Sleep apnea symptoms in post-menopausal women linked to low estrogen

Reduced levels of estrogen and progesterone seem to be what makes post-menopausal women more likely to have symptoms of sleep apnea, including snoring, irregular breathing or gasping at night


22 June 2022

Women can become more likely to snore as they get older

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Middle-aged women who have lower levels of estrogen and progesterone are more likely to snore, breathe irregularly and gasp while sleeping, which are all symptoms of sleep apnea.

The involvement of these chemicals means targeted hormone therapy might prove useful for post-menopausal women and their partners, says Kai Triebner at the University of Bergen in Norway.

“Women live, on average, longer than men, but during later years, the quality of women’s life is comparatively low, which is inherently associated with their [low-oestrogen] hormone profile, ”says Triebner. “Snoring and sleep-related breathing problems add to the burden.”

We have long suspected that sleep apnea is related to menopause, when hormone levels drop and periods cease, he says. A few small studies have pointed to the specific role of the hormones estrogen and progesterone, but Triebner and his colleagues wanted to test these theories on a bigger scale.

His team interviewed 774 women aged between 40 and 67 years old, mostly white, living in seven European countries about their respiratory health and lifestyles. The Team Also Carried Out Clinical Exams and Took Blood Samples. The Women Completed Questionnaires About their Sleep Habits and Health. The Study Didn’t Include Pre or Post-Menopausal Trans Men.

Nearly half the women reported that they had a “disturbing snore”, says Triebner. In addition, 14 percent had irregular breathing and 13 percent gasped while sleeping.

Blood analyzes revealed that the participants’ estrogen and progesterone levels varied widely, ranging from just a few units per liter in some women to tens of thousands of units per liter in others. Those Variations Had Clear Associations With Sleep Apnoea, He Says. As the levels of oestrone – a kind of estrogen – doubled, women were 19 per cent less likely to snore. And as progesterone levels doubled, women were 9 percent less likely to snore.

Within the group of women who snored, there was a 20 percent drop in the chances of having irregular breathing as estrogen levels doubled. And a doubling in progesterone levels was linked to a 12 percent lower likelihood of waking up feeling like they were choking.

All the findings were adjusted for the women’s stage of menopause, age, body mass index, smoking habits and educational backgrounds, some of which can affect hormone levels.

The results show a mechanism for the link between menopause and sleep apnea. And they make sense given that certain kinds of estrogen are involved in building respiratory muscles, and progesterone helps stimulate respiration, says Triebner.

Sleep apnea is a potentially serious condition that has been linked to heart disease and stroke, and snoring can lead to relationship problems, says Triebner. “I believe an individualized hormone treatment after menopause has great potential to improve the quality of life of many women, and it most likely would severely improve sleep-disordered breathing,” he says.

Even so, further research is necessary. “What may be beneficial for one woman could be potentially harmful for another,” says Triebner

Journal reference: PLoS OneDOI: 10.1371 / journal.pone.0269569

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