Sleep Apnea in Caucasian and Asian Climacteric Women

Irina Madaeva, Natalya Semenova, Erdem Ukhinov, Lubov Kolesnikova

International Journal of Biomedicine. 2018;8(4):296-300.
DOI: 10.21103/Article8(4)_OA5
Originally published December 15, 2018


The aim of our study was to define the structure of sleep in Caucasian and Asian peri- and postmenopausal women with sleep apnea.
Materials and Methods:   Two hundred and forty-seven menopausal women between 45 and 60 years of age participated in this study. The participants were divided into 2 ethnic groups, taking into account the genealogy (the representatives having in two generations of parents of one ethnic group) and self-identification, taking into account phenotype elements. Caucasians were represented by the Russian ethnic group (n=115) and Asians by the Buryat ethnic group (n=132). The study included the collection of anamnestic data, physical examinations, clinical (Berlin questionnaire, general medical examination, gynecological examination, polysomnographic monitoring according to American Academy of Sleep Medicine recommendations), and biochemical laboratory methods.
Results: Sleep complaints, such as difficulty falling asleep, frequent night awakenings (more than 2 times), difficulties of morning awakening or problems waking up too early, were increased in perimenopausal Caucasian women. We found ethnic differences in a greater frequency of complaints in Caucasian women, but Asian women also showed a tendency to increased complaints about poor sleep. Polysomnographic monitoring revealed that OSA was more common in Asian postmenopausal women than in Caucasians. However, in structure of sleep we have not seen distinctions.
Conclusion: For improving the quality of life, it is necessary not only to pay attention to menopausal problems, but also to solve the sleep problems associated with various strategies, both age management and lifestyle.

