MA Carskadon, HM Bearpark, KM Sharkey, RP Millman, C Rosenberg, A Cavallo, C Carlisle and C Acebo
Department of Psychiatry and Human Behavior, E.P. Bradley Hospital/Brown University, East Providence, Rhode Island 02915, USA.

Prevalence of sleep-disordered breathing (SDB) is reported to increase in menopausal women. We examined response to a nocturnal respiratory challenge (nasal occlusion) during overnight polysomnography in 31 women (45 to 55 yr). Thirteen were premenopausal, four perimenopausal, and 14 postmenopausal by history and hormonal assay. Nasal occlusion increased the apnea hypopnea index (AHI) (occlusion mean = 6.6 +/- 8.0 versus baseline mean = 1.6 +/- 2.6, p < 0.01) and arousal index (occlusion mean = 35.1 +/- 20.1 versus baseline mean = 20.7 +/- 11.6, p < 0.001), but did not change the oxygen saturation nadir in those with respiratory events (occlusion mean = 91.8 +/- 4.2 versus baseline mean = 92.0 +/- 11.6). Menopausal groups did not differ on AHI, arousal index, or oxygen saturation nadir in either condition. Key variables were compared between occlusion responders (n = 11) and nonresponders (n = 20). Responders and nonresponders were not distinguished by age, menopausal status, nor several cephalometric or anthropometric variables. Body mass index (31.1 +/- 8.5 versus 24.3 +/- 3.4, p < 0.003), neck circumference (34.0 +/- 2.5 versus 32.5 +/- 1.7 cm, p < 0.05), and mandibular-hyoid distance (18.5 +/- 3.8 versus 14.5 +/- 5.7 mm, p < 0.05) were greater in responders. These findings suggest hormonal factors may be less important than weight and facial morphology in midlife development of SDB in women.

This article has been cited by other articles:

				K. Yukawa, Y. Inoue, H. Yagyu, T. Hasegawa, Y. Komada, K. Namba, N. Nagai, S. Nemoto, E. Sano, M. Shibusawa, et al. Gender Differences in the Clinical Characteristics Among Japanese Patients With Obstructive Sleep Apnea Syndrome Chest, February 1, 2009; 135(2): 337 - 343. [Abstract] [Full Text] [PDF]

				T. Vaari, J. Engblom, H. Helenius, R. Erkkola, and P. Polo-Kantola Survey of sleep problems in 3421 women aged 41-55 years Menopause Int, June 1, 2008; 14(2): 78 - 82. [Abstract] [Full Text] [PDF]

				I. Koutsourelakis, G. Georgoulopoulos, E. Perraki, E. Vagiakis, C. Roussos, and S. G. Zakynthinos Randomised trial of nasal surgery for fixed nasal obstruction in obstructive sleep apnoea Eur. Respir. J., January 1, 2008; 31(1): 110 - 117. [Abstract] [Full Text] [PDF]

				H. A. McLean, A. M. Urton, H. S. Driver, A. K. W. Tan, A. G. Day, P. W. Munt, and M. F. Fitzpatrick Effect of treating severe nasal obstruction on the severity of obstructive sleep apnoea Eur. Respir. J., March 1, 2005; 25(3): 521 - 527. [Abstract] [Full Text] [PDF]

				M.F. Fitzpatrick, H. McLean, A.M. Urton, A. Tan, D. O'Donnell, and H.S. Driver Effect of nasal or oral breathing route on upper airway resistance during sleep Eur. Respir. J., November 1, 2003; 22(5): 827 - 832. [Abstract] [Full Text] [PDF]

				D. P. White The Hormone Replacement Dilemma for the Pulmonologist Am. J. Respir. Crit. Care Med., May 1, 2003; 167(9): 1165 - 1166. [Full Text] [PDF]

				E. Shahar, S. Redline, T. Young, L. L. Boland, C. M. Baldwin, F. J. Nieto, G. T. O'Connor, D. M. Rapoport, and J. A. Robbins Hormone Replacement Therapy and Sleep-disordered Breathing Am. J. Respir. Crit. Care Med., May 1, 2003; 167(9): 1186 - 1192. [Abstract] [Full Text] [PDF]

				T. Young, L. Finn, D. Austin, and A. Peterson Menopausal Status and Sleep-disordered Breathing in the Wisconsin Sleep Cohort Study Am. J. Respir. Crit. Care Med., May 1, 2003; 167(9): 1181 - 1185. [Abstract] [Full Text] [PDF]

				M. F. Fitzpatrick, H. S. Driver, N. Chatha, N. Voduc, and A. M. Girard Partitioning of inhaled ventilation between the nasal and oral routes during sleep in normal subjects J Appl Physiol, March 1, 2003; 94(3): 883 - 890. [Abstract] [Full Text] [PDF]

				T. Saaresranta and O. Polo Hormones and Breathing Chest, December 1, 2002; 122(6): 2165 - 2182. [Abstract] [Full Text] [PDF]

				D. R. Dancey, P. J. Hanly, C. Soong, B. Lee, and V. Hoffstein Impact of Menopause on the Prevalence and Severity of Sleep Apnea Chest, July 1, 2001; 120(1): 151 - 155. [Abstract] [Full Text] [PDF]

				E. O. BIXLER, A. N. VGONTZAS, H.-M. LIN, T. TEN HAVE, J. REIN, A. VELA-BUENO, and A. KALES Prevalence of Sleep-disordered Breathing in Women . Effects of Gender Am. J. Respir. Crit. Care Med., March 1, 2001; 163(3): 608 - 613. [Abstract] [Full Text] [PDF]

				C. O'CONNOR, K. S. THORNLEY, and P. J. HANLY Gender Differences in the Polysomnographic Features of Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., May 1, 2000; 161(5): 1465 - 1472. [Abstract] [Full Text]

				R. M. Popovic and D. P. White Upper airway muscle activity in normal women: influence of hormonal status J Appl Physiol, March 1, 1998; 84(3): 1055 - 1062. [Abstract] [Full Text] [PDF]