title: Menopause and post-polio symptoms as predictors of subjective sleep disturbance in poliomyelitis survivors.
abstract: OBJECTIVE
  Sleep disturbance in polio survivors is a common complaint, yet little is known about the effects of the interaction of physical disability and menopause on sleep. The purpose of this study was to understand the relative contribution of menopause factors and disability to subjective sleep disturbance.
  
  
  METHODS
  Participants were 465 women aged 50-65 years who had physical disabilities due to poliomyelitis. Hierarchical regression modeling was used to examine menopause (symptoms, status, hormone replacement use, ovarectomy status) and disability factors (post-polio symptoms) in sleep disturbance.
  
  
  RESULTS
  In the final model, 19% (frequency) and 17% (severity) of sleep disturbance variance was explained. Psychological symptoms exerted the most influence (for both outcomes) followed by post-polio symptoms, vasomotor symptoms, an interaction of vasomotor and post-polio symptoms and estrogen use. For women with fewer post-polio symptoms, vasomotor symptoms exerted greater influence on sleep disturbance than for women with greater post-polio symptoms.
  
  
  CONCLUSIONS
  Psychological symptoms had the strongest association with sleep disturbance in these women. Controlling for the influence of various menopause factors, our findings show that vasomotor symptoms were only one of several influences on sleep disturbance.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor 48109-0491, USA.
authors.forename: C Z
authors.initials: CZ
authors.lastname: Kalpakjian
authors.forename: E H
authors.initials: EH
authors.lastname: Quint
authors.forename: L L
authors.initials: LL
authors.lastname: Toussaint
mesh_terms: D005260:Female; D019584:Hot Flashes / Q000150:complications; D006801:Humans; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D016262:Postpoliomyelitis Syndrome / Q000150:complications*; D012044:Regression Analysis; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology*; D014666:Vasomotor System / Q000503:physiopathology*