Severe sleep difficulty found during menopausal transition

Women in menopausal transition are much more likely to report severe sleep problems than premenopausal women do, according to a prospective cohort study reported in Menopause (2010;17[6]:1128-1135).

Odds of reporting severe sleep difficulty were approximately 2- to 3.5-fold higher (95% Confidence Interval, 1.08-3.27 vs 1.99-6.04) for women in most menopausal statuses compared with premenopausal women, according to British and American researchers.

Investigators analyzed data on 962 women participating in the Medical Research Council National Survey of Health and Development (a social-class stratified, random sample of singleton births in England, Scotland, and Wales during 1 week in March l946). Relationships between menopausal transition status and self-reported sleep difficulty were assessed annually between 48 and 54 years of age.

“For women who report severe sleep difficulty, the relationships remained with adjustment by potential mediators and confounders,” the authors write, suggesting that severe disturbances may not result from factors such as psychological distress and life stress or other age-related health changes. They note that understanding whether midlife sleep problems are related to the menopause transition or other factors has important implications for their management.

The relationship between menopausal transition status and sleep difficulty was weaker for moderate than severe sleep difficulty, possibly because of variations in the way individual women defined moderate difficulty. More information is needed to determine whether treating psychological, vasomotor, and somatic symptoms or some other approach is best for this group of women, the authors suggest.

They conclude that “women without prior health problems may experience severe self-reported sleeping difficulty during the menopausal transition and require tailored care from health professionals.”