Snoring, Tiredness and PCOS, PMOS & PCOD: Could It Be Sleep Apnoea?

You slept eight hours. You wake up feeling like you slept two.

You have heard the reasons. It is stress. It is your thyroid. It is "just PCOS." You drink more coffee, go to bed earlier, and the tiredness stays.

For some women with PCOS, PMOS and PCOD, there is one more possible reason that rarely gets asked about: sleep apnoea. It is common, it can be treated, and it is worth knowing about.

Does this sound familiar?

• You wake up tired even after 7 or 8 hours in bed.
• You get headaches in the morning.
• Someone at home says you snore, or you wake up with a dry mouth or a gasp.
• You feel sleepy in the day. You nod off at your desk or in the car.
• You wake again and again at night, or at 3 in the morning.
• Your mood is low or anxious, and your mind feels foggy.

One or two of these can have many causes. Several together, especially with snoring, are worth mentioning to your doctor.

What is going on while you sleep

When you sleep, the muscles in your throat relax. In some people, the airway narrows so much that breathing dips or pauses. Think of a straw pinched in the middle. Air still tries to pass, but not enough.

Your brain notices and wakes you for a second, so you can breathe. You do not remember it. But if this happens many times a night, your body never gets a proper rest.

Why does it show up more with PCOS, PMOS and PCOD? Insulin resistance and higher male hormones seem to play a part. Extra weight around the middle raises the chance too. But it is not only about weight. Women of normal weight can have it as well.

It does not always look like loud snoring

This is why it is missed. In women, sleep apnoea often looks different from the picture most people have in mind:

• Tiredness more than loud snoring.
• Poor or broken sleep, or trouble falling asleep.
• Morning headaches.
• Low mood, anxiety, bad dreams.

So a woman can be told it is anxiety or depression for years, when her sleep was never checked.

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Myth versus fact

What you can do this week

1. Ask whoever sleeps near you if you snore or seem to stop breathing.
2. If you sleep alone, record your sleep on your phone for a night or two.
3. Note morning headaches, a dry mouth and how sleepy you feel in the day.
4. Try sleeping on your side. Lying flat on your back makes snoring worse for many people.
5. Avoid alcohol close to bedtime.
6. If several signs fit, tell your doctor. Take your notes or recording.

How it is checked

Your doctor will ask about your sleep, snoring and daytime sleepiness. A short questionnaire can raise suspicion. But a questionnaire cannot confirm sleep apnoea or tell how strong it is.

The real test is a sleep study. It records your breathing, oxygen level and heartbeat through the night. Some can be done at home, some in a sleep centre. Your doctor will refer you to a sleep specialist, such as a chest physician or sleep physician, who decides which test suits you.

You do not need a sleep study just because you feel tired. It is for women whose signs fit.

If it is confirmed

The main treatment for moderate to severe sleep apnoea is a CPAP machine. You wear a soft mask at night, and gentle air pressure keeps your airway open. Many people need a few weeks to get used to it. Your sleep specialist can adjust the mask and settings if it is uncomfortable.

Other steps help too: sleeping on your side, cutting alcohol near bedtime, managing body composition if that applies to you, and being careful with sleeping pills.

Be clear about what it does. Treating sleep apnoea is about sleeping well and feeling better. It can help your energy and may help blood pressure and sugar a little. It is not a PCOS, PMOS or PCOD treatment, and it will not fix your periods on its own.

Two situations to mention

• Surgery planned: tell your anaesthetist beforehand if you snore or think you may have sleep apnoea.
• Pregnant or planning: if you snore, tell your doctor. Sleep apnoea can become more common in pregnancy.

Common questions

When to see a doctor

• Loud snoring with gasping or choking at night.
• Someone has seen you stop breathing in your sleep.
• You fall asleep while driving or at work. Please do not drive when drowsy.
• Headaches in the morning, most days.
• You are tired despite 7 to 8 hours of sleep, for several weeks.
• You have high blood pressure and also snore.
• You are pregnant and snore.

What a consultation generally involves

You are asked about your sleep, snoring, daytime sleepiness and mood. Your PCOS, PMOS or PCOD is reviewed: cycles, symptoms, and tests such as sugar, insulin and thyroid if needed. Your blood pressure, waist and neck may be measured. If your signs fit, you may be referred to a sleep specialist. Here is how PMOS (PCOS) is diagnosed.

Also read: how insulin resistance is tested, lean PCOS and PMOS, the 4 types of PCOS and PMOS, and irregular periods. More answers are on the clinic's PCOS and PMOS FAQ page.