0555 A STUDY OF THE IMPACT AND MANAGEMENT OF OBSTRUCTIVE SLEEP APNEA IN THE POSTMENOPAUSAL WOMEN

Abstract

Introduction: Menopause is a universal event in midlife, occurring around the age of 50 years. It is associated with physical, psychosocial, sexual and vasomotor symptoms. The prevalence of Obstructive Sleep Apnea (OSA) increased about four fold in postmenopausal women. The management of menopause has changed dramatically due to the controversy of hormone replacement therapy (HRT). It became more challenging in primary care delivery with non-drug therapy for menopause. In this study, we investigate the management of OSA and its impact in the postmenopausal women. Method(s): Postmenopausal women were screened for OSA. Patients with HRT were excluded. Co-morbidities were recorded. The menopause symptoms were measured with a 29-item menopause-specific validated instrument (MENQOL) that evaluated the effect on 0 to 6 Likert scale. Forty-one patients without CPAP had mean age [+/-SD], 62 +/- 9; BMI 34.9 +/- 7.5; AHI, 16.4 +/- 12.4; RDI, 30.3 +/- 14.7. MENQOL vasomotor domain (sum of 3 items), 5.3 +/- 5.4; physical (sum of 16 items), 45 +/- 19.5; psychosocial (sum of 7 items), 15 +/- 9.7; sexual (sum of 3 items), 5 +/- 6.2; Total, 70.5 +/- 33.8. Fifty patients who received CPAP treatment had mean age, 65 +/- 9; BMI, 34.9 +/- 7.6; length of treatment (months), 23 +/- 28 (1-120); MENQOL vasomotor, 4.8 +/- 5; physical, 34 +/- 20.3; psychosocial, 10 +/- 8.3; sexual, 2.5 +/- 4.5; Total, 51.6 +/- 32. Difference and association between the two groups were examined using independent t- test and Pearson correlation respectively with IBM SPSS. A P-value < 0.05 was considered statistically significant. Result(s): In group with no CPAP, Pearson correlation analysis showed the vasomotor domain correlated with age (P=0.024) and psychosocial with BMI (P=0.004). MENQOL was not correlated with AHI or RDI. In group with CPAP, MENQOL was not correlated with the length of CPAP treatment. The CPAP group, as compared with no CPAP, had greater reduction in MENQOL Total (P = 0.008), psychosocial (P=0.014), physical (P=0.009), and sexual (P=0.032). No correlation was observed between MENQOL and co-morbidities such as hypertension, diabetes mellitus II, chronic pain, depression, and hypothyroidism. Conclusion(s): Menopause symptoms in physical, sexual and psychosocial domains in patients with OSA were significantly improved after CPAP treatment. Screening and management of OSA should be recommended to menopause patients who are not under HRT.