Recent studies
outcomes suggested that menopause can increase risk of developing sleep apnea,
a potentially serious sleep disorder, which can have substantial negative
effects on your general health.
What Is Sleep
Apnea?
Sleep apnea (AP-ne-ah), abbreviated as OSA, is a common
disorder in which you have one or more pauses in breathing or shallow breaths
while you sleep.
Breathing pauses can last from a few seconds to minutes.
They may occur 30 times or more an hour. Typically, normal breathing then
starts again, sometimes with a loud snort or choking sound.
Sleep apnea usually is a chronic (ongoing) condition that
disrupts your sleep. When your breathing pauses or becomes shallow, you’ll
often move out of deep sleep and into light sleep.
As a result, the quality of your sleep is poor, which
makes you tired during the day. Sleep apnea is a leading cause of excessive
daytime sleepiness.
What Causes Sleep
Apnea?
When you're awake, throat muscles help keep your airway
stiff and open so air can flow into your lungs. When you sleep, these muscles
relax, which narrows your throat.
Normally, this narrowing doesn’t prevent air from flowing
into and out of your lungs. But if you have sleep apnea, your airway can become
partially or fully blocked because:
ü
Your throat muscles and tongue relax more than
normal.
ü
Your tongue and tonsils (tissue masses in the
back of your mouth) are large compared with the opening into your windpipe.
ü
You are overweight. The extra soft fat tissue
can thicken the wall of the windpipe. This narrows the inside of the windpipe,
which makes it harder to keep open.
ü
The shape of your head and neck (bony structure)
may cause a smaller airway size in the mouth and throat area.
ü
The aging process limits your brain signals'
ability to keep your throat muscles stiff during sleep. Thus, your airway is
more likely to narrow or collapse.
Not enough air flows into your lungs if your airway is
partially or fully blocked during sleep. As a result, loud snoring and a drop
in your blood oxygen level can occur.
If the oxygen drops to a dangerous level, it triggers
your brain to disturb your sleep. This helps tighten the upper airway muscles
and open your windpipe. Normal breathing then starts again, often with a loud
snort or choking sound.
Sleep Apnea at
Menopause
The condition is most common in women and worsens in the
post-menopause period as the phase marks the end of the reproductive period of
a woman and brings about a lot of hormonal, physical and psychological changes
in them. The levels of estrogen and progesterone (hormones which protect the
airways from collapsing) released in the body declines during menopause, as a
result of which, women become more prone to contracting obstructive sleep apnea
in this phase.
According to a recent study, 0.6 percent of women in
their pre-menopausal stage suffered from OSA, while the incidence of the same
in post-menopausal women (who did not undergo the hormone replacement surgery)
was as high as 5.5 percent. Further, OSA puts post-menopausal women at high
risk of developing high blood pressure and congestive heart failure. Such women
usually remain awake at night and become lethargic as well as tend to fall sleepy
during the day. In addition, the prolonged periods of uncomfortable, disturbed
sleep causes tiredness, irritability and mood swings, which may also hamper
their various relationships. As many as 61 percent post-menopausal women
reported symptoms of insomnia. Menopause also reduces the focus and attention
span at work and may yield them unproductive. Symptoms of OSA in menopausal
women include hot flushes, increased body temperatures and night sweats because
of reduced levels of estrogen, loud snoring, choking in sleep, dry mouth at
night, frequent urination at night and grinding of teeth.
Symptoms of
Menopause Overlap with Sleep Apnea
There are symptoms that occur commonly just before
menopause, during perimenopause, or as part of menopause itself. Some of these
symptoms include:
ü
Irregular periods (varying frequency or
intensity)
ü
Hot flashes or hot flushes (feeling warm with
skin redness and sweating)
ü
Trouble sleeping (insomnia, night sweats,
daytime sleepiness)
ü
Poor concentration or memory loss
ü
Mood changes or mood swings (irritability,
tearfulness)
ü
Vaginal and urinary problems (dryness,
infections, incontinence)
ü
Decreased sexual interest or discomfort
ü
Joint or muscle pain
ü
Osteoporosis
ü
Weight gain
Interestingly, many of these symptoms can also occur with
sleep disorders.
Difficulty falling or staying asleep at night may represent
insomnia. Frequent nighttime awakenings may also be a sign of obstructive sleep
apnea. Moreover, night sweats, daytime sleepiness, depressed mood, and
cognitive complaints like poor concentration or problems with short-term memory
can also occur in sleep apnea. Because of this overlap, it is important to
recognize the additional potential symptoms of sleep apnea.
Beyond those symptoms described above, there are other
signs of sleep apnea. The most common include loud snoring, witnessed pauses in
breathing, and episodes of gasping or choking out of sleep. These events cause
sleep fragmentation and this can lead to unrefreshing sleep, daytime
sleepiness, and naps. In addition, dry mouth at night, grinding or clenching of
teeth, and frequent urination at night may also occur. Weight gain and loss of
muscle tone, a common part of aging, can also make sleep apnea worse.
Too often women attribute their difficulties to hormonal
changes or to the fact that they are just getting older.
Sleep Apnea Types
at Menopause
There are several types of sleep apnea during menopause:
ü
Obstructive sleep apnea: characterized by an
obstruction to the air passageway, such as a collapse of muscle tissue in the
throat or enlarged tonsils, and is the most prevalent type of the disorder.
Obstructive sleep apnea is usually associated with loud snoring.
ü
Central sleep apnea: occurs when the chest
muscles and diaphragm stop working temporarily.
ü
Mixed apnea: is a combination of obstruction and
central sleep apnea.
Treatment and diagnosis is critical because this sleeping
disorder can cause high blood pressure and heart problems. In addition, it may
adversely affect weight and memory.
How is Sleep Apnea
Diagnosed?
The first step to curing sleep apnea is to get a proper
diagnosis. This can often be difficult if you don't realize that you have the
disorder or don't recognize your loud snoring as sleep apnea. According to
experts, only 10-25% of people are diagnosed as having the disorder because of
these complications.
Sleep apnea is usually diagnosed after running tests in a
polysomnography (sleep study). The patient's heart rate, along with brain and
muscle activity, are measured during sleep. In some cases, the patient's throat
will also be examined to look for possible obstructions.
A case of sleep apnea is confirmed when the patient has
ceased breathing at least five separate times, with each period lasting for ten
seconds or longer. The patient may also exhibit an erratic heartbeat and a drop
in blood oxygen readings.
How Can I Cure my
Sleep Apnea?
Various forms of treatment that is available for women
with OSA include losing weight, avoiding alcohol four-six hours before going to
bed. Also, sleeping on sides rather than
on stomach or back can help in improving the situation.
The most common medical treatment includes the use of
nasal continuous positive airway pressure (CPAP) — a device to prevent the
airways from collapsing at night and hormone replacement therapy (HRT) —
wherein estrogen and progesterone are artificially introduced into the body to
help reduce OSA.
In other cases, nasal or septal surgery may be necessary
to rid the airway of obstacles.
Sources and
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