Predictors of sleep disturbance in menopausal transition.
OBJECTIVE
This follow-up study aimed to evaluate risk factors for menopausal sleep disturbances already identifiable before menopause.


METHODS
At baseline, all 81 women were premenopausal. At year-five follow-up, 27 of the women were premenopausal, 40 postmenopausal, and 14 postmenopausal and using hormone therapy. We used the Basic Nordic Sleep Questionnaire to study sleep; additional questionnaires evaluated risk factors for sleep impairment.


RESULTS
Sleep quality differed only marginally between the groups. The following baseline variables were associated with impaired sleep quality at follow-up: depressive symptoms increased the risk of nocturnal awakenings (OR 1.16 (95%CI 1.02-1.32), p=0.025), morning tiredness (OR 1.22 (95%CI 1.06-1.40), p=0.007), daytime tiredness (OR 1.24 (95%CI 1.06-1.44), p=0.007) and propensity to fall asleep during work or leisure time (OR 1.18 (95%CI 1.01-1.37), p=0.036). Personal crises increased the risk of longer sleep latency (OR 5.46 (95%CI 1.13-26.32), p=0.035) and of propensity to fall asleep when not active (OR 5.41 (95%CI 1.42-20.83), p=0.014). Use of medications affecting the CNS increased the risk of worse general sleep quality (OR 11.44 (95% CI 1.07-121.79), p=0.044). Perceived impaired general health (OR 2.87 (95%CI 1.04-7.94), p=0.043) and frequent night sweats (OR 10.50 (95%CI 2.25-49.01), p=0.003) increased the risk of difficulty falling asleep.


CONCLUSIONS
Various premenopausal health-related factors seem to predict poor sleep in menopausal transition. Menopause itself appears to have only minor effects. Thus, it is essential to identify high-risk women to allow timely interventions that may prevent the development of sleep disturbances at menopause.
Sleep Research Centre, Department of Physiology, University of Turku, Turku, Finland; Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland. Electronic address: lmlamp@utu.fi.
Laura
L
Lampio
Sleep Research Centre, Department of Physiology, University of Turku, Turku, Finland; Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital, Turku, Finland.
Tarja
T
Saaresranta
Department of Statistics, University of Turku, Turku, Finland.
Janne
J
Engblom
Department of Pulmonary Diseases, Tampere University Hospital, Tampere, Finland.
Olli
O
Polo
Sleep Research Centre, Department of Physiology, University of Turku, Turku, Finland; Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland.
Päivi
P
Polo-Kantola
D000328:Adult; D003863:Depression / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D017697:Premenopause; D012307:Risk Factors; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D011795:Surveys and Questionnaires
CNS medication; Depressive symptoms; Menopause; Night sweats; Perceived impaired health; Personal crises; Sleep disturbances