Anyone can have OSA, but men are twice as likely as women to have it. However, it may be underdiagnosed in women for a number of reasons. Women are less likely than men to report symptoms. Instead, they tend to dismiss their sleepiness or fatigue as a result of their lifestyles, but sleepiness and fatigue can affect quality of life, safety and productivity. Women who do report some symptoms suggestive of sleep apnea to a doctor are actually more likely to be misdiagnosed with other conditions like depression or insomnia. Women who are obese or who have been through menopause may be at a higher risk of developing OSA.Other risk factors include:Older age: People over 40 years of age are more likely to have sleep apnea, but it can affect anyone at any age.Excess weight: Two out of three people with sleep apnea are overweight or obese, but even thin people can have it. Extra fat deposits in the upper airway are thought to predispose to airway obstruction during sleep.Neck circumference: A thick neck is associated with an increased risk of sleep apnea.Narrowed airway: The size of the airways in the nose, throat or mouth may be decreased; for example, there may be physical abnormalities in the nose or upper airway or enlarged tonsils or adenoids.Nighttime nasal congestion: Allergic rhinitis, acute upper respiratory tract infection and anatomy have been linked to snoring and OSA.Use of alcohol or sedatives: These relax the muscles in the throat and may promote apneic episodes.Smoking: Smoking can increase inflammation and fluid retention in the upper airway, making apnea worse.Family history: OSA seems to run in some families, suggesting a possible genetic predisposition.