0508 Menopausal Hormone Therapy and Obstructive Sleep Apnea Risk Among Postmenopausal Women: Insights from NHANES

Abstract Introduction Postmenopausal women are at an increased risk of developing obstructive sleep apnea (OSA), possibly due to hormonal changes. The potential of hormone replacement therapy to reduce OSA risk in postmenopausal women remains unclear. Additionally, increasing age and obesity have been postulated to increase OSA risk in postmenopausal women. This study examined the association between menopausal hormone therapy (MHT) and OSA risk in postmenopausal women and examined the influence of confounding factors, age and body mass index (BMI), on this relationship. Methods Using data from the 2017-March 2020 National Health Nutrition Examination Survey, we identified 4863 women aged 20 years and older. Postmenopausal status was defined as self-reporting no menstrual period in the past year due to hysterectomy or menopause. High risk of OSA was determined with an adapted multivariable apnea prediction index score of > 0.5. MHT was defined as a positive response to ever using female hormones like estrogen and progesterone, not including birth control or use for infertility. Regression models adjusted for age, BMI, age at menopause, race/ethnicity, and federal poverty level were employed. Results The sample included 2082 postmenopausal women (mean age 63.4 years (SE 0.4); 70.7% non-Hispanic White; mean BMI 30.2 (SE 0.3); 24.7% living < 130% of federal poverty level). The mean age at menopause was 45.8 years (SE 0.4), and 28.7% reported ever using MHT. MHT users were older, more likely to be non-Hispanic White and have a higher income, experienced menopause at a younger age, and were more likely to have had a hysterectomy compared to non-users. There was no significant difference in BMI between users and non-users. No significant difference in OSA risk was found between MHT users and non-users. Age (OR=1.08, 95% CI 1.07–1.10) and BMI (OR=1.45, 95% CI 1.39–1.51) were significantly associated with high OSA risk, with increasing age and BMI linked to greater odds of being at high risk. Conclusion MHT use does not appear to reduce OSA risk in postmenopausal women, whereas age and BMI remain strong predictors of OSA risk. Further research using objective OSA diagnostic measures and more detailed characterization of hormone replacement therapy is needed. Support (if any)