photo of husband awaken by snoring from skinny woman who has sleep apnea

Can skinny women get sleep apnea?

By Jason Wooden, PhD | August 20, 2021

While obesity is one of the strongest risk factors, studies have found that as many as 20 percent of adults with obstructive sleep apnea are non-obese and 5 percent of non-obese women have moderate to severe symptoms.

If you suspect sleep apnea, your options include sleep hygiene, life style changes, stress management, exercise, diagnosis and treatment, sleep counseling, and checking for other health issues linked to sleep apnea.

Why it matters whether skinny women can get sleep apnea

If lately you haven’t been sleeping too great and you’re wondering whether skinny women can get sleep apnea, it’s understandable.

Has someone noticed something different about your sleep and is complaining about snoring?

Or maybe you just don’t feel as refreshed as you used to even after EIGHT hours of sleep…

You may be thinking I’m not that overweight, so it can’t be sleep apnea, right?

If you’ve started to suspect sleep apnea is the culprit, you’re not the only one.  Online in various forums you’ll see posts from other wise lean and healthy people wondering the same.

That shouldn’t be a surprise.  After all, sleep apnea affects millions of people in the US and nearly a billion worldwide.

Regardless of whether your sleep issues are mild or more serious, it’s worth knowing for your sure because the stakes for untreated sleep apnea are pretty serious.

It’s a real sleep killer that can make for miserable nights and miserable days.

If left untreated, it can increase your risk for other life threatening issues such including high blood pressure, heart disease, stroke, diabetes, and depression.

And even if your symptoms are currently mild, sleep apnea often becomes more severe as people age.

Unfortunately, some people may struggle for years before taking it more seriously.

So, even though sleep apnea may be thought of as a disease for overweight people, it REALLY does matter whether skinny women can get it.

Let’s take a look at what we know and what you can do about it.

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Can women REALLY get sleep apnea without being overweight?

So, it turns out researchers have taken a serious look at whether more slender men and women can get sleep apnea.

An Australian team looked at the data from a 163 sleep studies for patients suspected to have obstructive sleep apnea (OSA), the most common sleep apnea type.  The study included both male and female patients.

Surprisingly, many of the patients confirmed to have sleep apnea were not obese.

There’s also another study that was done by researchers at the University of Wisconsin looking at data from more than 1500 individuals.  They found that as many as 5 percent of non-obese women had moderate to severe OSA.

A Swiss study found that as many as 20 percent of adults with OSA are non-obese.

While the estimates may vary, taken together the picture is clear – skinny woman can get sleep apnea.

Since, you’re likely wondering why, let’s look at some likely culprits.

The skinny on why skinny women get sleep apnea

For starters, keep in mind obstructive sleep apnea is all about air flow.

It often happens when the muscles in the throat relax too much during sleep.  As a consequence, the airway gets too narrow, breathing is interrupted, there’s less oxygen to the brain, and your body arouses you out of deep sleep into a lighter sleep.

This is what also causes the snoring.

However, there are other reasons why air flow could be restricted:

Anatomical features – a naturally narrower airway, enlarged adenoids or tonsils, and retruded jaw

Ethnic features – sleep apnea is more common African-Americans, Hispanics, and Pacific Islanders

Athletes – may have thicker and more muscular necks

Medical conditions – hypothyroidism, growth hormone irregularities, allergies, deviated septum

Size – smaller build and more narrow airway in slender women may increase the risk

Edema – excess fluid in the larynx from smoking, alcohol, or gastroesophageal reflux

So, anything else that can keep air from flowing freely may cause sleep apnea symptoms in people who are not overweight.

What skinny women should look for if they suspect they have sleep apnea

If you haven’t been sleeping as great lately and suspect it’s sleep apnea, there are risk factors and symptoms you can check for.

While obesity is one of the strongest risk factors, other risk factors to look for are:

  • age (older women more likely to get it)
  • menopause
  • a neck circumference greater than 16 inches
  • anxiety and depression
  • poly-cystic ovarian syndrome

Among the possible symptoms are:

  • snoring (even if it’s not heavy)
  • breathing interruptions during sleep
  • fatigue
  • excessive daytime sleepiness
  • headaches in the morning
  • high blood pressure
  • frequent night time trips to the bathroom
  • you wake up feeling like you haven’t slept at all

12 Things skinny women can do for sleep apnea

Okay, let’s get to the good news – there’s plenty you can do if you’re a slender woman and suspect you have sleep apnea.

Many of the remedies you’ll find listed below are geared towards people with obstructive sleep apnea.  It’s by far the most common type.

(You can learn more about your options for central sleep apnea here.)

Some of the remedies are pretty simple and quick to get going on while others will take time to bear fruit.  They can all help improve sleep apnea symptoms and support healthy sleep.

drawing of woman asleep in bed

1) Sleep hygiene

Why is this on the list first?  That’s because it’s the foundation for good sleep. There’s so many different things that affect how you sleep.

Your everyday habits can make or break sleep.  Also, poor sleep hygiene can sabotage the other things you do to treat your sleep apnea.

For better sleep hygiene, you should:

  • Wake up and go to bed at the same time every day
  • Exercise
  • Avoid large meals, alcohol, and stimulants such as caffeine before bedtime
  • Maintain a bedtime routine
  • Avoid electronics (TVs, tablets, smartphones) near bedtime
  • Keep your bedroom dark, cool, quiet, & relaxing

Learn more

photo of glass of wine which is one of the things skinny women with sleep apnea should avoid

2) Lifestyle changes

Avoid substances like alcohol that may relax your throat muscles too much or smoking which can have harmful effects on the lung. 

