Are you sleeping poorly? Perhaps you are snoring at night, or wake up feeling breathless? If that’s the case, you may be dealing with sleep apnea with PCOS.
Sleep disorders are common in PCOS, particularly sleep apnea. Sleep apnea is characterized by a temporary pause in breathing during sleep. PCOS patients are particularly susceptible to Obstructive Sleep Apnea (OSA). This happens when airways are blocked causing loud snoring. Breathing may pause for several seconds or even minutes. Such pauses can recur several times during the night, resulting in disturbed sleep.
If you suffer from sleep apnea, you will start and stop breathing suddenly while asleep. But since you are asleep or unconscious while it happens, this condition can go undiagnosed for a long time. Your best bet? Take notice, and head to a doctor when any of these warning signs rear their head.
If you suspect you may have sleep apnea caused by PCOS, you’ll need tests for a proper diagnosis. In case your symptoms are not too severe, doctors will always advise you to make healthy lifestyle changes before undergoing more thorough testing. This is because some simple lifestyle modifications that help you shed excess weight, keep your insulin/blood sugar levels in check, and balance your hormones, will bring improvement in your OSA symptoms.
Here are some tips that are known to work in addressing sleep apnea caused by PCOS:
A healthy PCOS diet will keep glucose intolerance in check and also help improve insulin sensitivity. Eliminate all processed and refined foods from your diet. Cut back on grains and simple carbohydrates as well. Amp up your fat intake by eating – ghee, grass-fed butter, olive oil, fatty fish, coconut oil, sesame seed oil, nuts, seeds, and avocados. Partially-hydrogenated and hydrogenated fats are best avoided completely.
Since sleep apnea is more common in overweight PCOS women, it makes sense to lose weight. Excess weight gain can cause fat deposits around your throat. These deposits can block airways and interfere with smooth throat muscle function during the night. Losing weight with PCOS may seem like a challenge, but it is possible with the right combination of diet, exercise, and supplements.
Your sleeping position can worsen sleep disordered breathing. It’s a bad idea to sleep on your back, especially if you are snoring loudly and waking up choking/breathless at night. Sleeping on your back triggers apnea as your tongue may fall back during sleep, blocking airways. Elevate your head with pillows to ensure that your airways stay open throughout the night. If you have mild apnea, sleeping on the side may eliminate this problem and ensure a good night’s rest.
If you are waking up tired, drowsy and fatigued, it’s important to prioritize sleep over everything else. Since apnea can cause disturbed sleep, you want to make sure that you’re not slacking back on sleep time. Insufficient sleep interferes with memory and focus. It also leaves your brain unable to handle low oxygen supply, which occurs during apnea episodes. Aim for 7 to 9 hours of sleep every night. Sticking to a regular sleep routine can make a significant difference.
If you suffer from sleep apnea, avoid alcohol before bedtime. Not only does alcohol affect the quality of sleep, it also relaxes muscles. This means that your throat muscles may relax, leading to apnea. Smoking and drinking also relax the lower esophageal sphincter (LES.) LES is a muscular ring that prevents stomach contents from rising back into the esophagus, which can lead to GERD or acid reflux. Acid reflux can also trigger sleep apnea, so it’s a good idea to cut back on alcohol and nicotine.
Many PCOS women have irregular ovulation that causes low progesterone levels. Progesterone, a sex hormone, also keeps your airways open and improves breathing. When you breathe better, you sleep better. Get your progesterone levels tested and talk to your healthcare provider about taking Vitex Agnus – a nutritional supplement that may help the body to produce progesterone.
Keeps your bedroom humidified can minimize congestions and snoring, while promoting clear breathing. If you are prone to nasal congestions and allergies, a humidifier can help. A humidifier ensures proper drainage of the sinuses so that air can flow freely through your airways. If you can’t buy a humidifier, rubbing a few drops of eucalyptus essential oil on your chest before bedtime can get similar results.
