Women who take HRT for menopause symptoms could find it helps with their snoring too.
Around one in 20 post-menopausal women suffer from obstructive sleep apnea – a condition causing the airway to collapse which can cause loud snoring and wake someone up to 40 times a night.
Now a study suggests sleep apnea is more common in post-menopausal women because they have lower levels of the hormones estrogen and progesterone.
These are the hormones which are replaced when women have HRT, raising hopes it could help with snoring and sleep apnea.
But across the UK, tens of thousands of women for whom HRT is a lifeline are struggling to get hold of their menopause medication due to supply shortages.
Researchers from the University of Bergen, Norway, have found snoring can be caused by low levels of estrogen or progesterone after menopause
The Daily Mail’s HRT campaign secured a major victory last month after pharmacists were given the go-ahead to prescribe alternatives to out-of-stock treatment.
Researchers looked at 774 women given a sleep questionnaire to determine if they were likely (SUBS – pls keep the word likely) to have obstructive sleep apnea.
To fit the criteria, they needed to snore, and frequently had either irregular breathing, gasping or snores which disturbed other people in the previous 12 months.
Blood tests showed if women were able to double the amount of a type of oestrogen called oestrone in their body, they would be 19 percent less likely to have suspected obstructive sleep apnea.
If they could double their amount of progesterone, they would be nine percent less likely to have the condition.
WHAT IS OBSTRUCTIVE SLEEP APNOEA?
Obstructive sleep apnea (OSA) occurs when the walls of a person’s throat relax and narrow during sleep, blocking their airways.
This interrupts normal breathing, with symptoms including loud snoring, noisy and labored breathing, and repeated episodes when breathing is interrupted by gasping and snorting.
OSA affects between four and 10 per cent of people in the UK. In the US, around 22 million are affected.
During an episode, the lack of oxygen triggers a sufferer’s brain to pull them out of deep sleep so their airways reopen.
These repeated sleep interruptions can make the person very tired, with them often being unaware of what the problem is.
Risks for OSA include:
- Being overweight – excess body fat increases the bulk of soft tissues in the neck
- Being male
- Being 40 or over
- Having a large neck
- Drinking excessive amounts of alcohol
- Being in the menopause – hormonal changes cause the throat muscles to relax
Treatment includes lifestyle changes, such as loosing weight, if necessary, and avoiding alcohol.
In addition, continuous positive airway pressure (CPAP) devices prevent the airway closing by delivering a continuous supply of compressed air through a mask.
A mandibular advancement device (MAD) can also be used, which is like a gum-shield that holds the jaw and tongue forward to increase the space at the back of the throat.
Untreated, OSA increases a person’s risk of high blood pressure, stroke, heart attacks and type 2 diabetes.
There is still limited evidence suggesting that HRT could reduce the risk of the condition, so more research is needed (SUBS – pls keep).
But Dr Kai Triebner, senior author of the study, from the University of Bergen, said: ‘This study is exciting because it suggests HRT could be a solution to women suffering from snoring and sleep apnea because of the menopause.
‘It is important because sleep apnea is linked to serious conditions like heart disease and stroke.
‘We already know that HRT can improve temporary symptoms of menopause like hot flushes and night sweats, and help with more serious potential effects like osteoporosis, and now it could potentially help many women having a very hard time snoring and struggling for breath at night . ‘
The study, published in the journal PLOS One, looked at women aged 40 to 67 from seven different countries, who were involved in a European health survey.
Among the 774 post-menopausal women looked at, almost three-quarters, or 551 of them, were snorers.
These women were asked three additional questions about the previous 12 months to judge if they might have obstructive sleep apnea, which becomes more common and severe in post-menopausal women.
They fell into this category if they said they always or frequently woke up with a choking sensation or unable to breathe.
They also qualified if they had been told they frequently or always stopped breathing or breathed irregularly when asleep, or if they were told they always or frequently snored so loudly they disturbed others.
The researchers did not directly compare women’s levels of estrogen or progesterone, which drop dramatically after menopause, causing many of the unpleasant symptoms.
But their results suggest a doubling of the oestrogen type oestrone is linked to a fifth lower risk of sleep apnea, and a doubling of progesterone cuts the likelihood of having the condition by nine percent.
This was the case even taking into account factors like women’s weight and whether they smoked, which both increase the risk of sleep apnea and snoring.
The researchers suggest a drop in hormones after menopause could cause women to gain fat in certain parts of the body, which can increase the risk of sleep apnea, through fat deposits in the throat narrowing the airway.
Among snorers, a doubling of the blood level of three types of estrogen was linked to 23 percent lower odds of women being told they breathe irregularly during sleep. A doubling of progesterone, among snorers, was linked to 12 percent lower odds of women having woken up with a choking sensation in the previous year.
Erla Sigurðardottir, lead author of the study from the University of Iceland, said: ‘Higher female sex hormones were linked in this study with a lower likelihood of reporting symptoms of sleep apnea.
‘More research is needed to understand this and whether HRT after menopause could reduce symptoms of this worrying condition.’