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Objective and Subjective Sleep Quality in Premenopausal, Perimenopausal, and Postmenopausal Women in the Wisconsin Sleep Cohort Study
Abstract
STUDY OBJECTIVE: Assess objectively measured sleep quality in premenopausal, perimenopausal, and postmenopausal women. DESIGN: Observational epidemiology study. SETTING: Community-based. PARTICIPANTS: Probability sample of 589 premenopausal, perimenopausal, and postmenopausal women recruited from state employee records. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Menopausal status was determined by menstrual history, surgical history, and use of hormone replacement therapy. Sleep quality was objectively measured by full in-laboratory polysomnography and by self-reported sleep problems. Linear and logistic regression were used to estimate associations adjusted for potential confounding factors. OBJECTIVE: Sleep quality was not worse in perimenopausal or postmenopausal women, compared with premenopausal women. To the contrary, postmenopausal woman had more deep sleep (16% vs 13% stages 3/4, P < 0.001) and significantly longer total sleep time (388 minutes vs 374 minutes, P = 0.05). Menopausal status was moderately related to self-reported dissatisfaction with sleep but was not consistently associated with symptoms of insomnia or sleepiness. CONCLUSIONS: Menopause is not associated with diminished sleep quality measured by polysomnography. Although perimenopausal and postmenopausal women, relative to premenopausal women, were less satisfied with their sleep, menopause was not a strong predictor of specific sleep-disorder symptoms. Symptoms and signs of sleep abnormalities in midlife women should not be attributed primarily to menopause before ruling out underlying sleep disorders.
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“The Wisconsin Sleep Cohort study found that peri-menopausal women and postmenopausal women were twice as likely to be dissatisfied with their sleep as pre-menopausal women [96].”
From Non-Pharmacological Treatment of Insomnia (2012) · cites this paper as [96]
In the citing paper
“Although self-reported nocturnal flashes correlate with subjective poor sleep quality, such association is less clear when objective sleep measures are used [96,105,106].”
From Non-Pharmacological Treatment of Insomnia (2012) · cites this paper as [96]
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“[40] found that sleep quality problems reported by post-menopausal women are not easily verifiable with a PSG.”
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Lukacs, J. L., Chilimigras, J. L., Cannon, J. R., Dormire, S. L., & Reame, N. E. (2004) · Journal of Women s Health · doi:10.1089/154099904323016491 · Cited by 19
Kline, C. E., Colvin, A. B., Gabriel, K. P., Karvonen-Gutierrez, C. A., Cauley, J. A., Hall, M. H., Matthews, K. A., Ruppert, K. M., Neal-Perry, G. S., Strotmeyer, E. S., et al. (2021) · SLEEP · doi:10.1093/sleep/zsab059 · Cited by 19
“actigraphy or polysomnography) [58], and prior research suggests that changes in sleep over the midlife period in women differ between self-reported and polysomnographyassessed sleep [59].”
BackgroundYoon, J., Oh, D., Hwang, I., Park, J. A., Im, H., Lee, S. K., Jung, K., Park, S., THOMAS, R. J., Shin, C., et al. (2021) · Journal of Sleep Research · doi:10.1111/jsr.13358 · Cited by 19
“In community dwelling men older than 60 years, lower testosterone levels were associated with decreased SE, increased nocturnal awakenings and less N3 sleep (Young et al., 2003).”
BackgroundThe circadian variation of sleep and alertness of postmenopausal women
Pérez‐Medina‐Carballo, R., Kosmadopoulos, A., Boudreau, P., Robert, M., Walker, C., & Boivin, D. B. (2022) · SLEEP · doi:10.1093/sleep/zsac272 · Cited by 20
Ulander, M., Rångtell, F. H., & Theorell‐Haglöw, J. (2021) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2021.07.004 · Cited by 19
Alexander, J. L., Neylan, T. C., Kotz, K. J., Dennerstein, L., Richardson, G., & Rosenbaum, R. L. (2007) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.7.11s.s139 · Cited by 19
“Young et al. (2003) found no association between menopause and diminished sleep quality measured by polysomnography [40], and a recent study of women aged 46–51 years found no evidence to suggest that sleep disturbance is produced by hot flashes [41].”
