LOS ANGELES — Too many women veterans remained undiagnosed with sleep apnea, even if they were at high risk of adverse outcomes, according to a new study.

The report in the Journal of Clinical Sleep Medicine provided results of a study seeking to estimate rates of undiagnosed, diagnosed and treated sleep apnea in women veterans. Researchers also worked to identify factors associated with diagnosis and treatment of sleep apnea in that population.

To do that, the authors sent a large nationwide postal survey to a random sample of 4,000 women veterans who had received healthcare at a VHA facility in the previous six months. Survey items used for the current analyses included: demographics; sleep apnea risk, diagnostic status and treatment; symptoms of other sleep disorders (e.g., insomnia); mental health symptoms; and comorbidities.

From the 1,498 surveys completed, 13% of the women who responded reported a prior sleep apnea diagnosis. Among women who reported that diagnosis, 65% reported using positive airway pressure therapy.

The study determined that a sleep apnea diagnosis was associated with older age, higher BMI, non-Hispanic African American/Black racial/ethnic identity, being unemployed, other sleep disorder symptoms (e.g., insomnia), depression and post-traumatic stress disorder symptoms and multimorbidity.

Even among women without a sleep apnea diagnosis, however, 43% scored as “high risk” on the STOP (snoring, tiredness, observed apneas, blood pressure) questionnaire, according to the report.

Researchers associated high risk scores with older age, higher BMI, African American/Black identity, other sleep disorder symptoms (e.g., insomnia), mental health symptoms and multimorbidity. The only difference between women using vs. not using positive airway pressure therapy was high body mass index (BMI), they wrote.

“Women veterans with diagnosed sleep apnea were commonly treated with positive airway pressure therapy, which is standard first-line treatment; however, many undiagnosed women were at high risk,” researchers concluded. “Efforts to increase screening, diagnosis, and treatment of sleep apnea in women with comorbid mental and physical health conditions are needed.”


  1. Martin JL, Carlson G, Kelly M, et al. Sleep apnea in women veterans: results of a national survey of VA health care users. J Clin Sleep Med. 2021;17(3):555–565.