Menopausal status and sleep-disordered breathing in the Wisconsin Sleep Cohort Study

Am J Respir Crit Care Med. 2003 May 1;167(9):1181-5. doi: 10.1164/rccm.200209-1055OC. Epub 2003 Feb 13.


Menopause is considered to be a risk factor for sleep-disordered breathing, but this hypothesis has not been adequately tested. The association of premenopause, perimenopause, and postmenopause with sleep-disordered breathing was investigated with a population-based sample of 589 women enrolled in the Wisconsin Sleep Cohort Study. Menopausal status was determined from menstrual history, gynecologic surgery, hormone replacement therapy, follicle-stimulating hormone, and vasomotor symptoms. Sleep-disordered breathing was indicated by the frequency of apnea and hypopnea events per hour of sleep, measured by in-laboratory polysomnography. Multivariable logistic regression was used to estimate odds ratios for having 5 or more and 15 or more apnea and hypopnea events per hour. Odds ratios (95% confidence interval), adjusted for age, body habitus, smoking, and other potential confounding factors, for 5 or more apnea and hypopnea events per hour were 1.2 (0.7, 2.2) with perimenopause and 2.6 (1.4, 4.8) with postmenopause; odds ratios for 15 or more apnea and hypopnea events per hour were 1.1 (0.5, 2.2) with perimenopause and 3.5 (1.4, 8.8) with postmenopause. The menopausal transition is significantly associated with an increased likelihood of having sleep-disordered breathing, independent of known confounding factors. Evaluation for sleep-disordered breathing should be a priority for menopausal women with complaints of snoring, daytime sleepiness, or unsatisfactory sleep.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Cohort Studies
  • Confounding Factors, Epidemiologic
  • Estrogen Replacement Therapy
  • Female
  • Humans
  • Hysterectomy / adverse effects
  • Life Style
  • Logistic Models
  • Menopause*
  • Middle Aged
  • Odds Ratio
  • Ovariectomy / adverse effects
  • Polysomnography
  • Postmenopause*
  • Premenopause*
  • Risk Factors
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / classification
  • Sleep Apnea, Obstructive / diagnosis
  • Sleep Apnea, Obstructive / epidemiology
  • Sleep Apnea, Obstructive / etiology*
  • Smoking / adverse effects
  • Surveys and Questionnaires
  • Wisconsin / epidemiology