It’s common for women transitioning into menopause to get winded more easily or to start suffering from sleep apnea. During menopause, the body decreases the production of hormones such as estrogen and progesterone, which are closely linked to lung function.
Becoming winded and experiencing sleep apnea can also increase anxiety (which may cause additional hormone imbalances) and exacerbate or cause vasomotor symptoms, such as heart palpitations and hot flashes. However, these experiences don’t have to be a normal part of menopause.
Breathing exercises, though not the subject of abundant research, have been shown to improve sleep, lung function, anxiety, and vasomotor symptoms.
Breathing is a subject that Dr. Louise Oliver, a general practitioner, is so passionate about that she became certified as a functional breathing practitioner to help her patients navigate menopause.
Disordered breathing can make it very hard for women to function efficiently, she told The Epoch Times. Learning to breathe better is especially helpful in managing uncomfortable symptoms associated with menopause—as a replacement or supplement to hormone replacement therapy (HRT).
Lungs Gone Wrong
A 20-year study of 1,438 women found that lung function declined rapidly as women transitioned into and past menopause, even beyond the expected age-related decline. Researchers quantified the changes as comparable to smoking about a pack of cigarettes a day for at least two years, and even up to 10 years.
Published in the American Journal of Respiratory and Critical Care Medicine, the study examined breathing capabilities of the participants, and compared the results with hormone tests and other collected data.
“Hormonal changes in menopause, linked to complex biologic events, might contribute to the demonstrated acceleration in lung function decline with menopause,” the study said.
The authors of the study said this could be due to systemic inflammation associated with low estrogen levels. Estrogen is primarily related to reproductive health, but it also affects most of the body’s systems. It’s mostly made in a woman’s ovaries, but smaller amounts are made by the adrenal glands and fat cells.
Estradiol, the most dominant form of estrogen associated with childbearing years, modulates inflammation in the body. In animal research, low levels of estradiol appear to increase inflammation, whereas higher levels appear to calm inflammation.
Overlooked Sleep Apnea
Hormones such as estrogen and progesterone are believed to protect breathing, putting postmenopausal women at two to three times the risk of sleep apnea compared to premenopausal women.“Many other mechanisms by which menopause could affect sleep-disordered breathing are possible, but they have not been rigorously tested,” the study said. “Some short-term experiments on small samples have suggested that levels of sex hormones can affect breathing during sleep.”
Women who complain of snoring, unsatisfactory sleep, or daytime sleepiness should be evaluated, the study authors said, as women have a higher mortality rate for sleep-disordered breathing than men do.
“It’s well-documented there are various different reasons that it may happen. There’s not enough research on it,” Oliver said, adding that hormones are hardly the only thing affecting breathing.
Sleep-disordered breathing can occur due to weak throat muscles or to the tongue blocking the airway. It can also result from breathing through the mouth, taking in too much or too little oxygen, or breathing too quickly.
Changing Breathing Habits
The good news is that most contributing factors to disordered breathing are modifiable, she said.“We can change our own conscious breathing pattern while we’re awake to improve our unconscious breathing habits, but obviously it takes time,” Oliver said. “It can take three months to develop the muscle memory and the nerve connections to make it unconscious.”
She works with patients who want to improve their breathing before they undergo a sleep study. Often that’s because patients want to improve nasal breathing so they can use a nasal CPAP (continuous positive airway pressure) mask.
Oliver said her patients often find the breathing exercises alone are enough to reverse sleep apnea and they don’t require a CPAP.
There are also exercises that train the tongue to be in the right position and exercises to strengthen the throat muscles. Even simple techniques can make profound changes, Oliver said. Breathing should be light, low, and slow, using the diaphragm, the major muscle in respiration that’s often underused. Training the body to hold onto carbon dioxide, which is what happens when you hold your breath, also has benefits if done through slow breathing.
“I think the most important thing is to teach people to be more carbon dioxide tolerant because you breathe slower, and if you breathe slowly, you’re naturally going to breathe with the diaphragm,” she said.
Slow and gentle nasal breathing also strengthens the vagus nerve, Oliver said, which is the nerve that controls parasympathetic relaxation response and has a role in keeping heart rate and blood pressure steady.
Breathe Away Hot Flashes
Medical research on breathing techniques for menopause has focused primarily on paced breathing, a slow, deliberate nasal breathing often with a target rate of six breaths per minute.“This is something that’s accessible to everyone,” said Jennifer Harrington, a naturopath and the clinical director and founder of Menopause Natural Solutions. “It is free. They can do it in their own home. This should be something they try.” She said she has seen breathing practices have tremendous results for some.
In addition to practicing paced breathing for 15 minutes once or twice a day, women should do it during hot flashes.
Harrington herself practices paced breathing each day. She uses a timer to establish a rhythm of six breaths per minute for the first several breaths. She sets an alarm for 15 minutes, then closes her eyes while she relaxes into the deep breathing for the rest of the session.
“To be able to take a long, slow, deep breath is critical for health,” she said, adding that it seems to be especially helpful for restoring energy levels. “I don’t think people realize how important lung function is.”
Considering Lifestyle Approaches
A 2015 study comparing paced respiration to music therapy found both were effective. The study used tones synchronized with participants’ breathing.The 123 participants were each randomly given identical-looking small, portable devices that either guided them in paced breathing of less than 10 breaths a minute for 15 minutes daily or played relaxing, nonrhythmic music. Results were published in Obstetrics and Gynecology.
Music won over breathing alone for hot flashes. The study suggested that “the music-listening intervention used in this study featured a specific series of tonal nonrhythmic melodies, and findings may not be generalizable to other types of commercially available music.”
Harrington said there’s no doubt breathing exercises help improve stress responses and sleep.
“I really believe lifestyle interventions should be one of your first ports of call,” she said. “There is no one-size-fits-all strategy. We are all humans, but we are all different humans.”