Menopause symptoms linked to poor sleep quality, says study

Menopause symptoms make middle-aged sleep problems more likely for some women, a study from South Korea suggests.

“Sleep disorders are the most common complaints during (the) menopause transition and postmenopause,” said senior study author Dr. Hyun-Young Park of the National Research Institute of Health in Chungbuk.

“Poor sleep quality and inadequate sleep duration are associated with negative health outcomes, such as obesity, cardiovascular disease, cancer-related mortality, diabetes, depression and poor quality of life,” Park said by email.

During and after menopause, women are more prone to sleep problems like trouble falling asleep, waking up several times during the night and waking up earlier than desired, the study team writes in PLoS ONE online February 20, but it has been unclear whether menopausal symptoms contribute to these sleep disturbances.

Although hormonal changes may influence sleep problems, other factors may also play a role, they note.

To see if physical and psychological symptoms of menopause are linked to sleep problems, Park and colleagues analyzed data from 634 women between ages 44 and 56 who participated in a study that included an annual health exam at Kangbuk Samsung Hospital clinics in Seoul and Suwon in 2012-2013.

The study used questionnaires to measure sleep quality as well as hot flashes and flushes, night sweats, and other physical, sexual and psychological symptoms associated with peri-menopause and menopause. Park’s team also looked for differences among the women based on age, body mass index, chronic diseases, smoking status, marital status, income, education, employment status, physical activity, depression and stress.

Overall, they found that 19 per cent of the women in the study group reported poor sleep quality, and those who had sleep problems were more likely to have higher blood pressure, cholesterol, and triglyceride levels. They were also older, non-smokers, less educated and more likely to be living without a partner, to have depression and to have more stress.

Sleep quality seemed to get worse as women went through menopause, with about 30 per cent of postmenopausal women reporting poor sleep. In particular, sleep disturbances and sleep latency became worse in postmenopausal women.

Overall, poor sleep was related to physical symptoms and vasomotor symptoms such as night sweats, hot flashes and flushes. Those who reported more severe symptoms were also more likely to report poorer sleep.

Sexual and psychosocial issues associated with menopause did not track with sleep problems, the researchers found.

“As a sleep psychologist, I see many women whose sleep is negatively affected by menopausal symptoms, particularly hot flashes during the night,” said Aric Prather, a psychologist at the University of California, San Francisco, who wasn’t involved with the study.

The research team would like to further examine other factors related to sleep quality, including changes in hormone levels, mood disorders, other medical conditions and lifestyle factors. Other studies have suggested that hormone replacement therapy may improve sleep in postmenopausal women, which could be because estrogen is involved in sleep regulation, the study authors write. Other factors such as obesity may have a negative impact on sleep quality as well.

“There is a real need to develop novel and targeted strategies for getting women back to sleep when menopausal symptoms hit,” Prather said.