title: Insomnia in Japanese peri- and postmenopausal women.
abstract: OBJECTIVE
  To determine the prevalence and to identify the correlates of insomnia in Japanese peri- and postmenopausal women.
  
  
  METHODS
  We retrospectively analyzed the records of 1451 peri- and postmenopausal women enrolled in the Systematic Health and Nutrition Education Program, conducted at the Menopause Clinic of the Tokyo Medical and Dental University Hospital, between 1995 and 2009.
  
  
  RESULTS
  The prevalence of insomnia was 50.8%. The severity of insomnia correlated negatively with health-related quality of life (HR-QOL) scores on all the four domains assessed: physical health, mental health, life satisfaction and social involvement. With regard to other menopausal symptoms, insomnia correlated more strongly with depressed mood than with vasomotor symptoms, and one-third of insomniac women were seriously depressed. On categorizing the participants into four groups--not insomniac or depressed, N; insomniac but not depressed, I; not insomniac but depressed, D; insomniac and depressed, ID--the HR-QOL scores were observed to worsen in order N > I > D > ID. No significant difference was detected between groups I and ID with regard to their sleep quality measures. The number of heavy smokers was high in groups I and ID. With regard to the effect of the combination of medication and health/nutrition education, hormone therapy and nightly hypnotics significantly improved the insomnia symptoms, but hypnotics administered 'as needed' did not.
  
  
  CONCLUSIONS
  Insomnia in Japanese peri- and postmenopausal women correlates more strongly with depressed mood than with vasomotor symptoms. Cessation of smoking may improve the women's sleep quality, and hormone therapy and nightly hypnotics are both effective treatments.
authors.affiliation: Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Terauchi
authors.forename: S
authors.initials: S
authors.lastname: Obayashi
authors.forename: M
authors.initials: M
authors.lastname: Akiyoshi
authors.forename: K
authors.initials: K
authors.lastname: Kato
authors.forename: E
authors.initials: E
authors.lastname: Matsushima
authors.forename: T
authors.initials: T
authors.lastname: Kubota
mesh_terms: D000328:Adult; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D019584:Hot Flashes / Q000453:epidemiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D047648:Perimenopause; D017698:Postmenopause; D015995:Prevalence; D011788:Quality of Life; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000517:prevention & control; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014666:Vasomotor System / Q000503:physiopathology; D016387:Women's Health