Predictors of sleep disturbance in menopausal transition

Lampio, Laura; Saaresranta, Tarja; Engblom, Janne; Polo, Olli; Polo‐Kantola, Päivi

doi:10.1016/j.maturitas.2016.10.004

Cited by 36 publications

(19 citation statements)

References 35 publications

(34 reference statements)

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“…Sleep problems are multifactorial, strongly associated with HFs and depression (as discussed later), as well as other factors coincident with aging into midlife including stress, poor health and chronic pain. 25 , 36 , 37 There is also an age-related increase in the presence of sleep-related breathing and movement disorders, as discussed later. These factors may also interact with each other, providing a complex basis for sleep difficulties in midlife women.…”

Section: Sleep Difficulties Reported Across the Menopausal Transitionmentioning

confidence: 93%

Sleep problems during the menopausal transition: prevalence, impact, and management challenges

Baker¹,

Zambotti²,

Colrain³

et al. 2018

NSS

194

123

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A substantial number of women experience sleep difficulties in the approach to menopause and beyond, with 26% experiencing severe symptoms that impact daytime functioning, qualifying them for a diagnosis of insomnia. Here, we review both self-report and polysomnographic evidence for sleep difficulties in the context of the menopausal transition, considering severity of sleep complaints and links between hot flashes (HFs) and depression with poor sleep. Longitudinal population-based studies show that sleep difficulties are uniquely linked with menopausal stage and changes in follicle-stimulating hormone and estradiol, over and above the effects of age. A major contributor to sleep complaints in the context of the menopausal transition is HFs, and many, although not all, HFs are linked with polysomnographic-defined awakenings, with HF-associated wake time contributing significantly to overall wakefulness after sleep onset. Some sleep complaints may be comorbid with depressive disorders or attributed to sleep-related breathing or movement disorders, which increase in prevalence especially after menopause, and for some women, menopause, age, and environmental/behavioral factors may interact to disrupt sleep. Considering the unique and multifactorial basis for sleep difficulties in women transitioning menopause, we describe clinical assessment approaches and management options, including combination treatments, ranging from cognitive behavioral therapy for insomnia to hormonal and nonhormonal pharmacological options. Emerging studies suggest that the impact of severe insomnia symptoms could extend beyond immediate health care usage and quality of life issues to long-term mental and physical health, if left untreated in midlife women. Appropriate treatment, therefore, has immediate benefit as well as advantages for maintaining optimal health in the postmenopausal years.

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Section: Sleep Difficulties Reported Across the Menopausal Transitionmentioning

confidence: 93%

Sleep problems during the menopausal transition: prevalence, impact, and management challenges

Baker¹,

Zambotti²,

Colrain³

et al. 2018

NSS

194

123

View full text Add to dashboard Cite

show abstract

“…During the transition to menopause, around 43%‐47% of women will experience some kind of sleep disturbance, while they are also experienced by 15% of the general population but a 5 years follow‐up study found frequent night sweats, depressive symptoms, use of central nervous system medication, personal crises and unsatisfactory perceived health as predictors for poor sleep after menopause . The studies that objectively compared sleep patterns, via PSG or similar methods, during menopausal transition, are few and limited in number of patients and nights evaluated.…”

Section: Resultsmentioning

confidence: 99%

Fibromyalgia, sleep disturbance and menopause: Is there a relationship? A literature review

et al. 2019

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Introduction Fibromyalgia (FM) symptoms worsen in a significant portion of patients with the onset of menopause. Some patients report that their symptoms begin after menopause, suggesting a relationship between these entities. Sleep disturbance is a common condition in FM and menopause, and it is associated with chronic pain. Methods/Objectives Several electronic databases were searched, from the first available year to April 2018 to evaluate the publications that assessed the effects of menopause and sleep disturbance on the appearance or worsening of FM and the role of hormone therapy for these patients. Results The results are summarized in three tables. The objective sleep patterns of FM patients included high sleep latency, frequent arousals and intrusion of alpha wave sleep and NREM (non‐rapid eye movement) sleep in delta sleep. Poor sleep during menopause is more frequent in late perimenopause and surgical menopause, and may be related to vasomotor symptoms or not. Hormone therapy exerted a positive effect on subjective sleep quality of symptomatic menopausal women. Studies have shown a high association between FM and early and surgical menopause. Raloxifene exerted a positive effect on pain and sleep in FM patients; however one study that analyzed the effects of transdermal estrogen therapy found no improvement in subjective and objective parameters of pain. Conclusion Further studies are needed to elucidate the nature of the association between menopause, sleep and persistent pain syndromes, such as FM, showing the role of hormone therapy in prospective placebo‐controlled trials.

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“…Among postmenopausal women, this value varies from 40 to 60%, and it is 48% in perimenopause according to the study by Kloss et al 2,3 In the present study, the PSQI was used to assess sleep quality, with sensitivity and specificity of 98.3 and 90.2%, respectively, according to Zhang et al 1 Our results show that 57.28% of menopausal women presented poor sleep or sleep disturbance -values within the means for adults and climacteric, and above that for perimenopause. Considering this prevalence, the importance of this symptom is closely monitored in women during this period of life.…”

Section: /5 Menopausementioning

confidence: 95%

“…1,2 This study focuses on sleep quality in postmenopausal women. Justification is based on the fact that 40 to 60% of women report sleep disturbance during menopause, and the etiology of this impairment is probably multifactorial.…”

Section: Introductionmentioning

confidence: 99%

Factors Influencing Postmenopausal Women's Quality of Sleep

Luzo¹,

Conde²,

Coelho³

et al. 2018

Hum. Reprod. Arch.

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Objective: Verify the factors associated with poor sleep quality among postmenopausal women. Methods: Cross-sectional, descriptive, observational study conducted with 185 postmenopausal women assisted at the outpatient clinic of Santa Casa de Sao Paulo. Data were collected regarding sleep quality using the Pittsburgh Sleep Quality Index (PSQI); quality of life according to the WHO Quality of Life-BREF (WHOQOL-BREF) and the Alcohol Use Disorders Identification Test (AUDIT); and through the application of a questionnaire including information on socioeconomic profile, age of menopause, natural or surgical menopause, smoking, chronic diseases, use of hormonal therapy, hot flashes, and alcohol consumption. Data were analyzed using STATA 13 statistical software. Variables were compared by mean and standard deviation. Regression analysis was used to verify the possible factors associated with quality of sleep. The coefficients are considered significant when p<0.10. results: 57.28% of the women investigated presented poor sleep or sleep disturbance. Negative correlation was observed between quality of sleep and smoking (p=0.083), whereas positive correlation was found between poor sleep quality and number of hot flashes (p=0.00). In addition, the earlier the menopause, the worse the quality of sleep (p=0.05). conclusions: The following factors negatively influencing postmenopausal women's quality of sleep were identified: smoking, number of hot flashes, and age of menopause. It is not possible to identify causality; however, worsening sleep quality was identified when these factors were present.

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Predictors of sleep disturbance in menopausal transition

Cited by 36 publications

References 35 publications

Sleep problems during the menopausal transition: prevalence, impact, and management challenges

Sleep problems during the menopausal transition: prevalence, impact, and management challenges

Fibromyalgia, sleep disturbance and menopause: Is there a relationship? A literature review

Factors Influencing Postmenopausal Women's Quality of Sleep

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