk of sleep apnea. However, fluctuations in these hormones during key life stages can increase vulnerability to OSA. During menopause, declining estrogen levels substantially increase OSA risk by affecting metabolism, thermoregulation, and circadian rhythms. (2-3) Pregnancy-related hormonal and physical changes can also increase OSA risk, with up to 27% of pregnant women affected. (4) Additionally, OSA symptoms may worsen during certain phases of the menstrual cycle, particularly around menstruation. (5) Research shows a 56% prevalence of OSA in women with polycystic ovary syndrome (PCOS). (6)
- Atypical Symptoms: Women with OSA often experience symptoms such as chronic fatigue, anxiety, depression, and insomnia rather than loud snoring or excessive daytime sleepiness. (1) They are also more likely to report restless legs, nightmares, and palpitations, leading to frequent misdiagnosis. The societal stigma around snoring and attending medical visits alone may further hinder proper diagnosis, contributing to lower referral rates and underrepresentation in clinical studies. (7)
- Sleep Stages: Women with OSA experience more breathing disturbances during REM sleep, when the airway is most vulnerable to collapse. (1) These episodes tend to be longer and more de-saturating than those in non-REM sleep, increasing risks for systemic hypertension and cardiometabolic issues. Despite its significant impact, REM-related OSA often occurs in mild to moderate cases and may go unnoticed, contributing to delayed diagnosis and treatment. (8)
Gender Disparities in Sleep Apnea Diagnosis and Screening Limitations
Bias in sleep apnea diagnosis extends beyond outdated screening tools—it also influences how healthcare providers interpret symptoms. Research indicates that even when women present with hallmark OSA symptoms, they are significantly less likely to receive appropriate treatment compared to men. This discrepancy persists despite women facing similar risks for hypertension, diabetes, and cardiovascular disease. (9)
A key factor contributing to this gap is the reliance on screening tools that were primarily developed based on male-centric symptoms. The Epworth Sleepiness Scale (ESS), a widely used assessment for daytime sleepiness, evaluates an individual's likelihood of dozing off in various scenarios. However, this tool may not accurately capture the experiences of women with OSA, who are more likely to report insomnia and anxiety rather than excessive daytime sleepiness. Since the ESS prioritizes sleep propensity over sleep fragmentation or quality, it may fail to help providers identify cases of OSA in women. This male-oriented approach to screening may contribute to the underdiagnoses of OSA in women, further delaying access to necessary care and treatment. (1)
Empowering Women to Lead the Charge in Sleep Health
Raising awareness about the gender disparities in OSA diagnosis and treatment is a critical step toward improving women's overall health. Vivos is dedicated to addressing this issue by educating both patients and healthcare professionals on the unique ways OSA presents in women.
As part of this ongoing effort, Vivos hosts an Empowering Women to Champion Airway conference at the Vivos Institute in Denver, CO. This event brings together healthcare professionals, industry leaders, and advocates to discuss the latest research, treatment advancements, and strategies for overcoming gender disparities in airway health.
Held every fall, the conference fosters collaboration and education, empowering attendees with the tools to enhance patient outcomes and drive innovation in sleep medicine. "The more we talk about it, the more lives we can change," says Susie McCullough, EVP of Operations and Co-founder of Vivos Therapeutics. "Women should not have to fight for recognition of a condition that science has already proven exists."
Revolutionizing Sleep Apnea Treatment for Women with Non-Invasive Solutions
Vivos is transforming sleep apnea treatment by offering dentists and medical providers an innovative, non-invasive oral appliance that addresses the needs of all their patients.
The is the only FDA-cleared device designed for use in mild, moderate, and severe cases of obstructive sleep apnea. By targeting the anatomical root cause of airway obstruction, it improves sleep quality and overall health. In many cases, treatment can resolve sleep apnea in under 12 months. To ensure providers are equipped to deliver the best care, Vivos offers comprehensive training and support for dental and medical professionals across the United States and Canada. This includes advanced education on sleep testing, screening, diagnosis, and treatment protocols, empowering providers to offer the most effective, patient-centered solutions.
