Menopause Is Associated with Obstructive Sleep Apnea in a Population-Based Sample from Mecklenburg-Western Pomerania, Germany

Markus Krüger; Anne Obst; Till Ittermann; Olaf Bernhardt; Tatyana Ivanovska; Marek Zygmunt; Ralf Ewert; Ingo Fietze; Thomas Penzel; Reiner Biffar; Amro Daboul

doi:10.3390/jcm12062101

Menopause Is Associated with Obstructive Sleep Apnea in a Population-Based Sample from Mecklenburg-Western Pomerania, Germany

J Clin Med. 2023 Mar 7;12(6):2101. doi: 10.3390/jcm12062101.

Authors

Affiliations

¹ Poliklinik für Zahnärztliche Prothetik, Alterszahnmedizin und Medizinische Werkstoffkunde, Universitätsmedizin Greifswald, 17475 Greifswald, Germany.
² Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, 17475 Greifswald, Germany.
³ Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany.
⁴ Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pediatric Dentistry, University Medicine Greifswald, 17475 Greifswald, Germany.
⁵ Fakultät für Elektrotechnik, Medien und Informatik, Ostbayerische Technische Hochschule Amberg-Weiden, 92224 Amberg, Germany.
⁶ Department of Obstetrics and Gynecology, University of Greifswald, 17489 Greifswald, Germany.
⁷ Interdisziplinäres Schlafmedizinisches Zentrum, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany.

Abstract

Objective: Menopause is associated with multiple health risks. In several studies, a higher incidence or a higher risk for obstructive sleep apnea (OSA) in post-menopausal than pre-menopausal women is reported. This study was designed to verify such a connection between menopause and OSA in a population-based sample. Methods: For a subsample (N = 1209) of the Study of Health in Pomerania (N = 4420), complete polysomnography data was available. Of these, 559 females completed a structured interview about their menstrual cycle. Splines and ordinal regression analysis were used to analyze the resulting data. Results: In the ordinal regression analysis, a significant association between the apnea-hypopnea index (AHI) and menopause indicated that post-menopausal women had a substantially higher risk of OSA. In accordance with previous studies, risk indicators such as body mass index (BMI), age, and the influence of hysterectomies or total oophorectomies were included in the model. Conclusions: Our results clearly confirmed the assumed connection between menopause and OSA. This is important because OSA is most often associated with male patients, and it warrants further research into the underlying mechanisms.

Keywords: AHI; BMI; OSA; apnea-hypopnea index; body mass index; menopause; menstrual cycle; obstructive sleep apnea; obstructive sleep apnea syndrome; ordinal regression; polysomnography; sleep apnea; sleep-disordered breathing; splines; study of health in Pomerania (SHIP).

Grants and funding

This research was funded by the Deutsche Forschungsgemeinschaft (DFG), grant DA 1810/2-1 to Amro Daboul; the Bundesministerium für Bildung und Forschung, grants 01ZZ9603, 01ZZ0103, and 01ZZ0701; the Deutsche Stiftung für Herzforschung, grant F/34/10; and the Re-search Network of Community Medicine, University Medicine Greifswald.

The Study of Health in Pomerania (SHIP) is part of the Community Medicine Research Network of the University Medicine Greifswald, which is supported by the German Federal State of Mecklenburg-West Pomerania, the Ministry of Cultural Affairs, and the Social Ministry of the Federal State of Mecklenburg—West Pomerania.