Sleep disorders underestimated among mid-life women

Sleep problems in middle-aged women are too often attributed to menopausal symptoms such as hot flashes, leading to under-treatment of conditions including obstructive sleep apnoea (OSA) and restless legs syndrome, a recent report has claimed."The prevalence and severity of OSA, long regarded as a disease of males, rise dramatically in women after menopause, boosting risks of heart disease and stroke," it said. The condition affected about 4% of middle-aged men but also 2% of middle-aged women, and the prevalence was likely to increase along with levels of obesity. Women often presented with insomnia, fatigue, depression and hypothyroidism, in contrast to men in whom the classic picture of snoring and excessive daytime sleepiness was more common. Nasal CPAP was effective for women but they were less keen to use it. Marketing of CPAP perpetuated the stereotype of OSA being a male disease, with virtually all promotions featuring men using the devices.Restless legs syndrome, like OSA, was not directly linked to menopause but increased in middle age. It was thought to affect 2-4% of all adults and was often relieved by dopaminergic therapy. Allegations that direct-to-consumer marketing of these agents was 'disease mongering' had done patients a disservice, as many endured moderate or severe symptoms for years before being treated.Social and psychological stresses could also affect sleep in middle age. "Many women not only hold paid jobs in midlife, but also care for ageing parents, an ill spouse or other relatives," the report stated. "Their 'second shift' often involves night-time 'on call' duty." Some women's sleep was also interrupted by a partner's snoring or restlessness.Although women consistently reported more sleep problems around the time of menopause, their subjective impressions were not supported by objective evidence. Sleep studies found postmenopausal women had longer and deeper sleep than their younger, premenopausal counterparts.Reference...