"Every woman suffering from OSA deserves a solution that is not only effective but also tailored to her unique needs," says Susie McCullough, EVP of Operations and Co-founder of . "We are dedicated to empowering women to make informed decisions about their options and live healthier, more fulfilling lives, while ensuring that providers have the knowledge and tools they need to make a difference in patient care."
About VIVOS THERAPEUTICS
Obstructive sleep apnea (OSA) affects over 1 billion people worldwide, yet 85% remain undiagnosed and unaware of their condition. This chronic disorder is not just a sleep issue—it's closely linked to nearly every modern chronic health condition. While the medical community has made strides in treating sleep disorders, breathing and sleep health remain areas that are still not fully understood. As a result, solutions are often mechanistic and fail to address the root causes of OSA.
Vivos Therapeutics, founded in 2016 and based in Littleton, CO, is changing this. Through innovative technology, education, and partnerships with dentists, functional medicine doctors, and sleep specialists, Vivos is empowering healthcare providers to more thoroughly address the complex needs of patients. Their groundbreaking device is the only FDA 510(k) cleared technology for treating severe OSA and the first to receive clearance for treating moderate to severe OSA in children.
The Vivos Method offers a unique, clinically effective solution that is nonsurgical, noninvasive, and nonpharmaceutical, providing hope for patients with mild to severe OSA. Vivos: Breathe New Life. For more information, visit .
References
1. Vera Summer, Jay . "Sleep Apnea in Women." SleepApnea.org, 5 Nov. 2024, sleepapnea.org/sleep-health/sleep-apnea-in-women/.
2. Krüger, Markus, et al. "Menopause Is Associated with Obstructive Sleep Apnea in a Population-Based Sample from Mecklenburg–Western Pomerania, Germany." Journal of Clinical Medicine, vol. 12, no. 6, 1 Jan. 2023, p. 2101, mdpi.com/2077-0383/12/6/2101, .
3. Pacheco, Danielle. "How Can Menopause Affect Sleep?" Sleep Foundation, 22 Jan. 2021, sleepfoundation.org/women-sleep/menopause-and-sleep.
4. Maniaci, Antonino, et al. "Obstructive Sleep Apnea in Pregnancy: A Comprehensive Review of Maternal and Fetal Implications." Neurology International, vol. 16, no. 3, 7 May 2024, pp. 522–532, doi.org/10.3390/neurolint16030039.
5. Pacheco, Danielle, and Abhinav Singh. "Sleep Apnea Symptoms in Women." Sleep Foundation, 1 June 2023, sleepfoundation.org/sleep-apnea/sleep-apnea-symptoms-in-women.
6. Liu, Peijun, et al. "Association of Obstructive Sleep Apnea Syndrome with Polycystic Ovary Syndrome through Bidirectional Mendelian Randomization." Frontiers in Medicine, vol. 11, 28 June 2024, doi.org/10.3389/fmed.2024.1429783.
7. Wimms, Alison, et al. "Obstructive Sleep Apnea in Women: Specific Issues and Interventions." BioMed Research International, vol. 2016, 2016, pp. 1–9, ncbi.nlm.nih.gov/pmc/articles/PMC5028797/, .
8. Bonsignore, Maria R., et al. "REM Sleep Obstructive Sleep Apnoea." European Respiratory Review, vol. 33, no. 171, 31 Jan. 2024, err.ersjournals.com/content/33/171/230166#:~:text=Obstructive%20sleep%20apnoea%20(OSA)%20can, .
9. Lastra, Alejandra Carolina, and Hrayr Pierre Attarian. "The Persistent Gender Bias in the Diagnosis of Obstructive Sleep Apnea." Gender and the Genome, vol. 2, no. 2, Apr. 2018, pp. 43–48, doi.org/10.1177/2470289718787107.
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