title: Additive effect of depressed mood and vasomotor symptoms on postmenopausal insomnia.
abstract: OBJECTIVE
  The aim of this study was to investigate the role of vasomotor and mood symptoms on insomnia in postmenopausal women.
  
  
  METHODS
  One hundred sixty-three postmenopausal women, not receiving hormone therapy, attending a menopause clinic at the University of Athens, Greece, were included in this cross-sectional study. Climacteric symptoms were assessed by Greene's scale, whereas psychological morbidity was measured by Zung Self-Assessment Depression Scale, Symptom Checklist-90-R, and Athens Insomnia Scale.
  
  
  RESULTS
  Vasomotor symptoms were significantly associated with insomnia (P = 0.001). When depressive symptomatology was added to the logistic regression analysis, the predictive ability of the model was significantly improved as defined by the increase in the log likelihood (P < 0.001) and the increase in the area under the receiver operating characteristic curve.
  
  
  CONCLUSIONS
  Insomnia in postmenopausal women attending a menopause clinic is related both to the effects of vasomotor symptoms and depressive symptomatology. Mood symptoms seem to affect sleep independently of vasomotor symptoms, suggesting that depression should be carefully assessed and treated in postmenopausal women with insomnia.
authors.affiliation: Women's Mental Health Clinic, Eginition Hospital, Athens, Greece.
authors.forename: Iannis M
authors.initials: IM
authors.lastname: Zervas
authors.forename: Irene
authors.initials: I
authors.lastname: Lambrinoudaki
authors.forename: Areti C
authors.initials: AC
authors.lastname: Spyropoulou
authors.forename: Kalliopi L
authors.initials: KL
authors.lastname: Koundi
authors.forename: Eleni
authors.initials: E
authors.lastname: Voussoura
authors.forename: Chara
authors.initials: C
authors.lastname: Tzavara
authors.forename: Helen
authors.initials: H
authors.lastname: Verdeli
authors.forename: Leon
authors.initials: L
authors.lastname: Aravantinos
authors.forename: Maria
authors.initials: M
authors.lastname: Creatsa
authors.forename: Thomas
authors.initials: T
authors.lastname: Paparrigopoulos
mesh_terms: D000339:Affect; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications*; D005260:Female; D006115:Greece; D019584:Hot Flashes / Q000150:complications; D006801:Humans; D016015:Logistic Models; D017533:Marital Status; D008875:Middle Aged; D017698:Postmenopause / Q000502:physiology / Q000523:psychology; D012372:ROC Curve; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology*; D014666:Vasomotor System / Q000503:physiopathology*