title: Self-reported sleep difficulty during the menopausal transition: results from a prospective cohort study.
abstract: OBJECTIVE
  The aim of this study was to examine the relationship between menopausal transition status and self-reported sleep difficulty.
  
  
  METHODS
  With the use of data on women participating in the Medical Research Council National Survey of Health and Development who have been followed up from birth in March 1946 (n = 962), relationships between menopausal transition status and self-reported sleep difficulty were assessed annually in women between ages 48 and 54 years.
  
  
  RESULTS
  Menopausal transition status was related to severe self-reported sleep difficulty. The odds of reporting severe self-reported sleep difficulty were increased approximately by 2- to 3.5-fold (95% CI ranges from 1.08-3.27 to 1.99-6.04) for women in most menopausal transition statuses compared with women who remained premenopausal. After adjustment for current psychological, vasomotor, and somatic symptoms and waking frequently at night to use the toilet, only women who had a hysterectomy remained at an increased risk for moderate sleep difficulty.
  
  
  CONCLUSIONS
  The modest relationship between menopausal transition status and moderate sleep difficulty may be related to greater variation in individual definitions of moderate difficulty. Attention to the level of sleep difficulty in this group of women will assist in the decision to address current health symptoms versus sleep itself. Women without prior health problems may experience severe self-reported sleeping difficulty during the menopausal transition and require tailored care from health professionals.
authors.affiliation: Group Health Research Institute, Seattle, WA 98101-1448, USA. tom.s@ghc.org
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Tom
authors.forename: Diana
authors.initials: D
authors.lastname: Kuh
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.forename: Gita D
authors.initials: GD
authors.lastname: Mishra
mesh_terms: D000367:Age Factors; D001007:Anxiety / Q000503:physiopathology; D003710:Demography; D003863:Depression / Q000503:physiopathology; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D008137:Longitudinal Studies; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D053158:Nocturia / Q000150:complications; D016017:Odds Ratio; D057566:Self Report; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D013315:Stress, Psychological / Q000503:physiopathology; D006113:United Kingdom / Q000453:epidemiology; D014666:Vasomotor System / Q000503:physiopathology