In Pursuit of a Good Night’s Sleep

Many of us in perimenopause or postmenopause struggle to get a solid night’s sleep. There are lots of possible causes, from night sweats (nocturnal hot flashes) to stress associated with events in our lives. One possible cause that’s often discounted by women—because it’s more common among men—is sleep apnea.

Quote: There is a time for many words, and there is a time for sleep. [Homer]

Sleep apnea is a disorder defined by disrupted breathing while you sleep. There are a couple of types: “obstructive” apnea is the more common variety, when your muscles relax and block your breathing; there’s another type that involves the brain not sending the right signals to regulate breathing; and sometimes there’s a combination of the two. What’s happening in obstructive sleep apnea is that your airway is obstructed (hence the name) when muscles in your throat relax. When your oxygen is reduced, your brain wakes you up—usually so briefly you’re not conscious of it—so you’ll open the airway, which you do—again, usually unconsciously—by shifting your position or tightening the relaxed muscles.

If you sleep with a partner, they might note that you’re snoring; they might also hear gasps or “snorts” at that moment when you rouse. 

As I said, this is typically a bigger issue for men than women—two or three times as likely. But women after menopause increase their risk, with weight gain as a likely factor. Other factors that may come into play are consumption of alcohol or certain medications (sedatives) that relax throat muscles, congestion from allergies or other causes, and smoking. And sleep apnea is not just an obstacle to a good night’s sleep. It’s also been linked to increased risk of heart disease, Type 2 diabetes, metabolic syndrome, and liver function issues. A few of those may strike you as cyclical—that is, metabolic syndrome can lead to weight gain, which can lead to sleep apnea; and sleep apnea can lead to metabolic syndrome. Frustrating, yes, and accurate. 

Sleep apnea needs to be diagnosed by your health care provider for the complete range of treatments. They may suggest lifestyle changes, like losing weight, or treatment for an underlying cause of congestion. If those steps don’t solve the problem, there are further options, like the use of a CPAP (continuous positive airway pressure) machine or, in extreme cases, surgery. But the first step is that diagnosis.

If you’d like to eliminate other possible causes for restless nights, start with evaluating and improving your “sleep hygiene,” which I’ve described in detail in an earlier blog post. But if you (or your partner) suspects sleep apnea based on the sounds you make in the night, don’t hesitate to see your health care provider! A good night’s sleep is worth it.


Dr. Barb DePree MD
Dr. Barb DePree MD

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