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    After Menopause Sleep Apnea More Common, More Severe

    A recent study found that after menopause, women are more likely to develop sleep apnea than women who have not yet gone through menopause are. What's more, their sleep apnea tends to be more severe as well.

    David R. Dancey, MD from St. Michael's Hospital of the University of Toronto, presented the results of this study at the 96th International Conference of the American Thoracic Society in Toronto. Dr. Dancey and his colleagues examined the prevalence and severity of sleep apnea in pre- and post-menopausal women to see if there were any differences between the two groups of women.

    Dr. Dancey explained, "Sleep apnea is a serious condition in which an individual stops breathing intermittently through the night -- we all do it to a certain extent, but if you do it too much you end up with extreme daytime sleepiness." He added, "It has a serious impact on an individual as well as on society -- those who have sleep apnea have incredible degrees of…sleepiness…difficulty with memory and concentration, it has effects on the cardiovascular system, making heart failure worse, possibly contributing to high blood pressure as well. It's a significant contributor to motor vehicle accidents, which is part of the effect on society."

    Using age as an indicator of menopause (women under 45 were considered pre-menopausal and women over 55 were considered post-menopausal), researchers identified 290 pre-menopausal and 400 post-menopausal women. Women who were taking hormone replacement or who had gone through premature menopause were excluded from the study. Since neck size and obesity are important risk factors associated with sleep apnea, they measured neck circumference and body mass index (BMI) in all of the women in the study. Sleep testing was conducted in the Sleep Laboratory at St. Michael's Hospital.

    The prevalence of sleep apnea was more than double (47 percent) in post-menopausal women than in pre-menopausal women (21 percent). When they looked at the number of times these women stopped breathing over the course of one hour, they found that post-menopausal women also had more severe sleep apnea.

    Previous research has already shown that obesity and large neck size increase one's risk for having sleep apnea, therefore these researchers wanted to find out whether those factors were responsible. After adjusting for neck circumference and obesity, Dr. Dancey and his colleagues found that the differences in prevalence were not related to either factor.

    Dr. Dancey explained that post-menopausal women tend to have more difficulty sleeping due to insomnia and hot flashes, and therefore may benefit from referral to a sleep center. Said Dr. Dancey, "Now that we know structural differences like neck size and obesity don't explain the observed differences in apnea prevalence and severity between these two groups of women, we can begin looking at whether or not hormone therapy will be helpful for these women".


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