Has your snoring worsened recently? Are you a woman aged 45-55?
Menopause may be the culprit.
The physiology behind snoring differs somewhat between men and women. Why do women snore? In part, it is related to relative lung volume, respiratory function, and airway size. Additionally, thanks to the influence of hormones, women are at greater risk of snoring from around age 45-50. Menopause and snoring are directly linked.
The American Sleep Foundation reports that approximately 12% of women experience sleep issues, and this rate dramatically increases to over 40% of women from the late 40s to early 50s. The cause of this, for a lot of women, is menopause.
How are menopause and snoring linked?
Menopause is a natural part of the ageing process for all women. It typically occurs between ages 45-55, though it can occasionally happen earlier or later. A woman is menopausal at twelve months after she naturally experiences her last menstrual period; in NZ, this occurs at an average age of 52 years. In most cases, these changes occur as a gradual process.
Menopause can also occur suddenly (literally overnight) due to the surgical removal of the ovaries (this is often – but not always – carried out alongside a hysterectomy, which medically refers to the removal of the uterus).
Perimenopause refers to the period (usually between seven and ten years) leading up to menopause. The ovaries gradually decrease producing oestrogen and progesterone and stop releasing ova (eggs).
The changes between perimenopause and menopause signify the end of a woman’s reproductive years. (Until menopause is complete, a woman can potentially still become pregnant). While they are mostly associated with the cessation of menstruation, there is much more to menopause than this and cessation of monthly bleeding for women but a consequence of menopause.
For most women, this is a time of physiological and even emotional turmoil as the body and brain adjust to these changes. Signs and symptoms associated with this include:
- Irregular, heavier, or extremely light menstrual bleeding (menses)
- Ultimately, cessation of the menses
- Hot flushes/flashes
- Night sweats
- Memory and concentration issues
- Irritability, anxiety, depression, and mood swings
- Emotional upheaval over the end of “youth” and fertility
- Headaches and migraines
- Heart palpitations
- Vaginal dryness and sexual discomfort
- Changes in libido (sex drive)
- Breast tenderness and benign lumpiness/cysts
- Joint and muscle aches and pains
- Urinary urgency
- Female-pattern hair thinning/loss
- Increased risk of developing osteoporosis, heart disease, sleep apnoea, and other health conditions.
For some women, these symptoms may continue for up to fifteen years after menopause.
Hormones and Your Sleep
During perimenopause, the ovaries stop producing two main hormones:
- Oestrogen – this hormone influences a vast range of functions including the regulation of body temperature and the neurotransmitters that impact the sleep-wake cycle, including serotonin. It also has an anti-depressant mood impact (again, due to serotonin regulation).
- Progesterone affects functions including the breathing drive. This varies throughout the menstrual cycle. Prior to menopause, progesterone provides women with some protection against snoring and sleep apnoea. This protection diminishes after menopause.
The years surrounding menopause can be stressful for an array of external reasons as well – including dealing with adolescent children, adult offspring moving out of home, caring for elderly parents, female “mid-life-crisis”, and much more. All of these stressors can also impact sleep quality.
The Link Between Menopause and Snoring
Sleep disturbances are a common symptom of perimenopause and menopause, and new or worsening snoring is directly linked with it.
Snoring and sleep apnoea are more prevalent from middle age in women and this is very much due to menopause. Scientists believe this may be due to lower circulating levels of the hormone progesterone. One of the functions of progesterone is to maintain the integrity of the tissues of the upper airways and prevent them from relaxing too much, as well as to manage the breathing drive. Without this protective influence, snoring and lapses in breathing that characterise sleep apnoea occur.
How to Relieve Snoring in Menopause
- Hormone Replacement: Hormone Replacement Therapy may help to minimise snoring in some women. This is a medication-based treatment that is suitable for a lot of (but not all) women within the first 5 years of menopause (or possibly longer for women who undergo surgical menopause before around age 50). It can also help prevent conditions like osteoporosis and heart disease, which are more common in postmenopausal women.
There are two types: Oestrogen Replacement Therapy, which replaces oestrogen alone, is suitable only for women who have had their uterus surgically removed. Women who have their uterus will need to use Combined Hormone Replacement Therapy, which includes both oestrogen and progesterone (oestrogen used without progesterone can increase the risk of endometrial hyperplasia and cancer).
Hormone replacement must be overseen by a doctor. Its use (especially for combined HRT) carries certain health risks, especially for women who have had a deep vein thrombosis (blood clot), stroke, heart attack, breast or gynaecological cancer, and who are very overweight or smoke cigarettes.
- Antidepressants: A low dose of a selective serotonin reuptake inhibitor (SSRI) can help some women better manage hot flashes and sleep disturbances associated with menopause.
- Melatonin: This is the body’s natural sleep hormone, and the production in the body diminishes with age. Low doses of supplemental melatonin (over the counter or medically prescribed) can help to both improve mood and regulate sleep.
- Phytoestrogens: Consuming soy products may be beneficial as these boost oestrogen in the body.
- Cognitive Behavioural Therapy: This can help with mood issues and anxiety/depression, thereby improving sleep.
Tactics to Sleep Better (and Reduce Snoring)
- Drink plenty of water to stay hydrated
- Minimise or cut out caffeine
- Maintain a healthy weight and lose weight if you are overweight
- Exercise regularly
- See your GP to discuss whether hormone replacement is suitable for you.
- Treat allergies and sinus issues
- See your doctor for management of anxiety, depression, and irritability
- Minimise stress
- Maintain a good sleep schedule
- Minimise alcohol consumption, especially before bedtime
- Quit smoking and don’t vape
ApneaRx – Your Key to Better Sleep
For health and wellbeing, you must minimise or stop snoring.
ApneaRx is a MedSafe registered Class 1 Patented mandibular advancement device available on the NZ market. It is a stop-snoring solution used successfully by thousands of people globally and is also designed to treat the symptoms associated with mild to moderate Sleep Apnea.