New research alert: Joint Pain and Sleep Apnea in Postmenopausal Women

A study describing an interesting relationship regarding joint pain in postmenopausal women was recently published. This study found that sleep apnea seems to have a strong association with joint pain severity in postmenopausal women. Sleep apnea refers to when the airway becomes blocked, reducing or fully stopping airflow to the lungs (U.S. Department of Health and Human Services). Menopause is the period of time 12 months after a woman’s last menstruation (U.S. Department of Health and Human Services). Any time prior to this is considered pre-menopausal and after is considered post-menopausal.

Sleep apnea has previously been found to have strong associations with hypertension and diabetes and has been found to play a role in the onset of cardiovascular diseases. Additionally, research has indicated that postmenopausal women tend to have a higher incidence of sleep apnea than premenopausal women, as well as a generally higher incidence of joint pain. However, up until now, the relationship between sleep apnea and symptoms of menopause has not been determined.

In this study, researchers monitored postmenopausal Japanese women overnight using the respiratory disturbance index (RDI), a measure of the number of times an apneic event occurs over a one hour period. Using several questionnaires, researchers assessed participants’ sleep quality, psychological symptoms and physical symptoms. After adjusting for various factors and confirming a sleep apnea diagnosis, the researchers found that patients who had a higher RDI were found to have increased incidence of joint pain.

Possible reasons for this link could be the increase in reactive chemicals formed from oxygen, reactive oxidative species (ROS), which are harmful to the body. Patients who have sleep apnea tend to have more ROS, which has been found to cause degeneration of cartilage in bone and the death of chondrocytes, which are bone-forming cells. Increased ROS also causes an inflammatory response which may be the cause of joint pain. These factors, combined with the established link that lower estrogen levels (common in postmenopausal women) increase the production of ROS may be the reason why researchers found high rates of joint pain.

Further research needs to be done to investigate and expand on the relationship between joint pain and sleep apnea in postmenopausal women, so that potential treatment options can be found.

References:

Odai, T., Terauchi, M., Umeki, H., Miyasaka, N., & Somekawa, Y. (2022). Sleep apnea in postmenopausal women is associated with joint pain severity and fatigability: a cross-sectional study. Menopause (New York, NY).

U.S. Department of Health and Human Services. (n.d.). Sleep apnea - what is sleep apnea? National Heart Lung and Blood Institute. Retrieved from https://www.nhlbi.nih.gov/health-topics/sleep-apnea

U.S. Department of Health and Human Services. (n.d.). What is menopause? National Institute on Aging. Retrieved from https://www.nia.nih.gov/health/what-menopause