As if suffering from severe hot flashes wasn’t enough, these are linked to a serious sleep disorder in which the airway is repeatedly blocked during the night: obstructive sleep apnea.
Menopause, an online journal of The North American Menopause Society, has published a report (Nov. 2, 2017) detailing the link between obstructive sleep apnea and severe hot flashes.
Hot flashes, simply due to their uncomfortable nature, can awaken a woman from overnight sleep. Other women will wake up for the day, realizing that their skin, and sometimes clothes, are damp.
And sometimes menopausal and postmenopausal women who experience hot flashes from time to time or frequently, will wake up in the middle of the night for no apparent reason – they are dry and there was no arousing noise nearby.
So what caused them to wake up? And these mysterious awakenings happen frequently. In many instances it’s sleep apnea.
Obstructive sleep apnea, once thought to be a man’s medical condition, affects plenty of women.
A large number will be misdiagnosed with another condition for many years before they are finally properly diagnosed with OSA.
Common Misdiagnoses Include:
• Stress, anxiety
• Chronic fatigue syndrome
• ADHD or ADD
• Effects of obesity
• Being “out of shape”
• Acid reflux
Symptoms of OSA
• Waking with headaches that soon disappear.
• Interruptions during the night to urinate.
• Always feeling tired and unrested despite eight hours in bed and daytime naps.
• Never waking from sleep feeling refreshed.
• Unexplained fatigue and depression.
• Easily dozing off during computer work, reading, watching TV, business meetings and driving.
• Unexplained brain fog and trouble concentrating.
• High blood pressure that doesn’t respond to dietary improvements or exercise.
• Snoring (though a small percentage of OSA patients do not snore).
• Abruptly waking in the middle of the night gasping for air.
People with OSA may have only a few of these symptoms.
The Menopause report points out that 53 percent of a sampling of perimenopausal and postmenopausal women, who were having sleep disturbances, actually had either obstructive sleep apnea, restless leg syndrome or both.
OSA in a Nutshell
• During sleep, the soft tissues of the throat collapse onto the windpipe, obstructing airflow.
• The cause may be a large tongue and/or large uvula (the “punching bag” that hangs in the back of the throat).
• A naturally narrow airway and/or surplus throat tissue increase the risk of obstructions.
• Obesity makes the situation worse, but thin women can have OSA.
• Alcohol shortly before bedtime is also a risk factor, as it relaxes the throat muscles too much.
• Throughout the night, OSA causes repeated events of strangling, more eloquently termed as “disordered breathing.”
The study revealed that women who reported severe hot flashes in mid life had a higher risk for obstructive sleep apnea – 1.87 times more risk than in women who had mild or zero hot flashes.
“Sleep disruption is a common complaint at menopause,” says Dr. JoAnn Pinkerton in the report, executive director of the NAMS.
“Early morning headaches or excessive daytime sleepiness should raise concern for OSA and signal a possible need for sleep apnea testing.” A sleep study can be done at a lab or at home and will detect the frequency of disordered breathing events.