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Hormone replacement therapy and sleep-disordered breathing.

TitleHormone replacement therapy and sleep-disordered breathing.
Publication TypeJournal Article
Year of Publication2003
AuthorsShahar E, Redline S, Young T, Boland LL, Baldwin CM, Nieto JF, O'Connor GT, Rapoport DM, Robbins JA
JournalAm J Respir Crit Care Med
Volume167
Issue9
Pagination1186-92
Date Published2003 May 01
ISSN1073-449X
KeywordsAge Distribution, Aged, Body Mass Index, Causality, Cohort Studies, Confidence Intervals, Estrogen Replacement Therapy, Female, Humans, Logistic Models, Middle Aged, Multivariate Analysis, Odds Ratio, Polysomnography, Postmenopause, Prevalence, Sensitivity and Specificity, Severity of Illness Index, Sleep Apnea Syndromes, Sleep Stages, United States
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 noninstitutionalized 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.

DOI10.1164/rccm.200210-1238OC
Alternate JournalAm J Respir Crit Care Med
PubMed ID12531779
Grant ListUO1HL53916 / HL / NHLBI NIH HHS / United States
UO1HL53931 / HL / NHLBI NIH HHS / United States
UO1HL53934 / HL / NHLBI NIH HHS / United States
UO1HL53937 / HL / NHLBI NIH HHS / United States
UO1HL53938 / HL / NHLBI NIH HHS / United States
UO1HL53940 / HL / NHLBI NIH HHS / United States
UO1HL53941 / HL / NHLBI NIH HHS / United States
UO1HL63429 / HL / NHLBI NIH HHS / United States
UO1HL63463 / HL / NHLBI NIH HHS / United States