Pennsylvania University. US: Women in their late thirties and forties who have trouble sleeping are
more than three times more likely to suffer sleep problems during
menopause than women who have an easier time getting shut-eye,
according to a new study by researchers from the Perelman School of Medicine at the University of Pennsylvania.
Only 25 percent of women who had reported no earlier sleep problems
developed moderate or severe insomnia or other sleep disturbances
during a 16-year period around menopause.
What’s more, the researchers
say that these sleep woes did not appear to be caused by menopause
itself, which may quell common fears about symptoms associated with this
phase of life. The study, published in the journal Menopause, is among the first to document long-term sleep patterns in women in the years before, during and after menopause.
“Sleep problems are a major issue for women approaching mid-life,
particularly for women who have moderate or severe sleeping problems
before reaching menopause as they are likely to experience increased
issues throughout the transition,” says lead author, Ellen W. Freeman, PhD,
research professor in the department of Obstetrics and Gynecology at
the Perelman School of Medicine at the University of Pennsylvania. “A
small subgroup of women with only mild sleep disturbance prior to
menopause also experienced worsening sleep disturbance during the
transition, but our results show that for the majority of women,
menopause does not further exacerbate existing sleep problems or cause
new ones.”
The study assessed annually the sleep patterns of 255 women
participating in the Penn Ovarian Aging Study who reached natural
menopause during a 16-year period (1996-2012). At enrollment, all women
were aged 35 to 48 years and premenopausal, with 28 percent reporting
moderate-to-severe sleep disturbances, which is similar to the
prevalence of insomnia symptoms among adults, and 56 percent reporting
no sleep disturbances at all. Over the 16 year period, 82 percent of
the sample experienced moderate-to-severe issues with sleep, while only
7 percent had no poor sleep.
The study also found that hot flashes are strongly associated with
poor sleep as expected, but a large proportion of poor sleep in
menopausal women occurred without hot flashes. The finding, Freeman
says, indicates that sleep difficulties in the transition to menopause
in generally healthy women should not automatically be imputed to
ovarian decline.
“Our study raises the question of why a significant increase in poor
sleep should surface for a group of women who experienced only mild
sleep problems earlier, but not among women who had moderate or severe
sleep problems,” said Freeman. “This is an area for future study and
many potential factors should be considered, such as hormone
fluctuations or changes, stress, anxiety, relationships, life events
and health problems.”
Freeman added that clinicians should be alert to the strong
possibility that poor sleep in women approaching menopause is not
simply caused by menopause or hot flashes.
“Possible reasons for poor sleep instead may include health
problems, anxiety, and stress,” she said, advising that clinicians
should ask patients whether they had problems sleeping before midlife
as well as obtain information on the level and duration of earlier poor
sleep patterns to devise the most effective treatments.
In addition to Freeman, other Penn co-authors are Mary D. Sammel,
ScD, and Stephanie A. Gross, MS. Grace W. Pien, MD, from Johns Hopkins
University was an additional co-author.
This study was supported by the National Institutes of Health (RO1-AG-12745, RR024134).