Impact of menopause on the manifestation and severity of sleep-disordered breathing

Background. Decreased production of female hormones might explain the increased prevalence of sleep-disordered breathing in postmenopausal women. Objectives. We evaluated, whether menopause has an impact on the manifestation of sleep- disordered breathing in terms of signs, symptoms, and breathing pattern. Methods. The study was a cross-sectional study utilizing a patient database, hospital records, sleep studies, and questionnaires. The hospital records and sleep studies were reviewed in 601 consecutive women studied between 1994 and 1998 in a university hospital pulmonary clinic. The records were completed with questionnaires. Results. Nocturnal breathing abnormalities covered a greater proportion of the night in postmenopausal than in premenopausal women (68.1% versus 35.8% of time in bed, p < 0.0001), and the prevalence of sleep- disordered breathing tended to be higher (86.2% versus 79.4% of time in bed, p=0.057). The body mass indices and the major symptoms of sleep- disordered breathing were similar in pre- and postmenopausal women. Postmenopausal women had less nasal congestion (p < 0.001) than premenopausal ones. Body mass index was a significant explanatory factor of daytime sleepiness. Conclusions. Post- and premenopausal women present with similar signs and symptoms when referred to sleep studies. However, sleep- disordered breathing is more severe in postmenopausal than in premenopausal women.