Caractéristiques individuelles et mortalité associées au traitement hormonal substitutif de la ménopause : étude d’une cohorte française de femmes d’âge compris entre 60 et 69 ans

Ha-Vinh, Philippe; Clavaud, Henri; Sauze, Laurent

doi:10.1016/j.jgyn.2010.06.006

Cited by 3 publications

(1 citation statement)

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“…While development of sleep-disordered breathing itself is unlikely to be a reason for stopping hormone therapy use, some of its sequelae could be. Furthermore, socioeconomic status, exercise, and alcohol use have been shown to be predictors of hormone therapy use [33,35–37]. Our measures of socioeconomic status and exercise were too limited to allow us to model whether they were associated with hormone therapy initiation or maintenance, but alcohol and smoking were weak predictors of hormone therapy use.…”

Section: Discussionmentioning

confidence: 99%

Menopausal hormone therapy and sleep-disordered breathing: evidence for a healthy user bias

Mirer

Peppard

Palta

et al. 2015

Annals of Epidemiology

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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 228 women age 38–62 were recruited from the Wisconsin Sleep Cohort Study. They underwent polysomnography to measure apnea-hypopnea index, at home semiannually from 1997–2006, and in the sleep laboratory every four years (N=1,828 studies). Hormone therapy was recorded monthly. Linear models with empirical standard errors regressed logarithm of apnea-hypopnea index on hormone use with a pre/post-July 2002 interaction, adjusting for menopause and age. Results The association of hormone therapy and sleep-disordered breathing was heterogeneous (p<0.01); apnea-hypopnea index among users was 15% lower in the early period (95% confidence interval: −27%, −1%), but similar to non-users in the late. Conclusions Hormone therapy was negatively associated with sleep-disordered breathing only until the Women’s Health Initiative results were publicized. Hormone therapy may have been a marker for healthfulness in the early period, creating a spurious association with sleep-disordered breathing.

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Section: Discussionmentioning

confidence: 99%