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Obstructive Sleep Apnea and Menopause

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Sleep Disorders in Women

Part of the book series: Current Clinical Neurology ((CCNEU))

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Abstract

A growing body of work supports the concept that menopause is a risk factor for obstructive sleep apnea (OSA). These observations come from clinical and population data examining the relationship between menopausal status and sleep-disordered breathing (SDB), studies examining the clinical characteristics of disease in preand postmenopausal women, and laboratory studies of the factors that might place postmenopausal women at increased risk for OSA. This chapter reviews what is known about the increased prevalence of OSA among postmenopausal women, how menopausal status affects the presentation of SDB, and the mechanisms that may underlie the development of sleep apnea among postmenopausal women.

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References

  1. Block, A.J., et al., Sleep apnea, hypopnea and oxygen desaturation in normal subjects. A strong male predominance. N Engl J Med, 1979;300(10):513–517.

    Article  PubMed  CAS  Google Scholar 

  2. Guilleminault, C., et al., Women and the obstructive sleep apnea syndrome. Chest, 1988;93(1):104–109.

    Article  PubMed  CAS  Google Scholar 

  3. Block, A.J., J.W. Wynne, and P.G. Boysen, Sleep-disordered breathing and nocturnal oxygen desaturation in postmenopausal women. Am J Med, 1980;69(1):75–79.

    Article  PubMed  CAS  Google Scholar 

  4. Young, T., et al., The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med, 1993;328(17):230–1235.

    Article  Google Scholar 

  5. Young, T., et al., Menopausal status and sleep-disordered breathing in the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med, 2003;167(9):1181–1185.

    Article  PubMed  Google Scholar 

  6. Bixler, E.O., et al., Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med, 2001;163(3 Pt 1):608–613.

    PubMed  CAS  Google Scholar 

  7. Gislason, T., et al., Snoring, hypertension, and the sleep apnea syndrome. An epidemiologic survey of middle-aged women. Chest, 1993;103(4):1147–1151.

    Article  PubMed  CAS  Google Scholar 

  8. Ferini-Strambi, L., et al., Snoring & sleep apnea: a population study in Italian women. Sleep, 1999;22(7):859–864.

    PubMed  CAS  Google Scholar 

  9. Ip, M.S., et al., A community study of sleep-disordered breathing in middle-aged Chinese women in Hong Kong: prevalence and gender differences. Chest, 2004;125(1):127–134.

    Article  PubMed  Google Scholar 

  10. Shahar, E., et al., Hormone replacement therapy and sleep-disordered breathing. Am J Respir Crit Care Med, 2003;167(9):1186–1192.

    Article  PubMed  Google Scholar 

  11. White, D.P., The hormone replacement dilemma for the pulmonologist. Am J Respir Crit Care Med, 2003;167(9):1165–1166.

    Article  PubMed  Google Scholar 

  12. Rossouw, J.E., et al., Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. JAMA, 2002;288(3):321–333.

    Article  PubMed  CAS  Google Scholar 

  13. Lawton, B., et al., Changes in use of hormone replacement therapy after the report from the Women’s Health Initiative: cross sectional survey of users. BMJ, 2003;327(7419):845–846.

    Article  PubMed  Google Scholar 

  14. Gottlieb, D.J., et al., Relation of sleepiness to respiratory disturbance index: the Sleep Heart Health Study. Am J Respir Crit Care Med, 1999;159(2):502–507.

    PubMed  CAS  Google Scholar 

  15. Resta, O., et al., Gender difference in sleep profile of severely obese patients with obstructive sleep apnea. Respir Med, 2005;99:91–96.

    Article  PubMed  CAS  Google Scholar 

  16. Leech, J.A., et al., A comparison of men and women with occlusive sleep apnea syndrome. Chest, 1988;94(5):983–988.

    Article  PubMed  CAS  Google Scholar 

  17. Resta, O., et al., Gender, age and menopause effects on the prevalence and the characteristics of obstructive sleep apnea in obesity. Eur J Clin Invest, 2003;33(12):1084–1089.

    Article  PubMed  CAS  Google Scholar 

  18. Dancey, D.R., et al., Impact of menopause on the prevalence and severity of sleep apnea. Chest, 2001;120(1):151–155.

    Article  PubMed  CAS  Google Scholar 

  19. Ware, J.C., R.H. McBrayer, and J.A. Scott, Influence of sex and age on duration and frequency of sleep apnea events. Sleep, 2000;23(2):165–170.

