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How are Sleep Apnea and Menopause Related?

Once upon a time – this is not a fairy tale – any woman in menopause (who had stopped having her monthly periods regularly) was regarded as “old-aged”. But that misconception should have been put to bed a long time ago. For most women, menopause starts in the early to mid-forties, and the great majority of women, from as far back as the mid-20th century, have lived well beyond their mid-seventies. The average life expectancy for women in the USA is currently around 84, and they are outliving their male counterparts by six to seven years. So to say that the last half of their adult lives was to be treated as “old-age” was, and increasingly is, an evil myth.

One sign of the improved attention that the medical research establishment is focusing on for menopausal women is the number of well-funded studies in leading universities into all aspects of life for these women. They aim to understand better what changes are happening in their bodies and minds. One such study, conducted by doctors at the Department of Oral Rehabilitation, which is part of the Maurice and Gabriela Goldschleger School of Dental Medicine at the Sackler Faculty of Medicine of Tel Aviv University, has come up with some really interesting findings. It brings attention to an area that was previously overlooked, namely the role that dentists can play in assisting their menopausal patients in avoiding some of the potentially serious consequences of snoring.

The study’s title is “Symptoms of nocturnal masticatory muscle activity among women of different age groups and their association to obstructive sleep apnea.” Putting it in simple terms, the doctors at Tel Aviv University, who are specialists in teeth and jaw structures and the associated problems, were looking to see if there is an association in menopausal women between sleep bruxism, which is the involuntary clenching and grinding (masticatory muscle activity) of the teeth during sleep, and the more extreme form of sleep-disordered breathing (SDB), which is known as obstructive sleep apnea (OSA).

Sleep-disordered breathing conditions range from snoring to obstructive sleep apnea. While snoring is a familiar and better-understood phenomenon in men, it is known to be under-reported by women for various social and self-image reasons. Along the SDB spectrum, a more extreme form is OSA. The primary associated causes of OSA are age and obesity. Obstructive sleep apnea is more prevalent in men than women, even after correcting for age and BMI. 

Obstructive sleep apnea is characterized by a repetitive collapse of the upper airway during sleep. It can result in complete blockage of the airways, which prevents inhalation. This can cause oxygen levels in the blood to fall (oxygen desaturation) and potentially lead to adverse medical events, such as cardiovascular events and hypertension, even something as serious as a heart attack or stroke. 

The main focus of the study was to find a relationship between sleep bruxism, snoring and obstructive sleep apnea with regard to age. The study compared two groups of women, the one comprising “early adults” aged 20–40 and the other “middle-aged adults” aged 50 and above. Although the levels of sleep bruxism were not particularly different, looking at the responses of the participants, the study found that in the second group, out of the women who snore, 11% showed a high risk for obstructive sleep apnea, as compared to only 1% among the non-snoring participants. 

Conclusions

The older women showed a significantly higher risk of obstructive sleep apnea than the younger group. Signs of nocturnal masticatory muscle activity, which often leads to snoring, can serve as initial indicators of OSA. Dentists can act as the first line of defense because they could be more aware of such signs among their menopause-aged female patients. Their proactive advice can prevent the development of harmful conditions associated with OSA.

FAQ

What is the most common cause of obstructive sleep apnea?

The most common cause of obstructive sleep apnea in adults is obesity. It can result in softer and swollen tissue in the mouth and throat. The throat and tongue muscles become more relaxed during sleep, allowing the airways to become blocked until the subject is awakened in response to the fall in blood oxygen levels.

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