Does Menopause Cause Snoring?

estrogen hormonal imbalance hormone replacement therapy hormones hrt menopause progesterone sex steroid hormones sleep sleep apnea snoring xenoestrogens Mar 11, 2023

A woman awake in bed looking at the clock

Menopause is a natural process in women’s lives. People think of menopause as a time when estrogen levels drop.¹ But by the time estrogen declines, the other sex hormones are almost gone. In most menopausal women, progesterone is hardly measurable, and testosterone is usually only around 15 percent of what it was.^2,3 So, even with less total estrogen, menopause comes with a relative excess of estrogen. This imbalance is linked to a number of symptoms, including sleep problems.⁴ Here are some of the ways sex hormone imbalance and sleep issues in menopause are related:

Effects of sex hormones on sleep neurotransmitters
Health risks from hormone replacement therapy (HRT) and xenoestrogens
The role of estrogen in sleep apnea
How excess estrogen causes snoring

Let’s take a closer look at each of these.

Effects of sex hormones on sleep neurotransmitters

Nerve cells involved in the sleep-wake cycle can be found in many parts of the brain. These nerve cells produce chemicals called neurotransmitters that change the activity of their target cells. One such neurotransmitter is gamma-aminobutyric acid (GABA), which promotes sleep and relaxes muscles. Two others are serotonin and cortisol. Serotonin hinders rapid eye movement (REM) sleep, while cortisol stimulates wakefulness.⁵ Progesterone and estrogen levels affect these three neurotransmitters.

Progesterone acts on GABA receptors. It enhances GABA activity by allowing more chloride ions (Cl^-) to enter target cells.⁶ Very low levels of progesterone in menopause are thus associated with low GABA activity and poor sleep.

During REM sleep, GABA inhibits the release of serotonin.⁵ Low GABA then leads to high serotonin, which causes shorter periods of (REM) sleep. This is problematic because REM sleep plays a crucial part in consolidating memories, processing emotions, and getting ready to wake up.^7,8 Many menopausal women are prescribed antidepressants to manage their emotional symptoms. These drugs work by boosting serotonin levels. Given what we’ve just said about serotonin, these women may be getting the wrong treatment.

Cortisol, the classic “stress” hormone, is produced in variable amounts over a 24-hour cycle. Cortisol production is lowest around midnight and peaks about an hour after waking up. This pattern helps with staying awake and alert in daytime. Increases in cortisol are linked to estrogen dominance (higher levels of estrogen relative to progesterone) and to HRT as well. Too much cortisol, in turn, can lead to waking up in the middle of the night and feeling anxious during the day.⁹ Both symptoms are common in menopause.

Health risks from HRT and xenoestrogens

Before menopause, hormones tend to be balanced overall. Thus, none of the health problems above are normally observed during that period. When menopause hits and hormones decrease, hormone replacement therapy (HRT) is one popular way to manage the symptoms.

HRT is the combined prescription of estrogen and progesterone. It aims to provide the lowest dose of both hormones that would relieve the symptoms of menopause.¹ The problem is, traditional HRT involves hormones that are man-made or come from animals. These substances have different chemical structures from those of estrogen and progesterone naturally found in humans.¹⁰

As mentioned earlier, menopausal women have relatively high estrogen levels. On top of that, women (and men too) are exposed to xenoestrogens every day.¹¹ Xenoestrogens mimic natural estrogen and increase its levels in the body. These synthetic chemicals are found in common products like makeup, toiletries, and even processed foods and food containers.

The chemical structures of HRT hormones and the relative excess of estrogen during menopause are associated with many health risks for women.¹¹ Some of these risks are cancer, stroke, blood clots, and smooth muscle tissue disorders.^12,13,14

The role of estrogen in sleep apnea

Estrogen receptors can be found in the smooth muscle tissue making up the human airway. When these receptors are activated, they lessen the entry of calcium ions across smooth muscle cell membrane. The lower levels of calcium within the cells then lead to greater relaxation and decreased tone of the airway smooth muscle.¹⁵ Tone refers to a muscle’s ability to maintain a partially contracted state. Most muscles are at least partially contracted all the time. When airway muscles are too relaxed, the airway can collapse during sleep, leading to obstructive sleep apnea (OSA). OSA is the most common form of sleep apnea, a disorder in which breathing stops and starts many times while an individual sleeps. When the flow of air into the lungs is stopped, blood oxygen levels are lowered. The brain senses the decrease in oxygen and causes awakening from sleep for a short time. The whole pattern happens again and again all night, making it difficult to have deep and restful sleep.¹⁶

How excess estrogen causes snoring

Relaxed airway smooth muscle due to estrogen action on calcium ions is the same mechanism that is responsible for snoring. Snoring happens when the partially relaxed muscle tissue in the airway vibrates as air flows past it.¹⁷ Snoring can thus be thought of as a milder form of sleep apnea. Because it does not result in blockage of airflow, people who snore do not usually wake up repeatedly like those with sleep apnea do.

Conclusion

Women in menopause face sleep problems that affect their health, productivity, and quality of life. These sleep issues, including snoring, are caused by a relative excess of estrogen, which comes naturally with menopause and is enhanced by HRT. Here’s some good news though: there’s a natural and permanent way to get rid of snoring in as little as two weeks! Learn more through The Snoring Diet Solution.

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