Sleep symptoms during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women's Health Study.
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.
Woods
Nancy Fugate
NF
Department of Family and Child Nursing, University of Washington, T318 Health Sciences Bldg., Box 357260, Seattle, WA 98195-7260, USA. nfwoods@u.washington.edu
Mitchell
Ellen Sullivan
ES
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
D005640:Follicle Stimulating Hormone; D006854:Hydrocortisone
Obstet Gynecol. 1981 Jul;58(1):5-9
7195531
JAMA. 2000 Aug 2;284(5):592-7
10918705
Psychosom Med. 2002 Sep-Oct;64(5):793-802
12271110
Menopause. 2009 Mar-Apr;16(2):286-92
19002015
Res Nurs Health. 2004 Aug;27(4):225-36
15264262
Menopause. 2009 Jan-Feb;16(1):90-7
18725864
J Womens Health (Larchmt). 2007 Jun;16(5):667-77
17627402
Sleep. 1991 Feb;14(1):18-23
1811314
Am J Epidemiol. 2000 Sep 1;152(5):463-73
10981461
J Nerv Ment Dis. 2002 Jul;190(7):442-52
12142845
Climacteric. 2007 Apr;10(2):112-9
17453859
Sleep. 2008 Jul;31(7):979-90
18652093
Clin Chem. 2003 Jul;49(7):1139-48
12816911
J Clin Endocrinol Metab. 2006 Sep;91(9):3432-8
16772350
Menopause. 2003 Jan-Feb;10(1):19-28
12544673
Psychoneuroendocrinology. 2004 Oct;29(9):1184-91
15219642
Menopause. 1999 Summer;6(2):122-8
10374218
Soc Sci Med. 1991;32(11):1237-43
2068606
Fertil Steril. 2001 Nov;76(5):874-8
11704104
Menopause. 2000 Sep-Oct;7(5):334-49
10993033
Psychosom Med. 1995 Mar-Apr;57(2):105-15
7792368
J Behav Med. 1987 Feb;10(1):61-74
3586002
J Immunoassay Immunochem. 2004;25(3):259-78
15461387
Obstet Gynecol. 2000 Sep;96(3):351-8
10960625
Menopause. 2009 Jul-Aug;16(4):708-18
19322116
Am J Obstet Gynecol. 1980 Jun 15;137(4):443-50
7386528
Environ Health Perspect. 1997 Aug;105(8):862-6
9347902
Menopause. 2005 Sep-Oct;12(5):567-77
16145311
Fam Pract Res J. 1993 Dec;13(4):373-84
8285088
Fertil Steril. 2008 Jan;89(1):129-40
17681300
J Steroid Biochem. 1984 Jan;20(1):161-73
6323862
Sleep. 2008 Oct;31(10):1339-49
18853931
Sleep. 2008 Jul;31(7):991-9
18652094
Biochem J. 1979 Feb 1;177(2):729-38
435263
Menopause. 2007 Sep-Oct;14(5):826-9
17486023
JAMA. 1968 Feb 5;203(6):377-80
5694118
Biol Res Nurs. 2004 Jul;6(1):46-58
15186707
Sleep. 1988 Dec;11(6):556-61
3148991
J Biol Chem. 1954 Jun;208(2):853-61
13174594
Obstet Gynecol. 2007 Aug;110(2 Pt 1):230-40
17666595