Menopausal Hormones May Cause Sleep Apnea in Women

Obstructive sleep apnea, or just sleep apnea, as it is commonly referred to, has recently been observed to occur in high incidences in peri-menopausal women. Other than observation and self-reporting of increased difficulties sleeping, there is no definitive scientific data linking sleep apnea to menopause. However, a four-year study concluded the lower levels of estrogen may be responsible for more cases of sleep apnea and that menopausal women were eight times more likely to suffer from the disorder.

The changes that happen during menopause can cause women to experience symptoms commonly associated with sleep apnea. According to the Sleep Foundation, "post-menopausal women are less satisfied with their sleep, and as many as 61% report insomnia symptoms. Snoring has also been found to be more common and severe in post-menopausal women. Snoring along with pauses in breathing or gasps are signs of a more serious sleep disorder, obstructive sleep apnea." Hot flashes also interrupt sleep for many patients who are post-menopausal. They are not only responsible for patients waking up frequently throughout the night, but also cause them to feel fatigued throughout the day. Before, women with severe symptoms were treating it with either estrogen replacement therapy (ERT) or with hormone replacement therapy (HRT), but a study done by the United States government found these drugs often place women at risk for cardiovascular disease and dementia. 

While HRT can be prescribed at low doses, there are several alternative methods that can also work, like:

• Calcium supplements
• Vitamin D
• Bisphosphonates
• Osteoporosis treatment
• Estrogen creams and rings to counter vaginal dryness
• Sleeping medication
• Soy products (which should be discussed with a healthcare professional)

Although weight is the most common risk factor for sleep apnea, researchers have recently noted that the loss of hormones due to the onset of menopause could also be a possible cause. During menopause, a woman’s body stops producing eggs. The beginning part is called peri-menopause, in which the regulation of hormones like estrogen and progesterone is lowered. A range of uncomfortable symptoms are often experienced between menopause and peri-menopause. Difficulty sleeping, for example, can occur due to these symptoms, as well as fibromyalgia, hot flashes, arthritis, and depression. Menopause also alters one’s sleep pattern and the stages of sleep.

Depression arises when the body is under stress and also experiences sleep interruptions due to night sweats and hot flashes. This can cause further sleep issues. The chances of developing severe sleep disorder are 10%, but the risk in women with peri-menopause or menopause is almost 30%. It has been suggested that an increase in weight may be caused by these hormonal changes. For sleep apnea, this is the most common risk factor. Others include low levels of estrogen and progesterone, causing the muscles that keep the airways open for breathing to collapse.

Side effects of sleep apnea include:

• Waking headache
• Reduced sex drive
• Depression

Any form of sleep apnea becomes scarier when coupled with menopause. However, both can be treated effectively. In order to determine whether the patient is indeed suffering from sleep apnea, a physician needs to conduct a sleep study. It may require the use of a CPAP machine. Hormone replacement therapy or supplements can be used to manage the loss of hormones due to menopause.

Sleep apnea affects 22 million people in the United States alone. This disorder causes sleep interruptions due to a blockage in the airways. When a person sleeps at night, the muscles of the throat and tongue relax. Sleep apnea is also caused by overly large tonsils that narrow the airway by pressing on it. Sleeping on one’s back, certain medications, drinking alcohol before bed, and being overweight are also factors for sleep apnea.