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NEW YORK, Mar 20 (Reuters Health) - Women who take hormone replacement therapy (HRT) after menopause face a lower risk of breathing problems during sleep--ranging from snoring to sleep apnea--compared with women not on hormones, a report suggests.
Sleep-related breathing problems (called sleep-disordered breathing) seem to be uncommon among women before menopause, but whether using HRT after menopause reduces the likelihood of such problems is controversial, according to Dr. Edward Bixler, from Pennsylvania State University College of Medicine in Hershey, and his colleagues.
To clarify sleep-disordered breathing rates among women and to see whether HRT affects those rates, the investigators examined 1,000 women and more than 700 men aged 20 to 100.
Overall, men were more than three times more likely than women to have obstructive sleep apnea, a more severe form of sleep-disordered breathing. According to the report in the March issue of the American Journal of Respiratory and Critical Care Medicine, 1.2% of women and 3.9% of men had obstructive sleep apnea, a disorder marked by repeated interruptions in breathing during sleep.
Obstructive sleep apnea rates were higher as women increased in age, the researchers note, and obese women faced 11.5 times the risk of having sleep apnea as women who were not obese.
But while postmenopausal women had higher rates of sleep apnea than did premenopausal women, the use of HRT completely eliminated the difference in risk between these two groups.
Hormone therapy containing both estrogen and progesterone provided better protection than HRT with only estrogen, the results indicate.
"These data combined indicate that menopause is a significant risk factor for sleep apnea in women and that hormone replacement appears to be associated with reduced risk," Bixler and colleagues conclude.
However, he told Reuters Health, "the decision to employ HRT is a very controversial one. Thus, when a women is making the decision regarding HRT, this association is one additional piece (of information) that should be considered."
HRT is believed to cut women's heart disease risk, which naturally rises after menopause. Since sleep-related breathing problems may trigger high blood pressure, the authors note, the effects of HRT on breathing problems may be one reason for its benefits to heart health.
SOURCE: American Journal of Respiratory and Critical Care Medicine 2001;163:608-613.
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