BackgroundLucchini, M., O'Brien, L. M., Kahn, L. G., Brennan, P. A., Baron, K. G., Knapp, E. A., Lugo-Candelas, C. I., Shuffrey, L. C., Dunietz, G. L., Zhu, Y., et al. (2022) · SLEEP · doi:10.1093/sleep/zsac075 · Cited by 18
Thongchumnum, W., Vallibhakara, S. A.-O., Sophonsritsuk, A., & Vallibhakara, O. (2023) · Nutrients · doi:10.3390/nu15051187 · Cited by 17
“’s report of sleep patterns from PSG among premenopausal, perimenopausal, and postmenopausal women showed no significant difference across all groups [9].”
BackgroundCorrelates of sleep quality and sleep duration in a sample of urban-dwelling elderly Nigerian women
Fawale, B., Ismaila, I. A., Mustapha, A. F., Komolafe, M. A., & Ibigbami, O. I. (2017) · Sleep Health · doi:10.1016/j.sleh.2017.05.008 · Cited by 18
Matthews, K. A., Lee, L., Kravitz, H. M., Joffe, H., Neal-Perry, G. S., Swanson, L. M., Evans, M. A., & Hall, M. H. (2021) · SLEEP · doi:10.1093/sleep/zsab139 · Cited by 18
Orff, H. J., Meliska, C. J., López, A. M. V., Martinez, F., Sorenson, D. L., & Parry, B. L. (2012) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2012.14.4/hjorff · Cited by 17
Pavlova, M. K., & Sheikh, L. (2011) · Seminars in Neurology · doi:10.1055/s-0031-1293539 · Cited by 18
Doo, M., & Kim, Y. (2017) · Nutrients · doi:10.3390/nu9030206 · Cited by 17
“However, some studies have reported that poor sleep is not primarily attributed to decreases in the production of estrogen [8,9].”
BackgroundClinical profile of menopausal insomniac women referred to sleep laboratory
Hachul, H., Brandão, L. D. C., Bittencourt, L., et al. (2009) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1080/00016340902777509 · Cited by 16
“(23) stated that, although women report sleep disturbance during both perimenopause and postmenopause, menopause itself was not a strong predictor of specific sleep-disorder symptoms.”
BackgroundNocturia in Women With Obstructive Sleep Apnea
Doyle-McClam, M., Shahid, M. H., Sethi, J. M., & Koo, P. (2018) · American Journal of Lifestyle Medicine · doi:10.1177/1559827618782657 · Cited by 18
“However, being postmenopausal increased the risk of having SDB.(18,19) The mechanism of menopause increasing the risk of OSA is not clearly understood.”
BackgroundInfluentialThe influence of sex and gonadal hormones on sleep disorders
Parry, B. L., Orff, H. J., Meliska, C. J., & Martinez, F. (2014) · ChronoPhysiology and Therapy · doi:10.2147/cpt.s44667 · Cited by 16
“54 Conversely, in a large epidemiologic study, 55 objective sleep quality was not worse in peri-or postmenopausal women than in premenopausal women, with postmenopausal woman actually exhibiting more deep sleep and significantly longer total sleep times.”
Metadata
- Authors
- Young, T., Rabago, D., Zgierska, A., Austin, D., & Finn, L.
- Affiliations
- University of Wisconsin–Madison (US)
- Corresponding author
- Young, Terry
- Venue
- SLEEP
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-09-01
- Volume
- 26
- Issue
- 6
- Pages
- 667-672
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- OpenAlex
- W172588831
- Cited by
- 371
- References
- 0
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 7 · 2023: 18 · 2022: 8 · 2021: 16 · 2020: 11 · 2019: 14 · 2018: 12 · 2017: 15 · 2016: 19 · 2015: 18 · 2014: 22 · 2013: 24 · 2012: 15
- FWCI
- 21.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- SLEEP (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG1412)
- National Heart, Lung, and Blood Institute (R01HL062252, HL62252)
- National Center for Research Resources (RR03186)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- sleep quality, menopause, perimenopause, postmenopausal women, premenopausal women, slow-wave sleep, total sleep time, sleep dissatisfaction, insomnia, daytime sleepiness, sleep disorders, Wisconsin Sleep Cohort Study
- MeSH terms
- Adult, Climacteric, Female, Humans, Sleep Initiation and Maintenance Disorders, Middle Aged, Population Surveillance, Probability, Sleep Apnea Syndromes, Sleep Stages, Vasomotor System, Cohort Studies, Body Mass Index, Polysomnography, Premenopause, Postmenopause
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