Hormones are linked to sleep apnea, snoring

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Middle-aged women with low estrogen and progesterone levels are more likely to snore and report symptoms of obstructive sleep apnea, according to a new study published this week in the open-access journal PLOS ONE by Kai Triebner of the University of Bergen, Norway, and colleagues.

The prevalence of obstructive sleep apnea – in which breathing stops and resumes during sleep – is known to be higher in women after menopause. However, no population-based studies have previously examined whether this is the result of altered sex hormone levels.

In the new study, researchers analyzed data from 774 women aged 40 to 67 as part of the Community Lung Health Survey conducted in seven countries between 2010 and 2012. The women participating in the study participated questionnaires on their respiratory health, women’s health factors, their lifestyle. and sleep, and donated blood samples for hormone analysis.

551 of the women in the study (71.2%) had been told they snored, and 411 of these women also reported other symptoms of sleep apnea. In all women, a doubling of serum estrone concentrations was associated with a 19% lower risk of snoring. A doubling of progesterone levels was associated with a 9% lower risk of snoring. In snorers, a doubling of levels of three estrogens (17β-estradiol, estrone, and estrone 3-sulfate) was associated with a 17% to 23% decrease in the odds that women were told they were breathing irregularly during sleep. A doubling of progesterone levels in snorers was associated with a 12% lower risk of waking up feeling choked in the past year.

The authors conclude that adjustment of female sex hormones could be a strategy to reduce the high prevalence and associated morbidity of obstructive sleep apnea, but say further longitudinal studies are needed to confirm the findings.

The authors add, “Female sex hormones are crucial to health and disease, and particularly after menopause, hormonal status must be considered in developing holistic treatment strategies.”

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In your coverage, please use this URL to provide access to the article available for free in PLOS ONE: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0269569

Quote: Sigurðardóttir ES, Gislason T, Benediktsdottir B, Hustad S, Dadvand P, Demoly P, et al. (2022) Female sex hormones and obstructive sleep apnea symptoms in European women from a population-based cohort. PLoS ONE 17(6): e0269569. https://doi.org/10.1371/journal.pone.0269569

Author countries: Iceland, Norway, Spain, France, Sweden, Germany, Australia, United Kingdom, Estonia

Funding: The work was funded by a postdoctoral fellowship from the University of Bergen. Recipient: Dr. Kai Triebner.


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