Do women with premature ovarian insufficiency have worse sleep quality?

Sleep disturbances are among the most common complaints of menopausal and postmenopausal women. A recent study appearing in Menopause compared the quality of sleep and fatigue between women with premature ovarian insufficiency (POI) receiving hormone therapy (HT) and women of the same age with still functioning ovaries. 

The cross-sectional quantitative study included 162 participants aged 18 to 45 (61 diagnosed with POI and treated with HT; 61 with preserved ovarian function [control group]). A personal interview was used to collect demographic data. 

The Pittsburgh Sleep Quality Index (PQSI), a 19-question self-evaluation of sleep over 1 month, was administered to the participants. The answers to the individual questions generated seven component scores ranging from 0 (no difficulty) to 3 (great difficulty). The sum of scores for the seven components yielded one global score ranging from 0 to 21 points, with higher scores indicating worse sleep quality (a score of 5 points or more corresponds to poor sleep quality. 

The Chalder Fatigue Scale was also used to gather information on physical symptoms.

Mean ages of women with POI receiving HT and those in the control group were 35.03 ± 7.68 and 34.49 ± 7.55 years, respectively. Women with POI had been diagnosed 10.49 ± 7.44 years prior and had been receiving HT treatment for 7.84 ± 6.03 years. Women in the control group had a slightly higher mean number of children compared to the POI group (1.28 ± 1.38 children vs 0.44 ± 0.92 children, respectively). 

Scores from the PQSI were slightly lower in the POI group than in the control group (7.69 ± 4.18 vs 8.03 ± 4.53), though there was no statistical difference between the groups. In the POI group, 69% were considered poor sleepers and 62% were identified as such in the control group. 

While the overall scores did not vary greatly, the two groups did differ in the evaluated components. Women with POI had worse scores for questions related to sleep latency and use of sleep medication. Women in the control group rated themselves as having worse subjective sleep quality, more sleep disturbances, and more daytime dysfunction. 

According to Chalder scale scores, women with POI had higher fatigue indices than those with preserved ovarian function (5.25 ± 2.78 vs 3.49 ± 1.78 points; P< 0.001). Fatigue was present in 59% of women in the POI group and 18% of those in the control group. 

Although women with POI who receive HT have poor sleep quality, it is similar to women of the same age with preserved ovarian function. The authors believe this finding indicates the importance of discussing and evaluating sleep quality in all women who are nearing menopause or postmenopausal.