climacteric women • sleep apnea • Caucasians • Asians • sleep structure
  1. Madayeva IM, Kolesnikova LI, Petrova VA, Shevyrtalova ON, Sholokhov LF. [Changes in the processes of the lipid peroxidation and antioxidant defense system in patients with obstructive sleep apnea syndrome]. Pathological physiology and experimental medicine. 2009;(3):24-27 . [Article in Russian].
  2. Madayeva IM. Shevyrtalova ON, Madayev VV. Doksilamin's application at insomnia for patients with arterial hypertension. Consilium Medicum. 2009;(9): 69-72
  3. Avis NE, Stellato R, Crawford S, Bromberger J, Ganz P, Cain V, Kagawa-Singer M. Is there a menopausal syndrome? Menopausal status and symptoms across racial/ethnic groups. Soc Sci Med. 2001;52(3):345-56. PubMed
  4. Shaver JL.Women and sleep. Nurs Clin North Am.2002; 37(4):707-18. PubMed
  5. Im EO. The Midlife Women’s Symptom Index (MSI). Health Care Women Int. 2006;27(3):268-87. PubMed
  6. Minarik PA. Sleep disturbance in midlife women. J Obstet Gynecol Neonatal Nurs. 2009;38(3):333-43. doi: 10.1111/j.1552-6909.2009.01031.x. PubMed
  7. Kravitz HM, Joffe H. Sleep during the perimenopause: a SWAN story.  Obstet Gynecol Clin North Am. 2011;38(3):567-86. doi: 10.1016/j.ogc.2011.06.002. PubMed
  8. Kravitz HM, Zhao X, Bromberger JT, Gold EB, Hall MH, Matthews KA, Sowers MR.  Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women. Sleep. 2008;31(7):979-90. PubMed
  9. Durrence HH, Lichstein KL. The sleep of African Americans: a comparative review. Behav Sleep Med. 2006;4(1):29-44. PubMed
  10. Hall MH, Matthews KA, Kravitz HM, Gold EB, Buysse DJ, Bromberger JT, et al. Race and financial strain are independent correlates of sleep in mid-life women: The SWAN Sleep Study. Sleep. 2009;32(1):73-82. PubMed
  11. Mezick EJ, Matthews KA, Hall M, Strollo PJ Jr, Buysse DJ, Kamarck TW, et al. Influence of race and socioeconomic status on sleep: Pittsburgh Sleep SCORE Project. Psychosom Med. 2008;70(4):410-6. doi: 10.1097/PSY.0b013e31816fdf21. PubMed
  12. Ramos AR, Wohlgemuth WK, Dong C, Gardener H, Wright CB, Boden-Albala B, et al. Race-ethnic differences of sleep symptoms in an elderly multi-ethnic cohort: the Northern Manhattan Study. Neuroepidemiology. 2011;37(3-4):210-5. doi: 10.1159/000334315. PubMed
  13. Tan A, Cheung YY, Yin J, Lim WY, Tan LWL, Lee CH. Prevalence of sleep-disorderedbreathing in a multiethnic Asian population in Singapore: A community-based study. Respirology. 2016;21(5):943-50. doi: 10.1111/resp.12747. PubMed
  14. Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP.  Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med. 1999;131(7):485–91. PubMed
  15. Fietze I, Penzel T, Alonderis A, Barbe F, Bonsignore MR, Calverly P, et al. COST Action B26 Group. Management of obstructive sleep apnea in Europe. Sleep Med. 2011;12(2):190-7. doi: 10.1016/j.sleep.2010.10.003. PubMed
  16. Margallo VS, Muxfeldt ES, Guimaraes GM, Salles GF. Diagnostic accuracy of the Berlin questionnaire in detecting obstructive sleep apnea in patients with resistant hypertension. J Hypertens. 2014; 32(10):2030-6; discussion 2037. doi: 10.1097/HJH.0000000000000297. PubMed
  17. American Academy of Sleep Medicine Task Force. Sleep-related breathing disorders in adults: Recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999;22(5):667-89. PubMed
  18. Bixler EO, Vgontzas AN, Lin HM, Ten Have T, Rein J, Vela-Bueno A, Kales A. Prevalence of sleep-disordered breathing in women. Am J Respir Crit Care Med. 2001;163(3 Pt 1):608–13. PubMed
  19. Montplaisir J, Lorrain J, Denesle R, Petit D. Sleep in menopause: differential effects of two forms of hormone replacement therapy. Menopause. 2001;8(1):10–6. PubMed
  20. Netzer NC, Eliasson AH, Strohl KP. Women with sleep apnea have lower levels of sex hormones. Sleep Breath. 2003;7(1):25-9. PubMed
  21. Sowers MF, Zheng H, Kravitz HM, Matthews K, Bromberger JT, Gold EB, et al. Sex steroid hormone profiles are related to sleep measures from polysomnography and the Pittsburgh Sleep Quality Index. Sleep. 2008;31(10):1339-49. PubMed
  22. Randolph JF Jr, Sowers M, Gold EB, Mohr BA, Luborsky J, Santoro N, et al. Reproductive hormones in the early menopausal transition: relationship to ethnicity, body size, and menopausal status. J Clin Endocrinol Metab. 2003;88(4):1516-22. PubMed
  23.  Hall MH, Matthews KA, Kravitz HM, Gold EB, Buysse DJ, Bromberger JT, et al. Race and financial strain are independent correlates of sleep in mid-life women: the SWAN sleep study. Sleep. 2009;32(1):73-82. PubMed
  24. Im EO, Lee B, Chee W, Brown A, Dormire S. Menopausal symptoms among four major ethnic groups in the United States. West J Nurs Res. 2010; 32(4):540-65. doi: 10.1177/0193945909354343. PubMed
  25. Richard-Davis G, Wellons M. Racial and ethnic differences in the physiology and clinical symptoms of menopause. Semin Reprod Med. 2013;31(5):380-6. doi:10.1055/s-0033-1348897. PubMed
  26. Kravitz HM, Avery E, Sowers M, Bromberger JT, Owens JF, Matthews KA, et al. Relationships between menopausal and mood symptoms and EEG sleep measures in a multi-ethnic sample of middle-aged women: the SWAN sleep study. Sleep. 2011;34(9):1221-32. doi: 10.5665/SLEEP.1244. PubMed
  27. Woods NF, Mitchell ES. Sleep symptoms during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women’s Health Study. Sleep. 2010;33(4):539-49. PubMed

Download Article
Received September 2, 2018.
Accepted October 11, 2018.
©2018 International Medical Research and Development Corporation.