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Sleep and Menopause

Sleep disturbances are one of the most disruptive and least discussed symptoms of menopause.

Sleep physician Dr Anup Desai explains what is happening in your body — and how to reclaim your rest.

Remember, always seek professional help if symptoms are persistent, distressing, or unexplained.

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Sleep 101

Dr Desai is interviewed by Health Ed on the range of sleep disorders that present in General Practice and how to assess for them.

https://www.healthed.com.au/podcasts/the-clinical-takeaway-sleep-medicine-for-gps-its-more-than-just-osa/

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Home Assessments – Thoughts on Home Based Sleep Disorders

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Obesity and Sleep Apnoea

Obesity is the strongest risk factor for obstructive sleep apnoea (OSA). Approximately 60% of moderate-to-severe OSA is due to obesity. Other risk factors are increasing age, male gender, perimenopausal or postmenopausal status in women and craniofacial abnormalities (eg, a slightly backwards displaced lower jaw or overbite).

However there is evidence for a bi-directional relationship between obesity and OSA with recognition that the development of OSA and its subsequent sleep fragmentation may contribute to accelerated weight gain.

  • Many patients report rapid increases in weight in the year prior to OSA diagnosis
  • Data shows sleep deprivation states are associated with increases in appetite hormones
  • Sleep deprivation states result in altered eating patterns, including a preference for calorie-dense foods

Untreated OSA and obesity may create a vicious cycle of increased OSA and obesity, unless patients are properly managed.

 

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Comorbid Insomnia and Sleep Apnoea

SUMMARY

Obstructive sleep apnoea (OSA) and insomnia often coexist - a comorbidity known as COMISA.

Studies show a high overlap between the two conditions.

Traditionally, the two conditions have been viewed as distinct entities; however, they may be interrelated.

It is important to consider both in patients who present with sleep problems.

Several symptoms are common to both conditions, including non-restorative sleep, frequent awakening and fatigue.

All patients with insomnia should be screened for OSA, and insomnia should be considered in all patioents diagnosed with OSA.

COMISA is more challenging to treat than either disorder presenting alone, and therapy is generally guided by the presenting compliant and/or predominant complaint.

PUBLISHED: Australian Doctor GP Journal 6 April 2020

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