It is clear that symptoms experienced by males and females with snoring and sleep apnoea may differ. There are obvious biological differences in lung size and respiratory function in males and females which suggest that the upper airway is relatively greater in women. Additionally the airway walls are less flexible and therefore less prone to yield to pressure. This means that collapse of the airway is resisted when muscle tone falls during sleep.
The drive to breathe varies in phase with the menstrual cycle underlining the influence of the hormones progesterone and oestrogen. Ventilatory drive may be stronger in males than females whilst awake, but females do not experience such a great fall in the drive to breathe during sleep. Women are probably protected from snoring and sleep apnoea because of this effect.
It is thought that fluctuations in hormone levels can tip the balance in women who are predisposed to snoring and sleep apnoea.
Hormone Replacement Therapy (HRT) gives clear evidence that female hormones play a preventative role in reducing the incidence of snoring and sleep apnoea in pre-monopausal females. However, more research is needed to understand the treatment effect of HRT in post-menopausal women.
