Women and Sleep Apnea: Menopause, Airway, Posture and More: Part One

By Arthur M. Strauss, DDS

Our body is designed to survive. Its resources are constantly shifted to neutralize the most immediate threat. Cardiopulmonary resuscitation (CPR) follows this “survival” sequence of airway, breathing, circulation (ABC), prioritized to ensure survival. Heart rate variability (HRV) measurements suggest mini-second to mini-second body reaction to signals of correction to inadequate air flow 24/7 rather than when air is completely cut off as in choking or an obstructive sleep apnea (OSA) event.

The human throat is where the mouth merges with a semi-rigid airway tube extending from the nose to the lungs. It allows for swallowing, speaking and breathing through movements of our tongue within both the mouth and throat. Therefore, posture and position of the tongue (13 integrated muscles) related to the throat (out of it or within it) controls airway size (fully opened to fully blocked), thus airflow and breathing potential. Scientific publications suggest that a compromised airway is likely a twenty-four hour a day phenomenon, not limited to OSA.

Consensus reports support the premise that there is a correlation between stress (adrenaline-type) hormone release, as in the “fight or flight” phenomenon, and body management of the airway, airflow and oxygen delivery to the cells. It increases muscle tone of the tongue and supporting throat muscles, and increases breathing rate to get more air in faster through a narrower opening (as in snoring and apnea) and increases heart rate and blood pressure to circulate oxygen faster to the cells.

The continuum from mild snoring to severe sleep apnea is an indicator of varying blockage of the airway, mostly by the rear portion of the tongue as it loses muscle tone and droops down and backwards from deep relaxation during sleep, the depth and the restful and restorative levels of which depends upon decreasing levels of adrenaline type hormones in the system.

Men show gradual steady increase in the incidence and severity of disordered breathing (snoring and sleep apnea) over their lifetime. Women appear to have a much lower incidence and degree of severity of pre-menopause. The ratio of men to women is eight or 10 for men to one for women. Post-menopause the ratio is two for men to one for women.

Look for part two in the next edition of Your Health Magazine.