Hormone replacement therapy and sleep-disordered breathing

Eyal Shahar, Susan Redline, Terry Young, Lori L. Boland, Carol M. Baldwin, F. Javier Nieto, George T. O'Connor, David M. Rapoport, John A. Robbins

Research output: Contribution to journalArticle

224 Citations (Scopus)

Abstract

Disordered breathing during sleep is more common among postmenopausal women than among their premenopausal counterparts, possibly because of declining levels of estrogen and progesterone. We examined the relationship between the use of replacement hormones and sleep-disordered breathing in a sample of 2,852 non-institutionalized women, 50 years of age or older, who participated in the Sleep Heart Health Study. The frequency of apneas and hypopneas per hour of sleep (apnea-hypopnea index) was determined by unattended, single-night polysomnography at the participant's home. The prevalence of sleep-disordered breathing (apnea-hypopnea index of 15 or more) among hormone users (61 of 907) was approximately half the prevalence among nonusers (286 of 1,945). Multivariable adjustment for known determinants of the disorder, including age, body mass index, and neck circumference, has attenuated the association, but only moderately (adjusted odds ratio, 0.55; 95% confidence interval, 0.41 to 0.75). The inverse association between hormone use and sleep-disordered breathing was evident in various subgroups and was particularly strong among women 50 to 59 years old (adjusted odds ratio, 0.36; 95% confidence interval, 0.21 to 0.60). If the observed associations are causal, hormone replacement therapy could have a role in preventing or alleviating sleep-disordered breathing.

Original languageEnglish (US)
Pages (from-to)1186-1192
Number of pages7
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume167
Issue number9
DOIs
StatePublished - May 1 2003
Externally publishedYes

Fingerprint

Hormone Replacement Therapy
Sleep Apnea Syndromes
Hormones
Apnea
Odds Ratio
Confidence Intervals
Polysomnography
Progesterone
Sleep
Estrogens
Body Mass Index
Neck
Health

Keywords

  • Estrogen
  • Menopause
  • Progesterone
  • Sleep
  • Sleep apnea

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Shahar, E., Redline, S., Young, T., Boland, L. L., Baldwin, C. M., Nieto, F. J., ... Robbins, J. A. (2003). Hormone replacement therapy and sleep-disordered breathing. American Journal of Respiratory and Critical Care Medicine, 167(9), 1186-1192. https://doi.org/10.1164/rccm.200210-1238OC

Hormone replacement therapy and sleep-disordered breathing. / Shahar, Eyal; Redline, Susan; Young, Terry; Boland, Lori L.; Baldwin, Carol M.; Nieto, F. Javier; O'Connor, George T.; Rapoport, David M.; Robbins, John A.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 167, No. 9, 01.05.2003, p. 1186-1192.

Research output: Contribution to journalArticle

Shahar, E, Redline, S, Young, T, Boland, LL, Baldwin, CM, Nieto, FJ, O'Connor, GT, Rapoport, DM & Robbins, JA 2003, 'Hormone replacement therapy and sleep-disordered breathing', American Journal of Respiratory and Critical Care Medicine, vol. 167, no. 9, pp. 1186-1192. https://doi.org/10.1164/rccm.200210-1238OC
Shahar, Eyal ; Redline, Susan ; Young, Terry ; Boland, Lori L. ; Baldwin, Carol M. ; Nieto, F. Javier ; O'Connor, George T. ; Rapoport, David M. ; Robbins, John A. / Hormone replacement therapy and sleep-disordered breathing. In: American Journal of Respiratory and Critical Care Medicine. 2003 ; Vol. 167, No. 9. pp. 1186-1192.
@article{e24f45ad15ad4432a8940e8742cdf6cc,
title = "Hormone replacement therapy and sleep-disordered breathing",
abstract = "Disordered breathing during sleep is more common among postmenopausal women than among their premenopausal counterparts, possibly because of declining levels of estrogen and progesterone. We examined the relationship between the use of replacement hormones and sleep-disordered breathing in a sample of 2,852 non-institutionalized women, 50 years of age or older, who participated in the Sleep Heart Health Study. The frequency of apneas and hypopneas per hour of sleep (apnea-hypopnea index) was determined by unattended, single-night polysomnography at the participant's home. The prevalence of sleep-disordered breathing (apnea-hypopnea index of 15 or more) among hormone users (61 of 907) was approximately half the prevalence among nonusers (286 of 1,945). Multivariable adjustment for known determinants of the disorder, including age, body mass index, and neck circumference, has attenuated the association, but only moderately (adjusted odds ratio, 0.55; 95{\%} confidence interval, 0.41 to 0.75). The inverse association between hormone use and sleep-disordered breathing was evident in various subgroups and was particularly strong among women 50 to 59 years old (adjusted odds ratio, 0.36; 95{\%} confidence interval, 0.21 to 0.60). If the observed associations are causal, hormone replacement therapy could have a role in preventing or alleviating sleep-disordered breathing.",
keywords = "Estrogen, Menopause, Progesterone, Sleep, Sleep apnea",
author = "Eyal Shahar and Susan Redline and Terry Young and Boland, {Lori L.} and Baldwin, {Carol M.} and Nieto, {F. Javier} and O'Connor, {George T.} and Rapoport, {David M.} and Robbins, {John A.}",
year = "2003",
month = "5",
day = "1",
doi = "10.1164/rccm.200210-1238OC",
language = "English (US)",
volume = "167",
pages = "1186--1192",
journal = "American Journal of Respiratory and Critical Care Medicine",
issn = "1073-449X",
publisher = "American Thoracic Society",
number = "9",

