Risk of Sleep Apnea Worsens After Menopause

From the WebMD Archives

May 11, 2000 -- If you have passed menopause and are nodding off more during the day, the problem may be more than just maturity catching up with you. If your spouse or bed partner has reported that you snore or stop breathing while you're sleeping, it could be sleep apnea.

Apnea literally means "no breath," and episodes of sleep apnea are brief moments during which the sleeper quits breathing. Insufficient oxygen then forces the sleeper to awaken, often several times per hour. These episodes can leave the patient plagued with daytime grogginess.

Sleep apnea is also associated with several health problems, such as congestive heart failure and high blood pressure, and people who have this condition are more likely to have auto accidents because they are sleepy and can't concentrate, says David R. Dancey, who spoke at a meeting of the American Thoracic Society in Toronto.

"All patients who have daytime sleepiness, along with snoring or apnea observed by their bed partner, should report these symptoms to their physicians," Dancey tells WebMD.

Women past menopause should be particularly aware of these symptoms, says Dancey, a lecturer at St. Michael's Hospital at the University of Toronto. Although sleep apnea is often thought of as a man's condition, women's risk of having sleep apnea increases after menopause, and those who have the condition have more severe symptoms than do younger women, Dancey says.

Sleep apnea is estimated to occur in one in every 10 women and one in four men. Treatments range from simple behavioral changes, such as changing sleep position, to surgery to increase the size of the airway.

Dancey and colleagues sought to compare the rate and severity of sleep apnea in pre-and postmenopausal women. They looked at the records of nearly 2,000 women who had been assessed at a sleep clinic. Those who were younger than 45 were assumed to be premenopausal, and those older than 55 were assumed to be postmenopausal.

Among women 55 and up, 48% had sleep apnea, compared to 22% in the younger group, the researchers found.

Obesity is a risk for sleep apnea, as is a high proportion of body fat on the neck. Although the average body mass index was greater for the older group, the investigators found that the rates and severity of sleep apnea were distributed over a wide range of body sizes. And the average neck circumference was nearly identical for the two groups.

So Dancey and colleagues consider menopause to be a risk factor for sleep apnea in women regardless of weight or neck size. He says that the hormone progesterone may protect women against developing sleep apnea because it stimulates breathing, and suggests that future studies may examine whether supplemental hormones can protect against sleep apnea.