Low blood estrogen and progesterone levels tied to sleep apnea in middle-aged women: PLOS One

Iceland: A new study published in PLoS ONE showed that women in their forties and fifties who have low blood estrogen and progesterone levels are more prone to snoring and have symptoms of obstructive sleep apnea.

Obstructive sleep apnea (OSA) is more common in women after menopause. This is thought to be due to an altered sex hormone balance but has yet to be verified in a population-based investigation. As a result, Erla S. Sigurardóttir and colleagues undertook this study to determine if blood levels of estrogens and progesterone are related to the occurrence of sleep apnea signs in middle-aged women in the general population.

In the second follow-up of the European Community Respiratory Health Survey (2010-2012), data from 774 women (40-67 years) from 15 study locations in seven countries were evaluated. Multiple logistic regression models were applied with self-reported sleep apnea symptoms as outcomes and blood levels of different estrogens and progesterone as predictors. Age, BMI, education, smoking habits, study center, and reproductive age were all controlled for in all analyses.

The key findings of this study were as follows:

1. A doubling of blood estrone and progesterone concentrations was related to a 19% and 9% decrease in the likelihood of snoring, respectively.

2. A doubling of 17-estradiol, estrone, and estrone 3-sulfate concentrations in snorers was associated with 18%, 23%, and 17% lower odds of breathing irregularly, respectively, and a doubling of progesterone concentration was also associated with a 12% lower odds of waking up suddenly with a choking sensation.

In conclusion, researchers discovered that lower levels of female sex hormone in middle-aged women were related to a greater incidence of OSA symptoms. It is critical for developing strategies to reduce the higher incidence and associated morbidity of OSA, and adjusting female sex hormone levels may be the key to accomplishing this. However, additional longitudinal studies with repeated sex hormone measurements and objective portrayal of OSA are required to verify these findings in other settings.

Reference:

Sigurðardóttir, E. S., Gislason, T., Benediktsdottir, B., Hustad, S., Dadvand, P., Demoly, P., Franklin, K. A., Heinrich, J., Holm, M., van der Plaat, D. A., Jõgi, R., … Triebner, K. (2022). Female sex hormones and symptoms of obstructive sleep apnea in European women of a population-based cohort. In H. Wang (Ed.), PLOS ONE (Vol. 17, Issue 6, p. e0269569). Public Library of Science (PLoS). https://doi.org/10.1371/journal.pone.0269569