Menopause associated with insomnia, obstructive sleep apnea risk
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Healthy, postmenopausal women are 50% more likely to report symptoms of insomnia and screen positive for obstructive sleep apnea when compared with premenopausal or perimenopausal women, according to findings published in Menopause.
“The degree of sleep dysfunction seen with menopause remains controversial,” Sheida Zolfaghari, MD, of the integrated program in neuroscience from McGill University in Montreal, and colleagues wrote. “Several studies have indicated that women report more difficulties falling asleep, fragmented sleep, nighttime wakefulness and inability to resume sleep during the menopause transition. However, other studies did not find higher sleep disorders in postmenopausal women compared with premenopausal women. Moreover, there has been no consensus on which specific sleep disorders are associated with menopausal status. Our study, which included a very large sample, the assessment of numerous sleep disorders, and the ability to adjust for key confounds, was able to address this important area.”
Zolfaghari and colleagues analyzed data from the Canadian Longitudinal Study of Aging from 6,179 women aged 45 to 60 years who self-reported menopausal status, excluding those with prior hysterectomy. Participants completed assessments for overall sleep satisfaction, hours of daily sleep, sleep-onset insomnia, sleep-maintenance insomnia, daytime somnolence, rapid eye movement sleep behavior disorder, restless leg syndrome and obstructive sleep apnea. Researchers used linear regression analysis to compare each sleep variable between postmenopausal and premenopausal or perimenopausal women.
Within the cohort, 3,713 (60.1%) were postmenopausal (mean age, 56 years) and 2,466 (39.9%) were premenopausal or perimenopausal (mean age, 50 years). Compared with premenopausal or perimenopausal women, postmenopausal women were more likely to report requiring at least 30 minutes to fall asleep (20.4% vs. 15.5%), for an adjusted OR of 1.24 (95% CI, 1-1.53), and were more likely to meet criteria for possible sleep-onset insomnia disorder (10.8% vs. 7.3%), with an adjusted OR of 1.51 (95% CI, 1.07-2.12).
Postmenopausal women were also more likely to screen positive for obstructive sleep apnea when compared with premenopausal or perimenopausal women (14.6% vs. 10.4%; aOR = 1.48; 95% CI, 1.14-1.92).
There were no between-group differences when assessing measures of sleep dissatisfaction, daytime somnolence disorder, sleep-maintenance insomnia disorder, restless leg syndrome or rapid eye movement sleep behavior disorder.
The researchers noted that insomnia symptoms tended to begin in the years soon before and after menopause, indicating a temporal link between menopause and insomnia.
“We also observed increased possible obstructive sleep apnea in the postmenopausal women,” the researchers wrote. “Overall sleep satisfaction and other sleep disorders, including sleep-maintenance insomnia, possible rapid eye movement sleep behavior disorder and possible restless leg syndrome, did not differ between menopausal status groups.” – by Regina Schaffer
Disclosures: Zolfaghari reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Zolfaghari S, et al. Menopause. 2019;doi:10.1097/GME.0000000000001462.
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