    PubMed  CAS  Google Scholar 

  20. O’Connor, C., K.S. Thornley, and P.J. Hanly, Gender differences in the polysomnographic features of obstructive sleep apnea. Am J Respir Crit Care Med, 2000;161(5):1465–1472.

    PubMed  CAS  Google Scholar 

  21. Redline, S., et al., Gender differences in sleep disordered breathing in a community-based sample. Am J Respir Crit Care Med, 1994;149(3 Pt 1):722–726.

    PubMed  CAS  Google Scholar 

  22. Shepertycky, M.R., K. Banno, and M.H. Kryger, Differences between men and women in the clinical presentation of patients diagnosed with obstructive sleep apnea syndrome. Sleep, 2005;28(3):309–314.

    PubMed  Google Scholar 

  23. Guilleminault, C., et al., Chronic insomnia, postmenopausal women, and sleep disordered breathing: part 1. Frequency of sleep disordered breathing in a cohort. J Psychosom Res, 2002;53(1):611–615.

    Article  PubMed  Google Scholar 

  24. Young, T., et al., The gender bias in sleep apnea diagnosis. Are women missed because they have different symptoms? Arch Intern Med, 1996;156(21):2445–2451.

    Article  PubMed  CAS  Google Scholar 

  25. Polo-Kantola, P., et al., Climacteric vasomotor symptoms do not predict nocturnal breathing abnormalities in postmenopausal women. Maturitas, 2001;39(1):29–37.

    Article  PubMed  CAS  Google Scholar 

  26. Hannhart, B., C.K. Pickett, and L.G. Moore, Effects of estrogen and progesterone on carotid body neural output responsiveness to hypoxia. J Appl Physiol, 1990;68(5):1909–1916.

    PubMed  CAS  Google Scholar 

  27. Pickett, C.K., et al., Progestin and estrogen reduce sleep-disordered breathing in postmenopausal women. J Appl Physiol, 1989;66(4):1656–1661.

    PubMed  CAS  Google Scholar 

  28. Keefe, D.L., R. Watson, and F. Naftolin, Hormone replacement therapy may alleviate sleep apnea in menopausal women: a pilot study. Menopause, 1999;6(3):196–200.

    PubMed  CAS  Google Scholar 

  29. Manber, R., et al., The effects of hormone replacement therapy on sleep-disordered breathing in postmenopausal women: a pilot study. Sleep, 2003;26(2):163–168.

    PubMed  Google Scholar 

  30. Saletu-Zyhlarz, G., et al., Insomnia related to postmenopausal syndrome and hormone replacement therapy: sleep laboratory studies on baseline differences between patients and controls and double-blind, placebo-controlled investigations on the effects of a novel estrogen-progestogen combination (Climodien, Lafamme) versus estrogen alone. J Sleep Res, 2003;12(3):239–254.

    Article  PubMed  Google Scholar 

  31. Block, A.J., et al., Menopause, medroxyprogesterone and breathing during sleep. Am J Med, 1981;70(3):506–510.

    Article  PubMed  CAS  Google Scholar 

  32. Cistulli, P.A., et al., Effect of short-term hormone replacement in the treatment of obstructive sleep apnoea in postmenopausal women. Thorax, 1994;49(7):699–702.

    Article  PubMed  CAS  Google Scholar 

  33. Polo-Kantola, P., et al., Breathing during sleep in menopause: a randomized, controlled, crossover trial with estrogen therapy. Obstet Gynecol, 2003;102(1):68–75.

    Article  PubMed  CAS  Google Scholar 

  34. Nelson, H.D., et al., Postmenopausal hormone replacement therapy: scientific review. JAMA, 2002;288(7):872–881.

    Article  PubMed  CAS  Google Scholar 

  35. Meldrum, D.R., et al., Changes in circulating steroids with aging in postmenopausal women. Obstet Gynecol, 1981;57(5):624–628.

    PubMed  CAS  Google Scholar 

  36. Liu, P.Y., et al., The short-term effects of high-dose testosterone on sleep, breathing, and function in older men. J Clin Endocrinol Metab, 2003;88(8):3605–3613.

