Menopause has been described as risk for sleep disordered breathing or sleep apnea. During menopause, women experience hormonal and physical changes and these changes can affect sleep. Progesterone levels fluctuate during menopause transition, declining to very low levels in the postmenopausal period. In a study from women with sleep complaints, 53% had sleep apnea, periodic limb movement or both.
In a study by Dancey, et al. the prevalence rates for sleep disordered breathing were higher in postmenopausal women than in premenopausal women. In women older than 55 years, presumed to be postmenopausal (47%) the AHI (apnea/hypopnea index) was higher than women younger than 45 years old presumed to be premenopausal (21%). In perimenopause, the the risk of sleep disordered breathing, including sleep apnea, increases from 6.5% to 8.7% to 16% in women in their 30s, 40s, 50s, respectively. Research suggests that lower progesterone levels, weight gain and changes in adipose tissue disposition, all associated with menopause, may have an adverse impact on the upper airway. Post menopausal women were 2.6 times more likely than premenopausal women to have sleep disordered breathing.
Several factor may contribute to an increase in sleep disordered breathing after menopause:
Weight gain – The change in the distribution of adipose tissue, that tends to accumulate in the upper part of the body after menopause could contribute to sleep apnea.
Declining levels of estrogen and progesterone – Progesterone increases the ventilatory drive and increases the activity of the upper airway dilatory muscles, so a decrease in it could have an opposite effect.
The most common sleep problems in women include insomnia, hot flashes, mood disorders, and sleep disordered breathing. Have you been feeling fatigued or do you have any other sleep complaints? Consider an evaluation for sleep disordered breathing.
Have you been diagnosed with sleep apnea and are looking for CPAP alternatives? Oral appliance therapy is an alternative to CPAP in the management of sleep apnea.