HMN 2025: How Sleep-related disorders are associated with hypertension in postmenopausal women

Postmenopausal women are especially vulnerable to hypertension, which is a major cardiovascular risk factor. Women transitioning through or past the menopause transition are also more likely to report sleep disturbances (shorter sleep duration, trouble sleeping, or obstructive sleep apnea). A new study suggests sleep-related disorders in postmenopausal women may increase their risk of hypertension.

Study results are published in the article “Association between sleep-related disorders and hypertension in postmenopausal women from the United States” in the journal Menopause.

Postmenopausal women tend to have poorer blood pressure control compared with men in the same age group, partially because of a decline in estrogen levels. Although there is a notable research gap regarding the association between sleep-related disorders and hypertension risk in postmenopausal women, there is growing evidence supporting the fact that sleep disturbances are a substantial, yet often undervalued, risk factor.

Sleep is a fundamental physiologic necessity for cardiovascular health. It is well accepted in the medical community that women after the menopause transition report more difficulty in getting adequate sleep. A new study involving more than 3,500 naturally postmenopausal women aimed to examine the association between sleep-related disorders and the odds of hypertension.

Not only did the study conclude that trouble sleeping and obstructive sleep apnea were associated with increased odds of hypertension in postmenopausal women, but the results also suggested a U-shaped relationship between sleep duration and hypertension, indicating that both insufficient and excessive sleep were also associated with an increased risk of hypertension.

A subgroup analysis revealed that body mass index moderated these associations with stronger effects observed in obese women. The findings emphasized the importance of sleep health and weight management in helping control the risk of hypertension in this specific population.

“Although it isn’t possible to determine causality or which came first—sleep dysfunction or hypertension—the study findings raise awareness around the importance of improving sleep quality and optimal weight management during and after the menopause transition as key factors in mitigating long-term cardiovascular risk,” says Dr. Monica Christmas, associate medical director for The Menopause Society.

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