Smoking can aggravate and worsen inflammation in the airway causing your sleep apnea symptoms to be more severe.

cartoon drawing of skinny women sleeping on her back to help her sleep apnea

3) Change your sleep position

Did you know that over half of obstructive sleep apnea sufferers have symptoms that are “position-dependent”?  Their symptoms are worse if they sleep on their back.

Depending on the severity of your sleep apnea, sleeping on your side instead of your back may help keep your throat more open and improve symptoms.  Some people even claim that sleeping upright in a recliner helps.

Learn more

photo of plate with salad and salmon which may help skinny women with sleep apnea

4) Dietary changes

A low carb anti-inflammatory diet may help since sleep apnea has been connected to inflammation.  (Patients with obstructive sleep apnea, the most common sleep apnea type, have upper airway and systemic inflammation.)

Eating healthier can also keep you away from foods in the evening that may come back to wreck your sleep in other ways.

Learn more

5) Stress management

Diet isn’t the only thing that can worsen sleep apnea linked inflammation in the body.  Chronic stress may trigger inflammation too.

Also, stress and anxiety are two of the most common causes for insomnia.  It’s hard to drift off to sleep when your mind is racing.

You can fight stress with meditation, yoga, tai chi, and various other practices.

Learn more:
Six relaxation techniques to reduce stress
Stress Management (HelpGuide.org)

lady taking a walk with her dog

6) Exercise

Physical activity is known to promote deeper sleep and there’s evidence it can help reduce sleep apnea breathing disruptions.

Researchers have found that just 20 minutes of exercise can stimulate the immune system to be less inflammatory.

So, figure out something that will work for your situation whether it’s swimming, bicycling, jogging, or getting out for a walk.  If you’re dealing with other health issues, be sure to check with a doctor so you don’t overexert yourself.

Learn more

picture showing the narrow airway in a person with sleep apnea

7) Mouthpieces

Oral appliances are used to reposition the lower jaw and tongue so that the airway stays more open.  They may work best for people with mild symptoms.

You can order off the shelf mouthpieces online. They’ll send you a kit.

While this may be a poor man’s substitute for getting an oral appliance professionally fitted by a dental sleep specialist, it may help in some cases as a temporary remedy.

Learn more

picture of person doing throat exercises which may help skinny women with sleep apnea

8) Mouth and throat exercises

Various exercises using your mouth and throat may help strengthen your airway and surrounding muscles.  This can help the airway stay more open and improve sleep apnea symptoms.

Learn more:
Mouth And Throat Exercises to Help Stop Snoring and Improve OSA (sleepfoundation.org)
Video:  Throat exercises for snoring and sleep apnea

photo of person getting sleep counseling

9) Sleep counseling

Sleep counseling is one of the most effective treatments for insomnia.  Stress, anxiety, and depression are common causes for poor sleep.

It can also help identify and change thoughts and behaviors that affect sleep.

And evidence is growing that it can make a difference for sleep apnea patients.

Learn more

10) Diagnosis and treatment

CPAP is one of the most effective treatments for sleep apnea.  Unfortunately, it may not be an option if you’re strapped for cash and lack health insurance.

There’s the cost of an overnight sleep study, diagnosis by a board certified sleep physician, and getting a CPAP setup.

Did you know there are now one stop shopping online sleep apnea companies where you can get diagnosed and treated at a more affordable out-of-pocket cost?  They will send a home test kit, review the results, and write you a prescription so you can purchase a CPAP setup online.

Learn more

man at laptop ordering a home test kit which another option to treat sleep apnea yourself

11) Check for other health issues

As you get older, you encounter more health issues which can lead to more sleep problems.

What chronic pain does to sleep is pretty obvious.  Conditions like diabetes and high blood pressure are directly associated with higher rates of sleep apnea.

So, if you’re dealing with health challenges you didn’t have before, that’s another reason your sleep and sleep apnea could get worse with time.

It’s also another reason to get a checkup.

photo of medications which can make sleep apnea worse in skinny women

12) Check your meds

Have you started taking a new prescription lately?  Many medications can aggravate snoring and sleep apnea.

Those pills you’re taking for pain, anxiety, or insomnia can cause the throat to be even more relaxed and obstructed.

Learn more

Sources:

2. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis, Lancet Respir Med. 2019 Aug; 7(8): 687–698.

2. Obstructive Sleep Apnea without Obesity Is Common and Difficult to Treat: Evidence for a Distinct Pathophysiological Phenotype, J Clin Sleep Med. 2017 Jan 15; 13(1): 81–88.

3. Increased Prevalence of Sleep-Disordered Breathing in Adults, Am J Epidemiol. 2013 May 1; 177(9): 1006–1014.

4. Obstructive sleep apnea syndrome in non-obese patients, Sleep and Breathing (2021)

5. “4 Reasons Why You Could Be Thin and Have Apnea”, mysleepdevice.com

6. “Why Women are Less Often Diagnosed with OSA”, Alaska sleep clinic website

7. “Alcohol and sleep”, SleepFoundation.org

8. “How smoking affects sleep apnea and CPAP use”, 2019, VitalAire website

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