Sleep Apnea and PCOS: Understanding the Connection April 1, 2025 Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects women of reproductive age, often leading to menstrual irregularities, hormone imbalances, ovarian cysts, and weight gain.1 It is the leading cause of female infertility and increases the risk of insulin resistance and type 2 diabetes. Over half of women with PCOS develop diabetes by age 40.2 Now, what many people don’t realise is that PCOS may also increase the risk of another serious health issue: obstructive sleep apnea (OSA). Obstructive sleep apnea is a common sleep disorder that causes a person to stop breathing during sleep.3 When you have OSA, the muscles in your airway collapse, and cause repeated blockages during sleep, limiting the amount of air reaching your lungs.3 OSA is often associated with loud snoring, choking or gasping sounds, and frequent awakenings, which can result in poor sleep quality and excessive daytime fatigue. 3 Untreated sleep apnea can also contribute to a range of chronic health problems, including type 2 diabetes, obesity, and cardiovascular disease. 3 If you have PCOS, your risk of developing OSA may be higher than you realise. Recent population-based studies indicate a high incidence of OSA among adult women with PCOS.4 In fact, one study reports that the risk for OSA is at least 5-to-10-fold higher in women with PCOS compared to those without PCOS.5 So, what explains this strong connection? The link between sleep apnea and PCOS is largely due to factors such as obesity, insulin resistance, and hormonal imbalances—issues that women with PCOS often experience, increasing their risk of developing sleep apnea.1 Visceral fat accumulation, particularly around the organs, along with hormonal changes such as high androgen and low estrogen levels may contribute to the higher prevalence of OSA in women with PCOS.1 These physiological differences promote fat buildup around the neck, narrowing the airway and increasing the risk of sleep apnea.6 Importantly, neck circumference is a stronger predictor of OSA risk than waist circumference. 6 This risk is further amplified by obesity and aging. 6 Women with PCOS may be more likely to experience poor sleep quality or chronic daytime sleepiness, which can be symptoms of OSA.7 If you feel tired or unrefreshed after a full night’s sleep, have difficulty concentrating, or unintentionally fall asleep during the day, OSA may be the cause. Clinically, women with OSA may often present with insomnia, fatigue, or mood disturbances, rather than the more commonly recognized symptoms such as snoring.4 Untreated sleep apnea may worsen other PCOS symptoms, including insulin resistance, weight gain and hormonal imbalances.2 Researchers suggest that treating OSA may positively impact the health and quality of life of women with PCOS by reducing the risk of health problems such as type 2 diabetes, obesity, and cardiovascular disease.2 Continuous positive airway pressure (CPAP) therapy is the gold standard treatment for moderate to severe OSA, helping to keep the airway open during sleep. If you have PCOS and experience symptoms of sleep apnea, such as daytime fatigue, or restless sleep, speak to your doctor. Addressing both conditions together can improve sleep quality, overall health, and quality of life. How Sove CPAP Clinic Can Help Founded in 2008, Sove CPAP Clinic has grown to become a leading provider of respiratory and sleep services and products in Australia, with over 60 clinics nationwide. Our comprehensive clinical team includes Respiratory & Sleep Specialists, Sleep Technologists, and CPAP Consultants, ensuring that you receive comprehensive and personalised care. All medical procedures, including sleep studies and lung function testing, are bulk billed to all Australians, with minimal wait time. If you would like to speak to a Respiratory & Sleep Physician, book a bulk-billed sleep study, or seek treatment advice for your sleep apnea, you can reach us at 1300 76 29 39 or info@thecpapclinic.com.au. ALWAYS FOLLOW THE DIRECTIONS FOR USE. CPAP is used for Obstructive Sleep Apnea treatment. When considering whether a sleep study or CPAP is right for you, speak to your doctor. Medicare criteria and T&C’s apply. Citations 1. Tasali, Esra, et al. “Polycystic Ovary Syndrome and Obstructive Sleep Apnea.” Sleep Medicine Clinics, vol. 3, no. 1, Mar. 2008, pp. 37–46, www.sciencedirect.com, https://doi.org/10.1016/j.jsmc.2007.11.001. 2. Robards, Katherine. “Women with PCOS May Have Higher Risk of Sleep Apnea.” Sleep Education, 7 July 2022, sleepeducation.org. 3. Slowik, Jennifer M., and Jacob F. Collen. “Obstructive Sleep Apnea.” PubMed, StatPearls Publishing, 21 Mar. 2024, www.ncbi.nlm.nih.gov/books/NBK459252/. 4. Sam, Susan, and Esra Tasali. “Role of Obstructive Sleep Apnea in Metabolic Risk in PCOS.” Current Opinion in Endocrine and Metabolic Research, vol. 17, Apr. 2021, pp. 46–51, https://doi.org/10.1016/j.coemr.2021.01.002. 5. Ehrmann, David A. “Metabolic Dysfunction in PCOS: Relationship to Obstructive Sleep Apnea.” Steroids, vol. 77, no. 4, Mar. 2012, pp. 290–294, https://doi.org/10.1016/j.steroids.2011.12.001. Accessed 4 May 2020. 6. Deng, Hai, et al. “Association of Adiposity with Risk of Obstructive Sleep Apnea: A Population-Based Study.” BMC Public Health, vol. 23, no. 1, 21 Sept. 2023, https://doi.org/10.1186/s12889-023-16695-4. 7. Fernandez, Renae, et al. “Sleep Disturbances in Women with Polycystic Ovary Syndrome: Prevalence, Pathophysiology, Impact and Management Strategies.” Nature and Science of Sleep, vol. 10, Feb. 2018, pp. 45–64, www.ncbi.nlm.nih.gov, https://doi.org/10.2147/nss.s127475.
