16 Mar Menopause May Be the Time When Sleep Apnoea First Appears in Women.
Many women expect hot flushes, mood changes, and sleep disruption during menopause. However, one sleep condition that is often overlooked in women is Sleep Apnea. While it is commonly associated with men, sleep apnoea becomes much more common in women during and after menopause. Recognising the signs can help women seek help and improve both sleep and overall health.
Sleep apnoea occurs when breathing repeatedly stops and starts during sleep. The most common form is obstructive sleep apnoea, which happens when the airway becomes partially or completely blocked. These breathing pauses can occur many times during the night, often without the person realising it. As a result, sleep becomes fragmented and less restorative, leaving women feeling tired even after what seems like a full night’s sleep.
For women, menopause can increase the risk of developing sleep apnoea. Hormonal changes play a major role. During the reproductive years, the hormones oestrogen and progesterone help support healthy breathing patterns during sleep. Progesterone, in particular, helps stimulate breathing and maintain airway stability. As these hormone levels decline during menopause, the airway may become more likely to collapse during sleep.
Weight changes that often occur during midlife can also contribute. Many women notice weight gain or a shift in where fat is stored in the body during menopause, particularly around the abdomen and upper body. Extra tissue around the neck and airway can narrow breathing passages and increase the risk of airway obstruction during sleep.
Sleep apnoea symptoms in women can look different from those traditionally described in men. While loud snoring and choking during sleep can occur, many women present with less obvious symptoms. These may include persistent fatigue, insomnia, frequent nighttime awakenings, morning headaches, difficulty concentrating, mood changes, or feeling unrefreshed after sleep. Because these symptoms overlap with common menopausal complaints, sleep apnoea may be missed or misattributed to menopause alone.
If left untreated, sleep apnoea can affect more than just sleep quality. It has been linked to high blood pressure, heart disease, stroke, and metabolic conditions such as diabetes. Poor sleep can also worsen menopause symptoms, including irritability, low mood, and cognitive difficulties.
The good news is that sleep apnoea is treatable. Diagnosis typically involves a sleep study, which can be done in a sleep clinic or sometimes at home. Once diagnosed, several treatment options are available. The most common is continuous positive airway pressure (CPAP), a device that gently keeps the airway open during sleep. Some women may benefit from oral appliances, weight management strategies, or changes in sleep position.
If you are a woman experiencing menopause and struggling with ongoing sleep problems, daytime fatigue, or snoring, it is worth discussing these symptoms with your healthcare provider. Sleep apnoea is common, manageable, and often underdiagnosed in women. Seeking assessment and treatment can significantly improve sleep quality, energy levels, and overall wellbeing during this stage of life.