Menopausal hormone therapy and sleep-disordered breathing: evidence for a healthy user bias
Abstract Purpose Observational studies suggest that menopausal hormone therapy protects against sleep-disordered breathing, but such findings may be biased by a “healthy user effect.” When the Women's Health Initiative Study reported in 2002 that estrogen-progestin therapy increases heart disea...
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Veröffentlicht in: | Annals of epidemiology 2015-10, Vol.25 (10), p.779-784.e1 |
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Sprache: | eng |
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Zusammenfassung: | Abstract Purpose Observational studies suggest that menopausal hormone therapy protects against sleep-disordered breathing, but such findings may be biased by a “healthy user effect.” When the Women's Health Initiative Study reported in 2002 that estrogen-progestin therapy increases heart disease risk, many women discontinued hormone therapy. We investigate healthy user bias in the association of hormone therapy with sleep-disordered breathing in the Sleep in Midlife Women Study. Methods A total of 228 women aged 38 to 62 years were recruited from the Wisconsin Sleep Cohort Study. They underwent polysomnography to measure apnea-hypopnea index, at home semiannually from 1997 to 2006, and in the sleep laboratory every four years ( n = 1828 studies). Hormone therapy was recorded monthly. Linear models with empirical standard errors regressed logarithm of apnea-hypopnea index on hormone use with a pre- or post-July 2002 interaction, adjusting for menopause and age. Results The association of hormone therapy and sleep-disordered breathing was heterogeneous ( P |
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ISSN: | 1047-2797 1873-2585 |
DOI: | 10.1016/j.annepidem.2015.07.004 |