title: Sleep in midlife women: effects of menopause, vasomotor symptoms, and depressive symptoms.
abstract: OBJECTIVE
  This study aims to evaluate subjective sleep quality in premenopausal and postmenopausal women and to study its association with night sweats, hot flashes, and depressive symptoms.
  
  
  METHODS
  A total of 158 healthy women were recruited; 107 were premenopausal (44-48 y) and 51 were postmenopausal (53-58 y). Sleep quality was evaluated with the Basic Nordic Sleep Questionnaire, night sweats and hot flashes were evaluated with a specific symptom questionnaire, and depressive symptoms were evaluated with the Beck Depression Inventory.
  
  
  RESULTS
  Postmenopausal women had poorer general sleep quality (P < 0.001), slept more restlessly (P = 0.020), and had more nocturnal awakenings (P = 0.015). However, the frequency of difficulty falling asleep, snoring, witnessed apnea, or use of sleep medication was similar between the groups. Furthermore, sleep latency, morning tiredness, or daytime tiredness did not differ between the groups. Postmenopausal women did not report more unintentional falling asleep at work or during leisure time; however, when not active, they dozed off more easily than premenopausal women (P < 0.001). Postmenopausal women had more night sweats (P < 0.001), hot flashes (P < 0.001), and depressive symptoms (P < 0.001). Even a low frequency of night sweats disturbed sleep in postmenopausal women, whereas only frequent night sweats were disturbing in premenopausal women. Depressive symptoms disturbed sleep regardless of menopause status.
  
  
  CONCLUSIONS
  Maintenance insomnia, most evidently because of night sweats and hot flashes, seems to be the major type of insomnia in postmenopausal women and has to be considered when choosing insomnia treatment for this group. Initiation of sleep and daytime vitality are not, in general, affected by menopause.
authors.affiliation: From the 1Sleep Research Unit, Department of Physiology, University of Turku, Turku, Finland; 2Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland; 3Department of Pulmonary Diseases, Tampere University Hospital, Tampere, Finland; 4Department of Biostatistics, University of Turku, Turku, Finland; 5Department of Anesthesiology and Intensive Care, Turku University Hospital, Turku, Finland; and 6Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: Laura
authors.initials: L
authors.lastname: Lampio
authors.forename: Päivi
authors.initials: P
authors.lastname: Polo-Kantola
authors.forename: Olli
authors.initials: O
authors.lastname: Polo
authors.forename: Tommi
authors.initials: T
authors.lastname: Kauko
authors.forename: Jenni
authors.initials: J
authors.lastname: Aittokallio
authors.forename: Tarja
authors.initials: T
authors.lastname: Saaresranta
mesh_terms: D000328:Adult; D003863:Depression / Q000503:physiopathology*; D005260:Female; D019584:Hot Flashes / Q000503:physiopathology*; D006801:Humans; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D017698:Postmenopause / Q000502:physiology; D017697:Premenopause / Q000502:physiology; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000503:physiopathology; D011795:Surveys and Questionnaires; D013546:Sweating / Q000502:physiology*