Post Menopausal Women and OSA

[clenchingtobreathe]

I've been reading studies today that CLEARLY indicate a higher incidence of insomnia and OSA in post-menopausal women. Indications were that hormone replacement therapy can be helpful in reducing OSA even for those of us over 65! I told my DR that I started noticing my symptoms of snoring and insomnia during menopause and that they increased in severity AFTER menopause. He never indicated that he knew there was an association...nor did he recommend the additional help of HRT.
Have any of you learned of this or used HRT in addition to CPAP?

[jnk...]

HRT is not free of risks, and its usefulness as a treatment for moderate-to-severe OSA is not definitively established, as I understand it, despite the apparent protective role of female hormones during child-bearing years.

[chunkyfrog]

I was lucky. My doctor took me OFF HRT several years before my breast cancer diagnosis.
The lab analysis showed my cancer to be almost completely hormone receptive.
And the largest mass was necrotic--it was dying for lack of estrogen/progesterone.

[Julie]

And HRT will not help anatomically narrow airways.

[Janknitz]

My sleep went to hell in peri-menopause. CPAP helps me get back to sleep quickly, where before CPAP I'd be awake for hours at a time. But I still wake at least once a night and sometimes more--I'm all the way through menopause now. But I elected not to take HRT, and I am not convinced it would have helped.

All the women in my family have complained of sleep issues once in peri-menopause and beyond. My mom took HRT and it didn't seem to do anything for her sleep. Though she had really bad and untreated sleep apnea. Her sister and cousins did not seem to have apnea symptoms, but they ALL complained of sleep issues constantly whenever they were together. They had verbal contests to try to one up each other on how little sleep they got. As a kid, I was highly amused by these conversations--"I only slept one hour in the last three days!" a cousin would say. "Oh yeah, well I only slept 5 minutes". The latter was usually my mom, who kept ME awake all night with her snoring.

[jnk...]

It is difficult to study the full range of effects of HRT on sleep and health in general, and there seems to be quite a lot of conflict in how to interpret what little data there is.

Conclusion
The novel data in this study indicate that postmenopausal women taking HRT are more likely to have insomnia with objective short sleep duration, a more biological severe phenotype of the disorder associated with increased cardiovascular risk. These data also suggest that this insomnia subtype may be associated with more severe postmenopausal symptoms that may have required administration of HRT. -- https://academic.oup.com/sleep/article- ... 34/4988385

[clenchingtobreathe]

It is difficult to study the full range of effects of HRT on sleep and health in general, and there seems to be quite a lot of conflict in how to interpret what little data there is.

Conclusion
The novel data in this study indicate that postmenopausal women taking HRT are more likely to have insomnia with objective short sleep duration, a more biological severe phenotype of the disorder associated with increased cardiovascular risk. These data also suggest that this insomnia subtype may be associated with more severe postmenopausal symptoms that may have required administration of HRT. -- https://academic.oup.com/sleep/article- ... 34/4988385

You might be interested in this study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621258/
I only used HRT for about 2 years during the "height" of menopause misery. It certainly alleviated ALL the vasomotor and insomnia issues and stopped my hair from falling out....but I was fearful of long term use and stopped it.
More than anything, after doing some research, I'm dismayed that the sleep DR seemed to have no knowledge of the association between post-menopause and OSA...and did not ask me further questions about it. Not that he can do much about it....

[clenchingtobreathe]

I was lucky. My doctor took me OFF HRT several years before my breast cancer diagnosis.
The lab analysis showed my cancer to be almost completely hormone receptive.
And the largest mass was necrotic--it was dying for lack of estrogen/progesterone.

I hate to hear that! I hope all is well in that department! I felt so much better on HRT but was creeped out about it, so I stopped.

[clenchingtobreathe]

And HRT will not help anatomically narrow airways.

Understood.

[chunkyfrog]

After three years, I have nothing but good news--and a glorious rack.

[jnk...]

interested in this study:

Hormonal states may play a role as a factor in the development of a condition like OSA, but that is not useful information for a clinician until studies prove that HRT safely and consistently treats the condition for a significant population. Merely improving a condition is not enough, so many docs shrug off all info that provides no useful treatment clues. That makes for a focused doc, not a disappointing one or a bad one, IMO.

[palerider]

After three years, I have nothing but good news--and a glorious rack.

AND you got a t-shirt outta the deal!

[Cubbiebear]

I've been reading studies today that CLEARLY indicate a higher incidence of insomnia and OSA in post-menopausal women. Indications were that hormone replacement therapy can be helpful in reducing OSA even for those of us over 65! I told my DR that I started noticing my symptoms of snoring and insomnia during menopause and that they increased in severity AFTER menopause. He never indicated that he knew there was an association...nor did he recommend the additional help of HRT.
Have any of you learned of this or used HRT in addition to CPAP?

I went on HRT about 5 years ago and it relieved all my Post meno. issues including sleep issues and all was good. This last year my body went thru changes as my life did moving my 92 year old Mother into my home who is in early stages of Alzheimer's. My husband said I was snoring trains every night and very restless stealing all the blankets. My B/P was up, I couldnt sleep much worrying about Mom and my RLS got worse. I talked to my PCP who had me go to a Pulmonary Dr and the rest is history. The CPAP corrected everything except the anxiety I get from my Mom. LOL! If Mom had not needed to move in with me I would not be on the CPAP now, it truly altered my system having her.
Going on HRT is a personal decision and everyone is different so listen to yourself, it will relieve all the issues. Some Drs don't believe in HRT...if you want it find another Doctor and ask upfront if they believe in it.

[clenchingtobreathe]

I've been reading studies today that CLEARLY indicate a higher incidence of insomnia and OSA in post-menopausal women. Indications were that hormone replacement therapy can be helpful in reducing OSA even for those of us over 65! I told my DR that I started noticing my symptoms of snoring and insomnia during menopause and that they increased in severity AFTER menopause. He never indicated that he knew there was an association...nor did he recommend the additional help of HRT.
Have any of you learned of this or used HRT in addition to CPAP?

The CPAP corrected everything except the anxiety I get from my Mom. LOL! If Mom had not needed to move in with me I would not be on the CPAP now, it truly altered my system having her.
Going on HRT is a personal decision and everyone is different so listen to yourself, it will relieve all the issues. Some Drs don't believe in HRT...if you want it find another Doctor and ask upfront if they believe in it.

Are you still on HRT? I hear ya about the anxiety over your Mom! I always have PLENTY to be anxious about with a 99 yr old mom and 3 grown kids with their issues!

[D.H.]

I would not suggest that anybody try hormone replacement therapy only to treat sleep apnea. If there are other reasons, then I won't comment one way or the other.