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7430435 
Journal Article 
Obstructive Sleep Apnea and Menopause 
Pien, GW; Veasey, SC; , 
2013 
Humana Press 
Totowa, NJ 
Sleep Disorders in Women 
325-340 
A growing body of work supports the concept that menopause is a risk factor for obstructive sleep apnea (OSA). Compared to premenopausal women, the odds for developing OSA increases two- to threefold for postmenopausal women. The increased risk remains even after controlling for confounders including age, body habitus, and smoking. One reason for this association could be the lower levels of reproductive hormones among postmenopausal women and related endocrine changes. Several studies have examined the effects of hormone replacement therapy (HRT) on sleep-disordered breathing. Although no clear-cut answer has emerged, it does appear that HRT may attenuate the risk of OSA in menopause. Apart from hormonal changes, the menopausal transition also results in changes in body fat redistribution, respiratory drive, ventilatory stability, and upper airway anatomy and physiology all of which could contribute to the elevated risk for OSA. This chapter summarizes the data on increased prevalence, clinical presentation, and potential mechanisms for the higher occurrence of OSA in menopause.