Association of estradiol with sleep apnea in depressed perimenopausal and postmenopausal women: a preliminary study.
Association of estradiol with sleep apnea in depressed perimenopausal and postmenopausal women: a preliminary study.
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DOI：
10.1097/gme.0000000000000737
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发表时间：
2017-01
期刊：
影响因子：
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通讯作者：
Joffe H
中科院分区：
文献类型：
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作者：
Galvan T;Camuso J;Sullivan K;Kim S;White D;Redline S;Joffe H
Women’s risk of obstructive sleep apnea (OSA) increases substantially during and after the menopause transition, when depression risk is also elevated, raising the possibility that estrogen withdrawal contributes to OSA vulnerability, in turn contributing to mood disturbance. We examined the association between estradiol levels and OSA in depressed peri- and postmenopausal women. Thirty depressed peri/postmenopausal women (mean BMI 30.82 kg/m2) without known OSA completed routine polysomnography concurrent with serum estradiol levels. Estradiol in women with apnea-hypopnea indices (AHI)≥15 indicating moderate-to-severe OSA was compared against those with AHI <15 using logistic regression adjusting for age and body mass index (BMI). Thirteen women (43%) had AHI≥15 (median AHI 21.6). Estradiol levels were lower (p=0.02) in those with OSA (median 19, interquartile range [IQR] 9–25, pg/ml) than without OSA (median 29, IQR 19–66, pg/ml). On univariate analysis, higher estradiol was associated with reduced odds of OSA (odds ratio [OR] 0.95, 95% confidence interval [CI] 0.90–0.99, p=0.04). After adjusting for age and BMI, E2 levels remained associated with lower odds of OSA (OR 0.90), but the association was no longer statistically significant (95% CI 0.76–1.05, p=0.18). Montgomery Åsberg Depression Rating Scale scores did not differ between those with and without OSA. These preliminary results suggest that, in addition to higher BMI and age, lower estradiol may be associated with increased OSA risk in depressed women during the peri- and postmenopause, raising the possibility that estradiol withdrawal associated with menopause influences upper-airway patency in women.