    Article  PubMed  CAS  Google Scholar 

  37. Zhou, X.S., et al., Effect of testosterone on the apneic threshold in women during NREM sleep. J Appl Physiol, 2003;94(1):101–107.

    PubMed  CAS  Google Scholar 

  38. Di Carlo, C., G.A. Tommaselli, and C. Nappi, Effects of sex steroid hormones and menopause on serum leptin concentrations. Gynecol Endocrinol, 2002;16(6):479–491.

    Article  PubMed  Google Scholar 

  39. Tufano, A., et al., Anthropometric, hormonal and biochemical differences in lean and obese women before and after menopause. J Endocrinol Invest, 2004;27(7):648–653.

    PubMed  CAS  Google Scholar 

  40. Thomas, T., et al., Relationship of serum leptin levels with body composition and sex steroid and insulin levels in men and women. Metab Clin Exp, 2000;49(10):1278–1284.

    PubMed  CAS  Google Scholar 

  41. Tatsumi, K., et al., Role of endogenous female hormones in hypoxic chemosensitivity. J Appl Physiol, 1997;83(5):1706–1710.

    PubMed  CAS  Google Scholar 

  42. Takano, N., Change in time course of posthyperventilation hyperpnea during menstrual cycle. J Appl Physiol, 1988;64(6):2631–2635.

    PubMed  CAS  Google Scholar 

  43. Jordan, A.S., et al., Ventilatory decline after hypoxia and hypercapnia is not different between healthy young men and women. J Appl Physiol, 2000;88(1):3–9.

    PubMed  CAS  Google Scholar 

  44. Tarbichi, A.G., et al., Lack of gender difference in ventilatory chemoresponsiveness and posthypoxic ventilatory decline. Respir Physiol Neurobiol, 2003;137(1):41–50.

    Article  PubMed  Google Scholar 

  45. Morelli, C., M.S. Badr, and J.H. Mateika, Ventilatory responses to carbon dioxide at low and high levels of oxygen are elevated after episodic hypoxia in men compared with women. J Appl Physiol, 2004;97(5):1673–1680.

    Article  PubMed  Google Scholar 

  46. Jordan, A.S., P.G. D.J. McEvoy, Catcheside, and R. D. McEvoy, Ventilatory response to brief arousal from non-rapid eye movement sleep is greater in men than in women. Am J Resp Crit Care Med, 2003;166(12):1612–1619.

    Google Scholar 

  47. Carskadon, M.A., et al., Effects of menopause and nasal occlusion on breathing during sleep. Am J Respir Crit Care Med, 1997;155(1):205–210.

    PubMed  CAS  Google Scholar 

  48. Sternfeld, B., et al., Physical activity and changes in weight and waist circumference in midlife women: findings from the Study of Women’s Health Across the Nation. Am J Epidemiol, 2004;160(9):912–922.

    Article  PubMed  Google Scholar 

  49. Mohsenin, V., Effects of gender on upper airway collapsibility and severity of obstructive sleep apnea. Sleep Med, 2003;4(6):523–529.

    Article  PubMed  Google Scholar 

  50. Rowley, J.A., et al., Influence of gender on upper airway mechanics: upper airway resistance and Pcrit. J Appl Physiol, 2001;91(5):2248–2254.

    PubMed  CAS  Google Scholar 

  51. Dancey, D.R., et al., Gender differences in sleep apnea: the role of neck circumference. Chest, 2003;123(5):1544–1550.

    Article  PubMed  Google Scholar 

  52. Rowley, J.A., et al., Gender differences in upper airway compliance during NREM sleep: role of neck circumference. J Appl Physiol, 2002;92(6):2535–2541.

    PubMed  Google Scholar 

  53. Schwab, R.J., et al., Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. Significance of the lateral pharyngeal walls. Am J Respir Crit Care Med, 1995;52(5 Pt 1):1673–1689.

    Google Scholar 

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© 2006 Humana Press Inc., Totowa, NJ

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Pien, G., Veasey, S. (2006). Obstructive Sleep Apnea and Menopause. In: Attarian, H.P. (eds) Sleep Disorders in Women. Current Clinical Neurology. Humana Press. https://doi.org/10.1007/978-1-59745-115-4_19

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  • DOI: https://doi.org/10.1007/978-1-59745-115-4_19

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-592-7

  • Online ISBN: 978-1-59745-115-4

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