Tuesday, July 5, 2016

Can menopause put you at risk of sleep apnea?

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 Additional Information:

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