The results of a new study, published in the journal Menopause, suggest a significant association between sleep apnea and joint pain, with higher respiratory distress scores linked with joint pain severity.

One explanation is that joint tissues have estrogen receptors, and estrogen plays a role in maintaining the homeostasis of articular tissues such as cartilage, ligaments, and muscles.

Based on these results, the researchers suggest that a detailed examination of sleep-disordered breathing be conducted in women with severe joint pain and fatigability to help identify women with obstructive sleep apnea (OSA).

“This study highlights an opportunity to increase identification of women with OSA, which is underdiagnosed in women who often present with vague symptoms such as insomnia, fatigue, and morning headaches. According to these findings, joint pain may be another symptom that should prompt consideration of a diagnosis of OSA in women,” says Stephanie Faubion, MD, NAMS medical director, in a statement.

Efforts to decrease factors contributing to sleep apnea are important because the disorder is a risk factor for hypertension and diabetes, which can contribute to the progression of cardiovascular disease, the leading cause of death worldwide. Previous studies have shown that the severity of hot flashes is associated with the risk of sleep apnea in middle-aged women. However, the relationship between sleep apnea and other symptoms common to middle-aged and older women is still not fully understood.