Self-reported sleep difficulty during the menopausal transition

Tom, Sarah E.; Kuh, Diana; Guralnik, Jack M.; Mishra, Gita D.

doi:10.1097/gme.0b013e3181dd55b0

Cited by 64 publications

(75 citation statements)

References 35 publications

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“…Instead, vasomotor symptoms, which increased markedly in women entering postmenopause, and depressive symptoms were the most important risk factors for impaired sleep quality. Menopausal transition has been documented as an important hallmark for increased risk for sleep disturbances [5][6][7]. Furthermore, concurrent vasomotor symptoms add to the risk [9][10][11]24].…”

Section: Discussionmentioning

confidence: 99%

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Predictors of sleep disturbance in menopausal transition

et al. 2016

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a b s t r a c tObjective: This follow-up study aimed to evaluate risk factors for menopausal sleep disturbances already identifiable before menopause. Methods: At baseline, all 81 women were premenopausal. At year-five follow-up, 27 of the women were premenopausal, 40 postmenopausal, and 14 postmenopausal and using hormone therapy. We used the Basic Nordic Sleep Questionnaire to study sleep; additional questionnaires evaluated risk factors for sleep impairment.Results: Sleep quality differed only marginally between the groups. The following baseline variables were associated with impaired sleep quality at follow-up: depressive symptoms increased the risk of nocturnal awakenings (OR 1.16 (95%CI 1.02-1.32), p = 0.025), morning tiredness (OR 1.22 (95%CI 1.06-1.40), p = 0.007), daytime tiredness (OR 1.24 (95%CI 1.06-1.44), p = 0.007) and propensity to fall asleep during work or leisure time (OR 1.18 (95%CI 1.01-1.37), p = 0.036). Personal crises increased the risk of longer sleep latency (OR 5.46 (95%CI 1.13-26.32), p = 0.035) and of propensity to fall asleep when not active ), p = 0.014). Use of medications affecting the CNS increased the risk of worse general sleep quality (OR 11.44 (95% CI 1.07-121.79), p = 0.044). Perceived impaired general health (OR 2.87 (95%CI 1.04-7.94), p = 0.043) and frequent night sweats ), p = 0.003) increased the risk of difficulty falling asleep. Conclusions: Various premenopausal health-related factors seem to predict poor sleep in menopausal transition. Menopause itself appears to have only minor effects. Thus, it is essential to identify highrisk women to allow timely interventions that may prevent the development of sleep disturbances at menopause.

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Section: Discussionmentioning

confidence: 99%

“…Around 40-60% of women report sleep impairment during menopause [4]. Although both menopausal transition [5][6][7] and aging [8] increase sleep disturbances, etiology in menopausal women is probably multifactorial. The most common menopausal complaints, nocturnal vasomotor symptoms, are associated with poor sleep [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Predictors of sleep disturbance in menopausal transition

et al. 2016

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Section: Depression and Poor Sleepmentioning

confidence: 99%

“…About 30 % of adults have one or more symptoms of insomnia, according to the American Academy of Sleep Medicine [89], and these symptoms are more prevalent in women, particularly in mid-life [90][91][92][93]. While a high prevalence of poor sleep quality in mid-life women is well-documented, several welldesigned studies concluded that influences of both age and menopausal status on poor sleep were modest [92,93]. In addition, while there is considerable evidence that sleep difficulties are correlated with depressive symptoms, poor sleep is a core symptom of clinical depression [94,95], which frequently makes it difficult to determine whether sleep difficulties are a component of or independent of depressed mood or clinical depression.…”

Section: Depression and Poor Sleepmentioning

confidence: 99%

Depression in the menopause transition: risks in the changing hormone milieu as observed in the general population

Freeman

2015

womens midlife health

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There is accumulating evidence but no definitive answers about the incidence of depressed mood in the menopause transition and its association with the changing hormonal milieu. While a changing hormonal milieu is the natural condition for all women, only a minority of mid-life women experience debilitating depressive symptoms or clinical depression. This review focuses on associations between depressed mood and the menopause transition, primarily as identified in longitudinal, population-based studies in the past decade. Further aims were to present reported associations between depressed mood and reproductive hormones in the menopause transition as evaluated in the general population and associations of depressive symptoms or clinical depression with menopausal hot flashes or poor sleep in perimenopausal women. There is evidence to support the role of the changing endocrine milieu in the development of depressed mood in the menopause transition, but the contribution of hormones as measured is small. Disentangling the numerous factors that are associated with depression in midlife women is a major challenge for research and for clinical care, where treatments are needed to improve the most distressing menopausal symptoms.

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“…Cutoff scores of 5 and 8 have been reported to indicate poor sleep quality; 20,21 the higher cutoff point was used in exploratory analyses because of previous studies suggesting that self-reported sleep disturbance is common among perimenopausal and postmenopausal women. [22][23][24] Eighty percent of the women in this sample had a PSQI global score of greater than 5, and 49% had scores higher than 8.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

Effects of Yoga and Aerobic Exercise on Actigraphic Sleep Parameters in Menopausal Women with Hot Flashes

Buchanan

Landis

Hohensee

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: To determine effects of yoga and aerobic exercise compared with usual activity on objective assessments of sleep in midlife women. Methods: Secondary analyses of a randomized controlled trial in the Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) network conducted among 186 late transition and postmenopausal women aged 40-62 y with hot flashes. Women were randomized to 12 w of yoga, supervised aerobic exercise, or usual activity. The mean and coefficient of variation (CV) of change in actigraph sleep measures from each intervention group were compared to the usual activity group using linear regression models. Results: Baseline values of the primary sleep measures for the entire sample were mean total sleep time (TST) = 407.5 ± 56.7 min; mean wake after sleep onset (WASO) = 54.6 ± 21.8 min; mean CV for WASO = 37.7 ± 18.7 and mean CV for number of long awakenings > 5 min = 81.5 ± 46.9. Changes in the actigraphic sleep outcomes from baseline to weeks 11-12 were small, and none differed between groups. In an exploratory analysis, women with baseline Pittsburgh Sleep Quality Index higher than 8 had significantly reduced TST-CV following yoga compared with usual activity. Conclusions: This study adds to the currently scant literature on objective sleep outcomes from yoga and aerobic exercise interventions for this population. Although small effects on self-reported sleep quality were previously reported, the interventions had no statistically significant effects on actigraph measures, except for potentially improved sleep stability with yoga in women with poor self-reported sleep quality. Keywords: actigraphy, exercise, insomnia symptoms, menopause, variability, vasomotor symptoms, yoga Citation: Buchanan DT, Landis CA, Hohensee C, Guthrie KA, Otte JL, Paudel M, Anderson GL, Caan B, Freeman EW, Joffe H, LaCroix AZ, Newton KM, Reed SD, Ensrud KE. Effects of yoga and aerobic exercise on actigraphic sleep parameters in menopausal women with hot flashes.

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Self-reported sleep difficulty during the menopausal transition

Cited by 64 publications

References 35 publications

Predictors of sleep disturbance in menopausal transition

Predictors of sleep disturbance in menopausal transition

Depression in the menopause transition: risks in the changing hormone milieu as observed in the general population

Effects of Yoga and Aerobic Exercise on Actigraphic Sleep Parameters in Menopausal Women with Hot Flashes

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