Breathing during sleep in menopause: a randomized, controlled, crossover trial with estrogen therapy

Obstet Gynecol. 2003 Jul;102(1):68-75. doi: 10.1016/s0029-7844(03)00374-0.


Objective: To evaluate the prevalence of different types of nocturnal breathing abnormalities in postmenopausal women and the effect of estrogen replacement therapy (ERT) on nocturnal breathing.

Methods: A prospective, randomized, placebo-controlled, double-blind, crossover study was completed by 62 of 71 recruited healthy women. The first 3-month treatment period with either estrogen or placebo was followed by placebo washout for a month and then by a second treatment period with crossover to either estrogen or placebo. On a night after each treatment period, sleep was monitored with polysomnography, and breathing was assessed with a static-charge-sensitive bed and oximeter. For the respiratory variables, a sample size of 48 subjects was sufficient to give statistical power of 85% with a significance level of P <.05.

Results: The occurrence of obstructive sleep apnea in all women was low (1.6%), but partial upper airway obstruction, manifesting as an increased respiratory resistance pattern, was more common (17.7%). Estrogen replacement therapy decreased the occurrence (P =.047) and frequency (P =.049) of sleep apnea but had no effect on partial upper airway obstruction or arterial oxyhemoglobin saturation.

Conclusion: Partial upper airway obstruction is the most prevalent form of sleep-disordered breathing, occurring ten times more frequently than sleep apnea in postmenopausal women. Unopposed estrogen replacement therapy has only a minor effect on sleep apnea and has no effect on partial airway obstruction.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross-Over Studies
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Administration Schedule
  • Estrogen Replacement Therapy / methods*
  • Female
  • Humans
  • Incidence
  • Menopause
  • Middle Aged
  • Polysomnography / methods
  • Probability
  • Prospective Studies
  • Reference Values
  • Respiration / drug effects*
  • Risk Factors
  • Sleep / drug effects
  • Sleep / physiology*
  • Sleep Apnea Syndromes / diagnosis*
  • Sleep Apnea Syndromes / epidemiology
  • Sleep Wake Disorders / diagnosis
  • Sleep Wake Disorders / epidemiology