title: Relations among menopausal symptoms, sleep disturbance and depressive symptoms in midlife.
abstract: OBJECTIVE
  To investigate the relations among hot flashes, other menopausal symptoms, sleep quality and depressive symptoms in midlife women.
  
  
  METHODS
  A large population-based cross-sectional study of 639 women (ages 45-54 years) consisting of a questionnaire including the Center for Epidemiologic Studies-Depression (CES-D) Scale, demographics, health behaviors, menstrual history, and menopausal symptoms.
  
  
  RESULTS
  After controlling for menopausal status, physical activity level, smoking status and current self-reported health status elevated CES-D score is associated with frequent nocturnal hot flashes, frequent trouble sleeping, experiencing hot flashes, nausea, headaches, weakness, visual problems, vaginal discharge, irritability, muscle stiffness, and incontinence.
  
  
  CONCLUSIONS
  The present study found significant links between depressive symptoms and several menopausal symptoms including hot flashes, sleep disturbance, irritability, muscle stiffness, and incontinence after controlling for covariates. These findings suggest that a potential mechanism in which bothersome menopausal symptoms may influence depressed mood during the midlife is through sleep disturbance.
authors.affiliation: Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD, USA. jpbrown@epi.umaryland.edu
authors.forename: Jessica P
authors.initials: JP
authors.lastname: Brown
authors.forename: Lisa
authors.initials: L
authors.lastname: Gallicchio
authors.forename: Jodi A
authors.initials: JA
authors.lastname: Flaws
authors.forename: J Kathleen
authors.initials: JK
authors.lastname: Tracy
mesh_terms: D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications*; D005260:Female; D006261:Headache / Q000150:complications; D019584:Hot Flashes / Q000150:complications; D006801:Humans; D007508:Irritable Mood; D008593:Menopause / Q000502:physiology* / Q000523:psychology*; D008875:Middle Aged; D009135:Muscular Diseases / Q000150:complications; D009325:Nausea / Q000150:complications; D010146:Pain / Q000150:complications; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications*; D014549:Urinary Incontinence / Q000150:complications; D019522:Vaginal Discharge / Q000150:complications; D014786:Vision Disorders / Q000150:complications