Sleep Apnea Pathfinders

Is There A Difference Between Signs and Symptoms for Sleep Apnea? YES

Juanita Crawford, RPSGT, CHC & David Bishop, LCSW, CHC Season 1 Episode 4

Have you ever thought that signs and symptoms of sleep apnea are the same?  Well, we discuss the difference between signs and symptoms in this episode.  Signs are generally not observable, (with the exception of a few signs such as neck circumference) and the biggies are snoring, gasping and chocking.  These unobservable signs, are often subject to conflicts between bed partners.  We also discuss how some signs are different for men and women especially around neck circumference and types of things reported to primary care physicians.  This may lead to women being diagnosed less often then men.  We also talk about a big MYTH around BMI.  While BMI is a factor, there are individuals who have a low BMI and are considered thin who can have severe sleep apnea.

There is a disconnect sometimes between how we think we are sleeping versus how we are really sleeping.  We can rationalize that disconnected perception or even bolster how we feel with caffeine.  We discuss the effect of caffeine, and how it stimulates the body and then becomes  a contributing factor to unrefreshing sleep when used in large amounts. 

Some publicly available screening tools to fill out can give anyone a more subjective measure of how their unrefreshing sleep may be an indication of sleep apnea.  They are the Epworth Sleepiness Scale and the STOP-BANG.  The Epworth gives eight situations which you rate your tendency to become sleepy. 

The STOP-BANG stands for:

  1. Snoring History
  2. Tired during the day
  3. Observed stop breathing while asleep
  4. Blood PRESSURE
  5. Body Mass Index greater than 35
  6. Age greater than 50
  7. Neck Circumference greater than 16' for women and 17 'for men
  8. Gender-men have a higher prevalence


In regard to symptoms, Juanita and David discuss how men tend to bring common or classic symptoms of sleep apnea to their doctors attention.  Symptoms such as snoring, gasping and snorting.  Women tend to report symptoms such as mental and physical fatigue, headache, anxiety, and difficulty with insomnia.  This may cause some primary care physicians to not refer or even fill out some of the scales we mentioned.  It is important for women to advocate and use these scales so they can educate their doctors about their fatigue and hopefully get a full assessment of their sleep with a sleep physician.

We also want to introduce our Instagram account @SleepApneaPathfinders!

Interesting Studies:
Obstructive Sleep Apnea in Women: Specific Issues and Interventions

"Making a differential diagnosis of OSA in women might be more difficult given that they tend to present with more generalized daytime symptoms than men [4]. Women with OSA complain of symptoms such as insomnia, restless legs, depression, nightmares, palpitations, and hallucinations whereas men are more likely to report snoring and apneic episodes [7]."
https://doi.org/10.1155/2016/1764837