title: Relationship of sleep alterations with perimenopausal and postmenopausal symptoms.
abstract: OBJECTIVE
  Sleep disturbance is an important change in menopause because it affects quality of life and can lead to other conditions such as depression. This study measured sleep alterations and explored associated physical, emotional, hormonal, and lifestyle factors during perimenopause and postmenopause.
  
  
  METHODS
  This cross-sectional study enrolled 160 women who were classified as perimenopausal (n = 85) or postmenopausal (n = 75). Using diaries, we collected data on duration of sleep, time awake in bed, and sleep efficiency. Follicle-stimulating hormone, 17β-estradiol, and cortisol levels were quantified by radioimmunoassay, and serum anti-Müllerian hormone levels were measured using enzyme-linked immunosorbent assay. Correlations between sleep measurements and symptoms were assessed using a generalized linear model.
  
  
  RESULTS
  The reported duration of sleep was similar for both groups of women (close to 6.9 h), and sleep efficiency was 88%. We did not find any factor that was associated with duration of sleep. Sleep efficiency was negatively associated with age, perimenopause/postmenopause status, loss of sexual interest, hot flashes, and depressed mood. Time awake in bed was positively associated with depressed mood (P < 0.000001), cigarette smoking (P < 0.000041), menopause status (P < 0.00009), and age (P < 0.0009). These associations remained after controlling for exercise, alcohol consumption, and caffeine consumption as confounding variables. Finally, morning salivary cortisol was reduced in postmenopausal women.
  
  
  CONCLUSIONS
  Time awake in bed shows the most significant associations. Depressed mood, age, and menopause status are the main factors associated with sleep disturbances.
authors.affiliation: From the Department of Medical Sciences, University of Guanajuato, León Campus, León, Gto., Mexico.
authors.forename: Carmen
authors.initials: C
authors.lastname: Moreno-Frías
authors.forename: Nicté
authors.initials: N
authors.lastname: Figueroa-Vega
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Malacara
mesh_terms: D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D019584:Hot Flashes / Q000097:blood* / Q000150:complications; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008593:Menopause; D008875:Middle Aged; D012893:Sleep Wake Disorders / Q000097:blood* / Q000150:complications
chemical_list: D004958:Estradiol; D005640:Follicle Stimulating Hormone; D006854:Hydrocortisone