Sleep complaints of postmenopausal women

Abstract

Objective-To study correlates of sleep problems in postmenopausal women.Methods-Baseline questionnaire items related to sleep patterns and problems were administered to 98,705 postmenopausal women as part of the Clinical Trial and the Observational Study of the Women's Health Initiative.Results-Less than 27% of the sample reported sleeping 8 hours or more. Many women reported that at least once a week they awoke several times at night (61%), fell asleep during quiet activities (52%), or reported other symptoms suggestive of insomnia or excessive daytime sleepiness. More frequent insomnia problems were reported among women who reported nocturnal sleep longer than the mode of 7 hours, as well as among women who reported very short sleep. Age, ethnicity, hormone replacement therapy, employment, marital status, diet, and season explained remarkably little of the variance in sleep duration or insomnia complaints; however, black women reported sleeping 0.45 hours on average less than whites, with the other minorities being intermediate between these groups. Conclusions-The results suggest that simple abbreviation of sleep and demographic factors may be less important in the sleep complaints of postmenopausal women than other possible factors. Cognitive-behavioral processes, depression, and obesity with apnea may be among the causes. KeywordsSleep; insomnia; depression; menopause; obesity Many national and international surveys have indicated that sleep complaints increase with age, and that insomnia complaints are particularly prevalent among women after menopause. [1][2][3][4][5][6][7] Postmenopausal women have had the highest rates of insomnia complaints in the population and the highest rates of hypnotic drug usage, especially chronic hypnotic consumption. There are far more awakenings within sleep in samples of aging adults than Address reprint requests to Daniel F. Kripke, MD, Department of Psychiatry 0667, University of California San Diego, La Jolla, CA 92093-0667. NIH Public Access Author ManuscriptClin J Womens Health. Author manuscript; available in PMC 2011 March 30. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript among young adults, even among elders who do not complain of insomnia. 8 Brugge et al found that insomnia complaints in women increased sharply close to the time of menopause and were relatively stable after menopause, regardless of the age of onset of menopause, which suggests that menopause rather than age is a determining influence among women. 9 It is surprising that recent U.S. surveys found no excess of insomnia complaints among women older than age 64, partly because insomnia was rather prevalent among young women 10,11 ; this raises the question of whether contemporary changes in sleep habits or the increasing prevalence of hormone replacement therapy might be modifying the long-standing trends.The Women's Health Initiative (WHI) is an ongoing exploration of critical health risks among postmenopausal women. 12 Special efforts have been made to include an ...

Sleep-Related Behaviors and Beliefs Associated With Race/Ethnicity in Women

“…Previous research on postmenopausal women has shown that most in this group report problems with frequent nighttime awakenings and daytime sleepiness. 30 In addition, few differences in sleep duration and insomnia complaints existed across racial (and socioeconomic) categories, except that black women were more likely to report longer sleep. 30 This is in contrast to other findings that suggest that black postmenopausal women are more likely to be short sleepers on objective measures.…”

“…30 In addition, few differences in sleep duration and insomnia complaints existed across racial (and socioeconomic) categories, except that black women were more likely to report longer sleep. 30 This is in contrast to other findings that suggest that black postmenopausal women are more likely to be short sleepers on objective measures. 31 Additionally, this discrepancy was partially explained by increased oxygen desaturations.…”

Who are the long sleepers? Towards an understanding of the mortality relationship

“…Two large studies have reported increased rates of self-reported insomnia in long sleepers, compared to average sleepers 5,77 . Another study, analyzing data from a census-matched sample polled by the National Sleep Foundation, found that long sleepers report significantly more complaints than average sleepers 31 .…”

Sleep problems across the life cycle in women

“…There is an increased prevalence of insomnia in postmenopausal women, with estimates of complaints of insomnia in peri-and postmenopausal women ranging from 44% [45] to 61% [46]. There are three major proposed causes of poor sleep in perimenopausal women: 1) sleep disruption associated with hot flashes; 2) increased incidence of obstructive sleep apnea; and 3) inadequate sleep hygiene leading to a chronic insomnia.…”