Menopause and Sleep
The risk of sleep disorders and related health problems rise significantly after menopause.
By Michael Breus
Reviewed By Stuart Meyers
A new area of research in sleep medicine focuses on women's health and how menopause affects sleep. Menopause, regardless of age, is associated with poor sleep quality. These sleep problems are thought to be associated with hormonal function and also with psychological factors.
One study shows shows an association of hot flashes with a shorter amount of time sleeping and a higher incidence of arousals from sleep. Hot flashes that occur during sleep have the ability to affect the quality of sleep adversely by bringing women from a deeper, more restful stage of sleep to a lighter, less restful and restorative stage.
Hot flashes before bed may also cause insomnia. However, often cases of insomnia related to menopause are due to increased depression or anxiety, which may affect the time it takes to fall asleep. One study that factored in sleep disorders, including obstructive sleep apnea and periodic limb movement, and medications showed no differences in sleep patterns of postmenopausal women with hot flashes.
Researchers have also found that the frequency of nighttime urination may be a good predictor of disturbed sleep quality.
Some studies have reported that estrogen replacement therapy (ERT) is associated with better sleep quality, while others have shown no difference or poor sleep quality.
In premenopausal women, the incidence of sleep-disordered breathing (including snoring and apnea, a condition in which breathing starts and stops while asleep) is quite small, but it appears to increase dramatically (to 9% of the population) after menopause. Interestingly, recent research shows the effects of menopause on snoring or sleep apnea are due to advancing age (specifically changes in the tone of the muscles in the neck) and increased weight rather than directly from the hormonal changes of menopause itself.
The clinical consequences of untreated sleep disorders are quite large. Sleep-related breathing disorders are associated with high blood pressure, heart attack, heart failure, stroke, obesity, neuro-psychiatric problems including depression and other mood disorders, mental impairment, excessive daytime sleepiness, injury from accidents, disruption of bed-partner's sleep quality and poor quality of life. Recent studies also show a decrease in women's sex hormones with sleep-disordered breathing.
If you have trouble sleeping for more than a few weeks, or if sleep problems interfere with daily functioning, speak with your doctor.
SOURCES: The Journal for Respiratory Care Practitioners, 1996, "Menopause and Sleep." American Journal of Obstetrics and Gynecology, 1998, Vol. 178, "When does estrogen replacement therapy improve sleep quality?" American Review of Respiratory Diseases, 1992, Vol. 145, "Are postmenopausal women at increased risk of sleep disordered breathing?"
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