Research has found that Vitamin D deficiency is common and associated with metabolic risk factors in patients with polycystic ovary syndrome. More importantly, studies have now linked vitamin D deficiency to sleep apnea.
If you are constantly waking up feeling tired, it may be time to consider a natural sleep aid. Melatonin and Ashwagandha can both help you sleep more peacefully and wake up feeling rested. Talk to your naturopath physician about taking them before bedtime.
When all else fails, consider a snore guard. Anti-snore devices keep symptoms of sleep apnea at bay as they ensure your airways stay clear and open throughout the night. Yes, they don’t look very glamorous. But won’t you prefer a good night’s beauty sleep to wake up feeling and looking refreshed!
Insulin resistance lies at the center of both PCOS and sleep apnea. There’s a two-way connection between sleep and insulin resistance. Sleep difficulties cause hormonal imbalances and worsen insulin dysfunction. And in turn, the imbalanced hormones and fluctuating insulin levels make it difficult to sleep at night. Other factors that make PCOS patients more vulnerable to sleep apnea are increased androgen levels and being overweight.
A study published in The Journal of Clinical Endocrinology & Metabolism found that obese women with PCOS are at increased risk of OSA when compared with women without PCOS. PCOS also increases the likelihood of suffering from symptomatic OSA syndrome because of their high waist-to-hip ratio and high levels of testosterone.
A research done at Penn State University College of Medicine found that Sleep Disordered Breathing (SDB) and Excessive Daytime Sleepiness (EDS) are more frequent in PCOS women than PCOS-free women. Also, insulin resistance is a stronger risk factor for SDB in PCOS women than body mass index or testosterone. Hence, researchers concluded that sleep apnea could be a result of an endocrine/metabolic abnormality caused by insulin resistance.
High androgens levels can also contribute to Obstructive Sleep Apnea. This explains why women with PCOS who don’t suffer from insulin resistance may also suffer from sleep apnea. Studies have also found that free testosterone levels greater than 1.07 ng/dL are independently associated with OSA. High testosterone levels can influence sleep receptors in the brain that control breathing. In women with PCOS, the occurrence of Obstructive Sleep Apnea puts them at a risk of developing NAFLD (or Nonalcoholic Fatty Liver Disease), and a worse metabolic profile.
What all this means is that sleep apnea is not something to take lightly when you have PCOS. Not only will it worsen insulin resistance, blood sugar control, and hormonal balance, it also adds to unexplained weight gain, abdominal adiposity, stress, mood disorders and increased fatigue with PCOS.
Treating sleep apnea reduces your risk to diabetes and metabolic syndrome, so make it your No.1 priority. A good night’s sleep is one of the best ways to beat PCOS.
Polycystic ovary syndrome is associated with obstructive sleep apnea and daytime sleepiness: role of insulin resistance – https://www.ncbi.nlm.nih.gov/pubmed/11158002
Increased Prevalence of Obstructive Sleep Apnea Syndrome in Obese Women with Polycystic Ovary Syndrome – https://academic.oup.com/jcem/article/86/3/1175/2847650/Increased-Prevalence-of-Obstructive-Sleep-Apnea
Obstructive Sleep Apnea Predisposes to Nonalcoholic Fatty Liver Disease in Patients with Polycystic Ovary Syndrome – http://journals.aace.com/doi/abs/10.4158/EP12366.OR?code=aace-site
Impact of Obstructive Sleep Apnea on Insulin Resistance and Glucose Tolerance in Women with Polycystic Ovary Syndrome – https://academic.oup.com/jcem/article/93/10/3878/2627346/Impact-of-Obstructive-Sleep-Apnea-on-Insulin
Vitamin D deficiency is common and associated with metabolic risk factors in patients with polycystic ovary syndrome – http://www.sciencedirect.com/science/article/pii/S0026049511000588
Obstructive sleep apnea syndrome and its association with vitamin D deficiency – https://link.springer.com/article/10.3275/8923