title: Sleep symptoms during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women's Health Study.
abstract: OBJECTIVE
  Describe the severity of getting to sleep, nighttime awakening, and early morning awakening across the menopausal transition (MT) and early postmenopause (PM) and their relationship to age, menopausal transition factors, symptoms, stress-related factors, and health related factors.
  
  
  METHODS
  Cohort.
  
  
  METHODS
  community.
  
  
  METHODS
  286 women from the Seattle Midlife Women's Health Study cohort.
  
  
  METHODS
  Participants completed annual menstrual calendars for MT staging, diaries in which they rated their symptoms, stress levels, and perceived health multiple times per year from 1990-2007 and provided first morning urine samples assayed for E1G, FSH, cortisol, and catecholamines. Multilevel modeling (R program) was used for data analysis.
  
  
  RESULTS
  Severity of self-reported problems going to sleep was associated with all symptoms, perceived stress, history of sexual abuse, perceived health (-), alcohol use (-) (all P < 0.001), and lower cortisol (P = 0.009), but not E1G or FSH. Severity of nighttime awakening was significantly associated with age, late MT stage, and early PM, FSH, E1G (-), hot flashes, depressed mood, anxiety, joint pain, backache, perceived stress, history of sexual abuse, perceived health (-), and alcohol use (-) (all P < 0.001, except E1G for which P = 0.030). Severity of early morning awakening was significantly associated with age, hot flashes, depressed mood anxiety, joint pain, backache, perceived stress, history of sexual abuse, perceived health (-) (all P < or = 0.001, except E1G for which P = 0.02 and epinephrine (P = 0.038), but not MT stages or FSH. Multivariate models for each symptom included hot flashes, depressed mood, and perceived health.
  
  
  CONCLUSIONS
  Sleep symptoms during the MT may be amenable to symptom management strategies that take into account the symptom clusters and promote women's general health rather than focusing only on the MT.
authors.affiliation: Department of Family and Child Nursing, University of Washington, T318 Health Sciences Bldg., Box 357260, Seattle, WA 98195-7260, USA. nfwoods@u.washington.edu
authors.forename: Nancy Fugate
authors.initials: NF
authors.lastname: Woods
authors.forename: Ellen Sullivan
authors.initials: ES
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D000367:Age Factors; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology / Q000652:urine; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology / Q000652:urine; D005260:Female; D005640:Follicle Stimulating Hormone / Q000652:urine; D006304:Health Status; D006306:Health Surveys; D019584:Hot Flashes / Q000453:epidemiology / Q000523:psychology / Q000652:urine; D006801:Humans; D006854:Hydrocortisone / Q000652:urine; D008593:Menopause; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000523:psychology / Q000652:urine; D017698:Postmenopause; D012720:Severity of Illness Index; D012890:Sleep; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000523:psychology / Q000652:urine; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology / Q000652:urine; D014861:Washington / Q000453:epidemiology; D016387:Women's Health
chemical_list: D005640:Follicle Stimulating Hormone; D006854:Hydrocortisone
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