Menopause is a natural transition in a woman’s life.  It can often come with a range of symptoms that can affect everything from body temperature to sleep quality. While many people have heard about the symptoms associated with menopause, they may not have heard of the connection between menopause and sleep apnea, the impact on sleep, the persistent challenge of hot flashes, and the relationship between menopause, weight gain, and muscle mass.


Menopause and Obstructive Sleep Apnea(OSA): Why are they related?

Obstructive sleep apnea (OSA), a condition where breathing repeatedly stops and starts during sleep, is more common among postmenopausal women. Fluctuations in estrogen and progesterone levels can lead to weight gain and fat redistribution, potentially exacerbating sleep apnea. Additionally, menopausal women may be more likely to have additional risk factors for sleep apnea, such as hypertension, diabetes, or a family history of the disorder. These factors can further increase the likelihood of developing OSA. To diagnose OSA a sleep study typically needs to be done at a sleep clinic and is through a referral from your family doctor.


The Impact of Menopause on Sleep Quality

Many women report sleep problems during menopause, with symptoms such as insomnia and night sweats disrupting their sleep. Decreased estrogen levels are often to blame, as they can make it harder to fall asleep and stay asleep. Improving sleep hygiene and considering medical interventions can help manage these issues.


Hot Flashes & Night Sweats: A Heated Menopause Symptom

Hot flashes are sudden feelings of warmth, typically most intense over the face, neck, and chest. These can occur at any time but often disrupt sleep if they happen at night time. They result from the body's thermostat becoming more sensitive to slight changes in body temperature due to hormonal changes. Managing hot flashes can involve diet and lifestyle adjustments, hormone replacement therapy and sometimes prescription medication. wellness wave marketing


Menopause, Weight Gain, and Muscle Mass

Weight gain is a common concern I hear from my patients in menopause, with hormonal changes leading to a slower metabolism and increased abdominal fat. This is also the period when lean muscle mass naturally starts to decrease, a process known as sarcopenia. Maintaining good muscle mass is crucial as it helps regulate blood sugar levels, maintain metabolic rate, and support bone health. Resistance training and adequate protein intake are vital strategies to combat muscle loss and manage weight. I recommend a minimum of three weight training sessions a week and optimal protein intake is generally calculated based on body weight. For example a 150lb female I would take her weight x 0.7 to give 150 x 0.7 = 105 grams of protein daily minimum she requires.


Hormone Replacement Therapy

Hormone Replacement Therapy (HRT) remains a valuable treatment for many women and is considered still the standard of care for menopausal symptoms. HRT is effective in mitigating hot flashes, prevent bone loss, and potentially help maintain muscle mass.  The most commonly used forms of estradiol are topical forms such as creams, gels or patches (these can be prescription and or compounded forms). The progesterone that is bio-identical is considered an exact copy of the body's natural progesterone. These can be forms such as Bioidentical progesterone that comes in oral or cream form (compounded by a compounding pharmacy), Prometrium (generic form of natural progesterone that comes with a prescription), vaginal progesterone suppositories (compounded by compounding pharmacy).  It's essential to have an individualized approach when considering HRT, taking personal health history and discussing risks vs benefits for each individual. It's an important discussion to have with your primary care provider who is trained in menopausal health.


From the relationship between menopause and sleep disturbances, including sleep apnea, to managing hot flashes and understanding the critical need to maintain muscle mass to counter weight gain.  The journey through menopause is multifaceted. Engaging in a dialogue with healthcare providers about treatments like HRT and lifestyle changes can empower women to navigate menopause more comfortably.


If you would like to book a free 15 min discovery call with me I would happy to speak to you!


References:

Baker, F., De Zambotti, M., Colrain, I., & Bei, B. (2018). Sleep problems during the menopausal transition: prevalence, impact, and management challenges. Nature and Science of Sleep, 10, 73 - 95. https://doi.org/10.2147/NSS.S125807.

Maki, P., Panay, N., & Simon, J. (2024). Sleep disturbance associated with the menopause.. Menopause. https://doi.org/10.1097/GME.0000000000002386.

Shaver, J., & Woods, N. (2015). Sleep and menopause: a narrative review. Menopause, 22, 899–915. https://doi.org/10.1097/GME.0000000000000499.

Zolfaghari, S., Yao, C., Thompson, C., Gosselin, N., Desautels, A., Dang-Vu, T., Postuma, R., & Carrier, J. (2019). Effects of menopause on sleep quality and sleep disorders: Canadian Longitudinal Study on Aging.. Menopause. https://doi.org/10.1097/gme.0000000000001462.