A population-based survey of sleep disturbances in middle-aged women – Associations with health, health related quality of life and health behavior

Polo‐Kantola, Päivi; Laine, Antti; Aromaa, Minna; Rautava, Päivi; Markkula, Juha; Vahlberg, Tero; Sillanpää, Matti

doi:10.1016/j.maturitas.2013.11.008

Cited by 32 publications

(24 citation statements)

References 44 publications

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“…Use of alcohol may worsen sleep quality, leading to the need for sleep medication. The wellknown U-shaped association between alcohol consumption and sleep quality [33] has been confirmed previously in middle-aged female population [31]. We can also speculate that women in our study used alcohol as a sleep aid.…”

Section: Discussionsupporting

confidence: 88%

“…Perceived impaired general health at baseline predicted menopausal sleep disturbances. We have previously shown in middle-aged female population that perception of both physical and mental health is the most important contributor for sleep problems, to an even greater extent than the existence of chronic diseases or use of medications [31]. These results support the current view that sleep disturbances are more often comorbid than primary [29,32].…”

Section: Discussionsupporting

confidence: 78%

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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: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 78%

Predictors of sleep disturbance in menopausal transition

et al. 2016

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“…In addition to fluctuations and decrease in reproductive hormone concentrations, aging itself, 16 depressive symptoms, 17,18 sleep-disordered breathing, primary sleep disorders, other systemic diseases and/ or their medications as well as psychosocial or behavioral factors may contribute to sleep impairment. [19][20][21] Hence, the etiology of sleep disturbance in menopausal transition is probably multifactorial, which may challenge diagnosis and treatment.…”

Section: Introductionmentioning

confidence: 99%

Sleep During Menopausal Transition: A 6-Year Follow-Up

Lampio¹,

Polo‐Kantola²,

Himanen³

et al. 2017

Sleep

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Study Objectives: Menopausal transition is associated with increased dissatisfaction with sleep, but the effects on sleep architecture are conflicting. This prospective 6-year follow-up study was designed to evaluate the changes in sleep stages and sleep continuity that occur in women during menopausal transition. Methods: Sixty women (mean age 46.0 years, SD 0.9) participated. All women were premenopausal at baseline, and at the 6-year follow-up, women were in different stages of menopausal transition. Polysomnography was used to study sleep architecture at baseline and follow-up. The effects of aging and menopause (assessed as change in serum follicle-stimulating hormone [S-FSH]) on sleep architecture were evaluated using linear regression models. Results: After controlling for body mass index, vasomotor, and depressive symptoms, aging of 6 years resulted in shorter total sleep time (B −37.4, 95% confidence interval [CI] −71.5 to (−3.3)), lower sleep efficiency (B −6.5, 95%CI −12.7 to (−0.2)), as well as in increased transitions from slow-wave sleep (SWS) to wakefulness (B 1.0, 95%CI 0.1 to 1.9), wake after sleep onset (B 37.7, 95%CI 12.5 to 63.0), awakenings per hour (B 1.8, 95%CI 0.8 to 2.8), and arousal index (B 2.3, 95%CI 0.1 to 4.4). Higher S-FSH concentration in menopausal transition was associated with increased SWS (B 0.09, 95%CI 0.01 to 0.16) after controlling for confounding factors. Conclusions: A significant deterioration in sleep continuity occurs when women age from 46 to 52 years, but change from premenopausal to menopausal state restores some SWS.

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“…Increasing age has also been associated with increased frequency of sleep disturbance; however, this relationship is considerably modified when screening for comorbidity [2,8] and depends on the specific definition provided for the assessment of sleep disturbance [1,9]. In a recent cross-sectional investigation of sleep disturbances across the lifespan (n = > 155,000 participants of the Behavioral Risk Factor Surveillance System -BRFSS), a nonlinear, bimodal distribution emerged, with the highest rates of self-reported sleep disturbance found for young (ages [18][19][20][21][22][23][24] and midlife (ages 50-59) men and women [2]. Rates of sleep disturbance were lowest in the oldest age group, were significantly higher in women, and were associated with poor general health and depression.…”

Section: Introductionmentioning

confidence: 99%

“…Findings from a cross-sectional study of >4000 adults (ages 18-65) demonstrate that comorbid sleep disturbance with physical illness increases the likelihood of poor health-related QOL, compared to the presence of physical illness alone, even after adjusting for sociodemographic factors and mental and medical comorbidities [17]. In a cross-sectional analysis of women aged 32-58 in Finland, more severe physical and mental QOL conditions incurred higher risks for self-reported sleep problems [20]. Similar findings were reported in a sample of postmenopausal women in Australia [21].…”

Section: Introductionmentioning

confidence: 99%