Evolution of sleep‐disordered breathing and blood pressure during menopausal transition

Abstract

SummaryThe purpose of this study was to investigate how the blood pressure increase observed during menopausal transition is affected by sleep‐disordered breathing and the menopause itself. Further, we aimed to find new sleep‐disordered breathing related markers that would predict the development of hypertension. Sixty‐four community‐dwelling premenopausal women aged 45–47 years were studied. Polysomnography, serum follicle stimulating hormone, forced expiratory volume in 1 s, and a physical examination were performed at baseline and again after 10 years of follow‐up. Indices for sleep apnea/hypopnea and inspiratory flow‐limitation were determined. Regression models were used to study the relationships between variables. Changes in the apnea‐hypopnea index or serum follicle stimulating hormone were not significant for blood pressure change. An increase in morning blood pressure during the follow‐up period was associated with a body mass‐index increase. An increase in evening blood pressure was associated with an increase in inspiratory flow‐limitation during non‐rapid eye movement sleep. Incident hypertension during the follow‐up was associated with hypopnea (median hypopnea index 7.6/h, p = 0.048) during rapid eye movement sleep at baseline. Users of menopausal hormone therapy had a lower rapid eye movement sleep apnea‐hypopnea index (1.6/h vs. 6.9/h, p = 0.026) at baseline whereas at follow‐up users and non‐users did not differ in any way. The progression of menopause or the use of menopausal hormone therapy had a minimal effect on blood pressure in our population. The effects of inspiratory flow‐limitation on blood pressure profile should be studied further.