Is There Bias in the Diagnosis of Sleep Disorders in Women?

Are Women Really Treated Fairly In Healthcare?

In our western culture, we tend to treat the disease, not the person; and this can lead to a lot of misdiagnoses. Whereas eastern medicine focuses on the person.

It happens like this: Gender Bias

In a western hospital, 10 different people could receive the same treatment for the same disease. While in an eastern hospital, 10 different people could receive 10 different treatments for the same disease.

 

Then there’s the gender bias that’s apparent, especially in sleep medicine. As noted in my article ‘Are you Safe From Heart Disease?’ , I described how men and women can receive different treatment for chest pain.

The guy might go through a whole series of tests, and be prescribed an appropriate heart medicine. The gal, on the other hand, might get a psychological evaluation and be prescribed an anti-anxiety medication.

So really, women might receive different treatment; but it’s because of a false perception. And this only makes things worse.

Still, both genders receive the same treatment for sleep apnea. This is because the same standards are used to diagnose both; although women experience some symptoms differently than men.

Confusing?

Let’s take a closer look at some things.

Gender Bias

Women are more likely to describe their sleep disorder symptoms as insomnia, and less likely to be aware of sleep apnea symptoms than men. Women also experience stress more profoundly than men, and depression in women is twice that of men.

Sleep disordered symptoms increase with age but are greater in women. And menopause and pregnancy also increase the risk of sleep apnea (OSA). However, women tend to have less severe OSA, with shorter pauses in breathing.

And while women tend to be more obese and have smaller airways, their airways are more stable than men’s.

But does all this mean women are less vulnerable to sleep apnea?

Some studies show women with less severe sleep apnea are just as vulnerable as men with more severe apnea. Although other studies show the opposite.

Then there are studies that show women have better sleep quality than men, but they have more sleep-related complaints. Another study showed women had a poorer quality of sleep than men.

And while those results may be inconclusive; the one thing that is consistent is, OSA symptoms tend to be less in women.

O.K., so maybe it’s no big deal then.

But women are also under diagnosed more than men. Or is this just be because women describe their symptoms differently, and have more mild symptoms than their male counterpart? Not to mention gender bias.

And in my last article titled ‘Reducing Stress Improves Women’s Health’, we saw how women experience stress more profoundly than men. This alone has a huge effect on women’s sleep and their health.

The real question is, do more men than women have sleep apnea just because we use the same criteria for both genders? And if so, should we use gender specific standards for diagnosing and treating sleep apnea?

 

Same Disease Different Treatments

At this point in time, there’s only one standard for measuring the severity of sleep apnea in both genders.

And while  some studies show that women with milder sleep apnea (OSA) can be just as much at risk as men with more severe OSA, the same standards apply to both. However, there are CPAP machines that do have different settings for women and men.

But again, is this difference significant enough to be a cause of undertreatment in women, especially with sleep apnea? And if so, this should be alarming, knowing that women can be more vulnerable to this disease.

Clearly, more research is needed. And while I didn’t really answer any questions, I hope I got you thinking about this potentially critical area of sleep medicine.

Conclusion

On the one hand, there’s a tendency to treat the disease, not the person. And yet, there’s a gender bias that results in treating women differently. Unfortunately, this difference is based on somewhat false assumptions and not reality.

As a result, women receive different treatment when they should be getting similar treatment. And they receive similar treatment when they should be getting different treatment.

But again, are women with mild sleep apnea just as much at risk for heart disease as men with more severe OSA? Which would mean, the only reason sleep apnea is greater in men than in women is because we use the same standards for both.

If that’s the case, then women should qualify for treatment with milder sleep apnea than men.

Maybe it’s time to re-think treatment options.

 

 

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