title: Factors related to increased daytime sleepiness during the menopausal transition as evaluated by the Epworth sleepiness scale.
abstract: BACKGROUND
  Sleep disorders and sleep-apnea/hypopnea syndromes are very frequent in women, being misdiagnosed in many cases. The menopause, regardless of age, is associated to poor sleep quality and daytime sleepiness that can lead to impaired quality of life, and reduced productivity and functioning.
  
  
  OBJECTIVE
  To assess daytime sleepiness and related risk factors among middle aged Ecuadorian women using the Epworth Sleepiness Scale (ESS).
  
  
  METHODS
  In this cross-sectional study 149 women aged 40-59 years were assessed for hot flush presence and intensity using the Menopause Rating Scale (MRS) and requested to fill out the ESS and a questionnaire containing personal and partner data.
  
  
  RESULTS
  Mean age of surveyed women was 47.6+/-5.5 years, with 67.8% having less than 12 years of schooling, 33.6% being postmenopausal, and 2.7% on hormone therapy. A 10.1% were current smokers and 20.8% were sedentary. According to the MRS (item 1) 51.7% presented hot flushes, which were graded as severe-very severe in 42.8% of cases. Regarding the partner (n=132), erectile dysfunction was present in 10.6%, premature ejaculation 6.1% and 17.4% abused alcohol. Mean total ESS score was 8+/-4.4 (median 8), with 33.6% considered having some degree of daytime sleepiness (ESS score >or=10). Logistic regression analysis determined that postmenopausal status (OR 6.58, CI 95% [2.51-17.23], p=0.001), sedentarism (OR 3.43, CI 95% [1.14-10.26], p=0.02) and hot flush presence (OR 2.61, CI 95% [1.02-6.65], p=0.04) among women were risk factors for increased daytime sleepiness (ESS total score >or=10) whereas partner faithfulness decreased this risk (OR 0.47, CI 95% [0.24-0.90], p=0.02).
  
  
  CONCLUSIONS
  Increased daytime sleepiness in this middle aged series was related to female (hormonal status and sedentarism) and partner factors; several which are susceptible of intervention.
authors: Academic and Research Department, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Guayaquil, Ecuador. pchedraui@jbgye.org.ec <pchedraui@jbgye.org.ec>
authors: Peter
authors: P
authors: Chedraui
authors: Faustino R
authors: FR
authors: Pérez-López
authors: Marcela
authors: M
authors: Mendoza
authors: María L
authors: ML
authors: Leimberg
authors: María A
authors: MA
authors: Martínez
authors: Varinia
authors: V
authors: Vallarino
authors: Luis
authors: L
authors: Hidalgo
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis* / Q000453:epidemiology*; D004484:Ecuador / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008593:Menopause; D008875:Middle Aged; D016017:Odds Ratio; D017286:Polysomnography; D015995:Prevalence; D011594:Psychometrics; D012044:Regression Analysis; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012894:Sleep Stages; D011795:Surveys and Questionnaires; D016387:Women's Health