Menopause, snoring and sleep apnea: what changes

Menopause makes snoring and sleep apnea more likely. Hormone changes appear to play a part, and studies that followed women through menopause found breathing problems during sleep increased even after allowing for age and weight. Because sleep apnea in women often looks like tiredness, insomnia or morning headaches, it's easy to blame menopause and miss it, so it's worth asking a doctor if your sleep has changed.

Why does menopause affect snoring?

Cleveland Clinic says the average age of menopause in the United States is 52, and that the transition usually begins in your mid-40s. The NHS says symptoms usually last 7 to 9 years, sometimes longer, and can change over that time. That's a long stretch for sleep to be affected, so it's worth knowing what to look for.

Snoring is the sound of soft tissue in your mouth, throat or nose vibrating as you breathe. The NHS explains that these parts relax and narrow when you're asleep, and anything that narrows them further makes snoring more likely.

A 2024 systematic review notes that snoring is more common in men overall but increases in women after menopause, probably because of hormone changes. The NHLBI makes the same point about sleep apnea, saying women may be at increased risk during and after menopause, in part because of hormone changes.

Weight may add to it. The NHS says weight gain during perimenopause and menopause is common and often happens around the stomach and upper body, and it lists being overweight among the things that make snoring more likely. Cleveland Clinic says losing muscle as you get older can affect how your body gains weight.

What does the research show?

Three studies link menopause with more breathing problems during sleep, and they point the same way.

The Wisconsin Sleep Cohort Study, published in 2003, gave in-lab sleep studies to 589 women and compared them by menopausal stage. After adjusting for age, body size, smoking and other factors, postmenopausal women had 2.6 times the odds of at least mild sleep-disordered breathing and 3.5 times the odds of at least moderate sleep-disordered breathing compared with premenopausal women. The authors concluded that women going through menopause who complain of snoring, daytime sleepiness or unsatisfying sleep should be checked for it.

A 2017 follow-up, the Sleep in Midlife Women Study, tracked 219 women aged 38 to 62 with home sleep studies every six months. Compared with premenopause, the number of breathing interruptions per hour was 31% higher in postmenopause, and each additional year into menopause was linked with about 4% more. The researchers said the link held independent of aging and changes in body size. They also warned that blaming every sleep problem on menopause could lead to treatable sleep disorders being missed.

A 2001 study of 1,741 adults who had sleep lab testing found sleep apnea was rare in premenopausal women, at 0.6%. Postmenopausal women who weren't on hormone therapy had a rate of 2.7%, closer to the 3.9% seen in men. Women on hormone therapy had a rate similar to premenopausal women. That's an association, not proof that hormone therapy protects against sleep apnea, and any decision about hormone therapy belongs with your doctor.

How is sleep apnea different in women?

Sleep apnea can look different in women, which makes it easy to miss. The NHLBI says sleep apnea symptoms may be different in women, who more often have:

• anxiety or depression
• daytime sleepiness or tiredness
• headaches, especially in the morning
• insomnia
• waking up often during sleep

It also says that because some women don't have symptoms such as snoring, they may not think they have sleep apnea. The NHLBI also says hormone problems in women with polycystic ovary syndrome (PCOS) may raise the risk, and that it's important to talk to your healthcare provider if you have any of these symptoms or risk factors. Many of these overlap with menopause itself. The NHS lists trouble getting to sleep or staying asleep, night sweats, low mood and problems with memory and concentration among common menopause symptoms. So it's reasonable to treat new sleep problems in midlife as worth a closer look rather than something to put up with. Our article on sleep apnea in women goes further into the differences.

What are the warning signs to take seriously?

The NHS lists these symptoms of sleep apnoea:

• breathing that stops and starts while you sleep
• gasping, snorting or choking noises
• waking up a lot
• loud snoring
• feeling very tired during the day, finding it hard to concentrate, mood swings or a headache when you wake up

The NHLBI adds dry mouth and waking up often in the night to urinate. The NHS says it can help to ask someone to stay with you while you sleep so they can watch for symptoms, and to bring them to your appointment. Our list of sleep apnea warning signs has more detail.

When should you see a doctor?

The NHS says to see a GP if your breathing stops and starts in your sleep, you make gasping, snorting or choking noises, or you always feel very tired during the day. It also suggests seeing a GP about snoring if lifestyle changes aren't helping or it's having a big effect on you or your partner. For menopause itself, the NHS says early advice can help reduce its effects on your health, relationships and work.

It helps to raise both topics at the same appointment. Tell your doctor when the snoring or poor sleep started, whether anyone has noticed pauses in your breathing, and how tired you are during the day. If sleep apnea is possible, you may be referred for a sleep test, which the NHS says you can usually do at home. Our guide to the home sleep apnea test explains what's involved, and questions to ask your doctor about snoring can help you prepare.

How is sleep apnea treated?

The NHS says sleep apnoea can sometimes be treated with lifestyle changes like losing weight, giving up smoking and drinking less alcohol, but many people need a CPAP machine, which gently pumps air into a mask while you sleep. Other options include a mouthpiece that holds the airway open and, in some cases, surgery. Our overview of sleep apnea treatment options compares them.

Mouth tape and nasal strips are not treatments for sleep apnea. If you have any of the warning signs above, get checked before trying anything at home. Our safety page sets out who should avoid tape.

What can help with snoring and sleep during menopause?

If a doctor has ruled out sleep apnea, the usual snoring advice applies. The NHS suggests sleeping on your side, losing weight if you need to, not smoking, not drinking too much alcohol and avoiding sleeping pills, which it says can sometimes cause snoring. Cleveland Clinic adds that alcohol, sedatives and even lack of sleep can relax the muscles in your airway. Our guide on how to stop snoring covers each option.

For hot flashes at night, Cleveland Clinic suggests keeping your bedroom cool, wearing layers and quitting smoking, and says maintaining a healthy weight can also help. It lists hormone therapy and several non-hormonal options, including cognitive behavioral therapy, that a provider may recommend. If insomnia is the main problem, CBT for insomnia explains how it works. For more on sleep, browse our sleep articles.

Read next

• Sleep apnea in women: symptoms that get missed
• Snoring vs. sleep apnea: how to tell the difference
• Why people snore more as they get older

* This content is for informational and educational purposes only and is not medical advice. It is not intended to diagnose, treat, cure or prevent any disease or health condition. Talk to a qualified healthcare provider about your health.