The Sleep Change You Should Never Ignore In Menopause

Though sleep apnoea is expected to affect as many as 10 million people in the UK, the condition can be hard to spot – partly because you’re not awake when it happens. 

Obstructive sleep apnoea (OSA), which is the most common form of the condition, can present as seemingly innocent symptoms like loud snoring or feeling tired throughout the day.

OSA involves “stop and start” breathing patterns during sleep and is more common in men than it is in women. Without treatment, the NHS says, OSA may contribute to type 2 diabetes, heart disease, high blood pressure, and increased risk of stroke.

But speaking to HuffPost UK, Professor Esther Rodriguez-Villegas, founder and CEO of med-tech start-up Acurable and leading sleep apnoea expert, said OSA risk may rise in menopause and remain unnoticed.

Why does sleep apnoea risk rise in menopause?

“During menopause, women experience a fall in hormones such as oestrogen and progesterone. Both of these hormones play a role in keeping the muscles of the upper airway stable during sleep, as well as influencing breathing control,” Professor Rodriguez-Villegas said. 

When this happens, the airway is more likely to collapse during sleep, leading to an increased likelihood of OSA.

Weight distribution changes associated with menopause may also contribute, the expert added. 

“After menopause, women are more prone to storing fat around the neck and upper body, which can further narrow the airway,” she told us.

And menopause can disturb sleep in general, which the expert said can “mask or worsen underlying breathing problems at night”.

“Historically, sleep apnoea was thought of as a ‘male condition,’ but we now know that the risk in women rises sharply after menopause, to the point where it approaches that of men of the same age,” Professor Rodriguez-Villegas stated.

What are the signs of OSA in menopause?

One of the issues with sleep apnoea is that it often goes unnoticed, the expert advised.

Some of the signs – snoring, pauses in breathing during sleep, or waking up gasping or choking – remain the same, she told us, but “many women don’t notice these themselves”.

“What women more commonly report are the consequences: unrefreshing sleep, morning headaches, difficulty concentrating, memory lapses, low mood and daytime fatigue.” 

Some of these signs can be hard to separate from menopause symptoms, she added, and because of that overlap, “sleep apnoea can go undiagnosed for years in menopausal women, with symptoms written off as ‘just part of the change’”.

“That’s why it’s so important to raise awareness. If a woman in midlife is struggling with severe fatigue, cognitive difficulties, or unrefreshing sleep – especially if there is snoring or observed pauses in breathing – sleep apnoea should be considered and discussed with a doctor.”

Sleep apnoea can be serious if it’s not diagnosed and treated, warns the NHS. 

Treatment typically involves wearing a CPAP machine to improve your breathing while you sleep. Alternatively, you might be offered a mandibular advancement device (a gum shield-esque device to hold your airways open when you sleep) or surgery to help your breathing.

Exercising regularly, sleeping on your side, losing weight if you’re overweight and having good sleep hygiene habits might also help.