title: Menopause is associated with self-reported poor sleep quality in women without vasomotor symptoms.
abstract: OBJECTIVE
  The aim of this study was to investigate the relationship between menopause and self-reported sleep quality in Chinese women without vasomotor symptoms.
  
  
  METHODS
  Cross-sectional data were collected from a decoded database of the National Cheng Kung University Hospital. Menopause was defined as absence of menses for at least 12 months or a history of hysterectomy and oophorectomy. Self-reported sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). A higher global PSQI score indicates poorer self-reported sleep quality, and a global PSQI score greater than 5 differentiates poor sleepers from good sleepers.
  
  
  RESULTS
  Of the 1,088 women recruited, 353 (32.4%) were in postmenopause status. Postmenopausal women had higher mean (SD) global PSQI scores (8.0 [3.3] vs. 6.1 [2.2], P < 0.001) and a greater prevalence of poor sleepers (73.1% vs. 60.8%, P < 0.001) compared with premenopausal women. Multivariate linear regression analysis showed that menopause (β = 1.532; 95% CI, 1.135 to 1.949; P < 0.001) and snoring (β = 0.764; 95% CI, 0.299 to 1.228; P = 0.001) were positively associated with global PSQI scores, whereas long sleep duration (β = -0.791; 95% CI, -1.113 to -0.468; P < 0.001) was negatively associated with global PSQI scores. Multivariate logistic regression analyses showed that menopause (odds ratio, 1.453; 95% CI, 1.030 to 2.051; P < 0.05), long sleep duration (odds ratio, 0.545; 95% CI, 0.418 to 0.710; P < 0.001), and snoring (odds ratio, 2.022; 95% CI, 1.312 to 3.116; P = 0.001) were independent predictors of poor sleepers.
  
  
  CONCLUSIONS
  Postmenopausal women without vasomotor symptoms have significantly higher global PSQI scores and a higher risk of being poor sleepers than premenopausal women. In addition, menopause and snoring are associated with an increased risk of poor self-reported sleep quality independently of cardiometabolic factors and lifestyle, whereas long sleep duration is associated with a decreased risk of poor self-reported sleep quality.
authors.affiliation: From the 1Division of Endocrinology and Metabolism, Department of Internal Medicine, and 2Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; and Departments of 3Family Medicine and 4Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Hao-Chang
authors.initials: HC
authors.lastname: Hung
authors.forename: Feng-Hwa
authors.initials: FH
authors.lastname: Lu
authors.forename: Horng-Yih
authors.initials: HY
authors.lastname: Ou
authors.forename: Jin-Shang
authors.initials: JS
authors.lastname: Wu
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Yang
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Chang
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006785:Hospitals, University; D019584:Hot Flashes / Q000150:complications; D006801:Humans; D016014:Linear Models; D008593:Menopause; D008875:Middle Aged; D015995:Prevalence; D057566:Self Report; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000150:complications / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology