Association between personality traits and DSM-IV diagnosis of insomnia in peri- and postmenopausal women

Abstract

Objective The aim of this study was to determine the role of personality factors in the development of DSM-IV insomnia coincident with perimenopause. Method Perimenopausal women (35 with DSM-IV insomnia and 28 with self-reported normal sleep) underwent clinical assessments and completed menopause-related questionnaires, the NEO-FFI, and the Structured Interview for DSM-IV Personality (SID-P). Logistic regressions determined whether personality factors and hot flash-related interference were associated with an insomnia diagnosis concurrent with the menopause transition. Results Women with insomnia reported higher neuroticism, lower agreeableness, and lower conscientiousness than controls on the NEO-FFI. Moreover, women with insomnia were more likely to meet DSM-IV criteria for Cluster C personality disorders, particularly obsessive compulsive personality disorder, on the SID-P. Women with insomnia were more likely to have had a past depressive episode and history of severe premenstrual symptoms. Findings from regressions revealed that higher neuroticism and greater interference from hot flashes were associated with insomnia classification even after controlling for history of depression, suggesting that sensitivity to hot flashes and a greater degree of neuroticism are independent contributors toward establishing which women are most likely to have sleep problems during perimenopause. Conclusions Findings show the relevance of personality factors, particularly neuroticism and obsessive-compulsive personality, in influencing a woman’s experience of insomnia as she goes through the menopause transition.

Magnitude of the impact of hot flashes on sleep in perimenopausal women

“…The study was reviewed and approved by SRI International’s Institutional Review Board and all participants provided written informed consent. Screening procedures for the study are fully described elsewhere (8). All women were perimenopausal based on self-report menstrual cycle length, i.e.…”

Menstrual Cycle-Related Variation in Physiological Sleep in Women in the Early Menopausal Transition

“…The 20 participants included in this analysis were drawn from a study investigating sleep in women in the menopausal transition; details are described by Sassoon et al (18). Participants were recruited from the San Francisco Bay Area community area through flyers, advertisements, or word of mouth.…”

Reproductive Aging: Perimenopause and Psychopathological Symptoms

“…Hot flashes, night sweats, and other neurovegetative symptoms disrupt sleep, and insomnia may lead to depression [58]. Personality traits also predispose women to insomnia, and it can be most strongly related to neuroticism and DSM-IV personality disorder diagnoses, especially those of Cluster B (emotional, dramatic, and erratic/inconsistent styles) and Cluster C (anxious, fearful, and obsessive-compulsive styles) [56,57]. Women with perimenopausal insomnia also have a history of greater sensitivity to severe premenstrual symptoms [57].…”

“…Insomnia is one of the hallmarks of perimenopause and occurs in approximately 40% of perimenopausal women [57,58]. Hot flashes, night sweats, and other neurovegetative symptoms disrupt sleep, and insomnia may lead to depression [58].…”

“…Usually, women with a history of poor adaptation to stress or specific personality traits, particularly neuroticism, are predisposed to menopausal syndrome, with more than half of women feeling more stressed due to menopause or approaching menopause, and describing menopause as an unpleasant experience that has had a negative effect on their emotional state [43,53,56,57]. Research also showed that a later age of menarche carries more risk for psychiatric morbidity in perimenopause, because the exposure of women to neuroprotective and serotonin regulatory effects of estrogen is shorter [58].…”