}

TY - JOUR

T1 - Hormone replacement therapy and sleep-disordered breathing

AU - Shahar, Eyal

AU - Redline, Susan

AU - Young, Terry

AU - Boland, Lori L.

AU - Baldwin, Carol M.

AU - Nieto, F. Javier

AU - O'Connor, George T.

AU - Rapoport, David M.

AU - Robbins, John A.

PY - 2003/5/1

Y1 - 2003/5/1

N2 - Disordered breathing during sleep is more common among postmenopausal women than among their premenopausal counterparts, possibly because of declining levels of estrogen and progesterone. We examined the relationship between the use of replacement hormones and sleep-disordered breathing in a sample of 2,852 non-institutionalized women, 50 years of age or older, who participated in the Sleep Heart Health Study. The frequency of apneas and hypopneas per hour of sleep (apnea-hypopnea index) was determined by unattended, single-night polysomnography at the participant's home. The prevalence of sleep-disordered breathing (apnea-hypopnea index of 15 or more) among hormone users (61 of 907) was approximately half the prevalence among nonusers (286 of 1,945). Multivariable adjustment for known determinants of the disorder, including age, body mass index, and neck circumference, has attenuated the association, but only moderately (adjusted odds ratio, 0.55; 95% confidence interval, 0.41 to 0.75). The inverse association between hormone use and sleep-disordered breathing was evident in various subgroups and was particularly strong among women 50 to 59 years old (adjusted odds ratio, 0.36; 95% confidence interval, 0.21 to 0.60). If the observed associations are causal, hormone replacement therapy could have a role in preventing or alleviating sleep-disordered breathing.

AB - Disordered breathing during sleep is more common among postmenopausal women than among their premenopausal counterparts, possibly because of declining levels of estrogen and progesterone. We examined the relationship between the use of replacement hormones and sleep-disordered breathing in a sample of 2,852 non-institutionalized women, 50 years of age or older, who participated in the Sleep Heart Health Study. The frequency of apneas and hypopneas per hour of sleep (apnea-hypopnea index) was determined by unattended, single-night polysomnography at the participant's home. The prevalence of sleep-disordered breathing (apnea-hypopnea index of 15 or more) among hormone users (61 of 907) was approximately half the prevalence among nonusers (286 of 1,945). Multivariable adjustment for known determinants of the disorder, including age, body mass index, and neck circumference, has attenuated the association, but only moderately (adjusted odds ratio, 0.55; 95% confidence interval, 0.41 to 0.75). The inverse association between hormone use and sleep-disordered breathing was evident in various subgroups and was particularly strong among women 50 to 59 years old (adjusted odds ratio, 0.36; 95% confidence interval, 0.21 to 0.60). If the observed associations are causal, hormone replacement therapy could have a role in preventing or alleviating sleep-disordered breathing.

KW - Estrogen

KW - Menopause

KW - Progesterone

KW - Sleep

KW - Sleep apnea

UR - http://www.scopus.com/inward/record.url?scp=0037879193&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037879193&partnerID=8YFLogxK

U2 - 10.1164/rccm.200210-1238OC

DO - 10.1164/rccm.200210-1238OC

M3 - Article

VL - 167

SP - 1186

EP - 1192

JO - American Journal of Respiratory and Critical Care Medicine

JF - American Journal of Respiratory and Critical Care Medicine

SN - 1073-449X

IS - 9

ER -