Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women

Howard M. Kravitz, Xinhua Zhao, Joyce T. Bromberger, Ellen B Gold, Martica H. Hall, Karen A. Matthews, Mary Fran R Sowers

Research output: Contribution to journalArticle

176 Citations (Scopus)

Abstract

Study Objectives: Examine age-adjusted odds and racial/ethnic differences in self-reported difficulties falling and staying asleep and early morning awakening in midlife women to determine whether difficulty sleeping increased with progression through the menopausal transition. Design: Longitudinal analysis. Setting: Community-based. Participants: 3,045 Caucasian, African American, Chinese, Japanese, and Hispanic women, aged 42-52 years and pre-or early peri-menopausal at baseline, participating in the Study of Women's Health Across the Nation (SWAN). Interventions: None. Measurements and Results: Self-reported number of nights of difficulty falling asleep, staying asleep, and early morning awakening during the previous 2 weeks were obtained at baseline and 7 annual assessments. Random effects logistic regression was used to model associations between each of the 3 sleep measures and the menopausal transition, defined by bleeding patterns, vasomotor symptoms (VMS), and estradiol (E2) and follicle stimulating hormone (FSH) serum levels. Adjusted odds ratios (ORs) for difficulty falling asleep and staying asleep increased through the menopausal transition, but decreased for early morning awakening from late perimenopause to postmenopause. Naturally and surgically postmenopausal women using hormones, compared with those who were not, generally had lower ORs for disturbed sleep. More frequent VMS were associated with higher ORs of each sleep difficulty. Decreasing E2 levels were associated with higher ORs of trouble falling and staying asleep, and increasing FSH levels were associated with higher ORs of trouble staying asleep. Racial/ethnic differences were found for staying asleep and early morning awakening. Conclusions: Progression through the menopausal transition as indicated by 3 menopausal characteristics-symptoms, bleeding-defined stages, and endogenous hormone levels-is associated with self-reported sleep disturbances.

Original languageEnglish (US)
Pages (from-to)979-990
Number of pages12
JournalSleep
Volume31
Issue number7
StatePublished - Jul 1 2008

Fingerprint

Sleep Initiation and Maintenance Disorders
Sleep
Odds Ratio
Accidental Falls
Follicle Stimulating Hormone
Perimenopause
Hormones
Hemorrhage
Postmenopause
Women's Health
Hispanic Americans
African Americans
Estradiol
Logistic Models
Serum

Keywords

  • Estradiol
  • Follicle stimulating hormone
  • Longitudinal study
  • Menopausal transition
  • Race/ethnicity
  • Sleep difficulties
  • Vasomotor symptoms

ASJC Scopus subject areas

  • Physiology

Cite this

Kravitz, H. M., Zhao, X., Bromberger, J. T., Gold, E. B., Hall, M. H., Matthews, K. A., & Sowers, M. F. R. (2008). Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women. Sleep, 31(7), 979-990.

Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women. / Kravitz, Howard M.; Zhao, Xinhua; Bromberger, Joyce T.; Gold, Ellen B; Hall, Martica H.; Matthews, Karen A.; Sowers, Mary Fran R.

In: Sleep, Vol. 31, No. 7, 01.07.2008, p. 979-990.

Research output: Contribution to journalArticle

Kravitz, HM, Zhao, X, Bromberger, JT, Gold, EB, Hall, MH, Matthews, KA & Sowers, MFR 2008, 'Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women', Sleep, vol. 31, no. 7, pp. 979-990.
Kravitz HM, Zhao X, Bromberger JT, Gold EB, Hall MH, Matthews KA et al. Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women. Sleep. 2008 Jul 1;31(7):979-990.
Kravitz, Howard M. ; Zhao, Xinhua ; Bromberger, Joyce T. ; Gold, Ellen B ; Hall, Martica H. ; Matthews, Karen A. ; Sowers, Mary Fran R. / Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women. In: Sleep. 2008 ; Vol. 31, No. 7. pp. 979-990.
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abstract = "Study Objectives: Examine age-adjusted odds and racial/ethnic differences in self-reported difficulties falling and staying asleep and early morning awakening in midlife women to determine whether difficulty sleeping increased with progression through the menopausal transition. Design: Longitudinal analysis. Setting: Community-based. Participants: 3,045 Caucasian, African American, Chinese, Japanese, and Hispanic women, aged 42-52 years and pre-or early peri-menopausal at baseline, participating in the Study of Women's Health Across the Nation (SWAN). Interventions: None. Measurements and Results: Self-reported number of nights of difficulty falling asleep, staying asleep, and early morning awakening during the previous 2 weeks were obtained at baseline and 7 annual assessments. Random effects logistic regression was used to model associations between each of the 3 sleep measures and the menopausal transition, defined by bleeding patterns, vasomotor symptoms (VMS), and estradiol (E2) and follicle stimulating hormone (FSH) serum levels. Adjusted odds ratios (ORs) for difficulty falling asleep and staying asleep increased through the menopausal transition, but decreased for early morning awakening from late perimenopause to postmenopause. Naturally and surgically postmenopausal women using hormones, compared with those who were not, generally had lower ORs for disturbed sleep. More frequent VMS were associated with higher ORs of each sleep difficulty. Decreasing E2 levels were associated with higher ORs of trouble falling and staying asleep, and increasing FSH levels were associated with higher ORs of trouble staying asleep. Racial/ethnic differences were found for staying asleep and early morning awakening. Conclusions: Progression through the menopausal transition as indicated by 3 menopausal characteristics-symptoms, bleeding-defined stages, and endogenous hormone levels-is associated with self-reported sleep disturbances.",
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AU - Hall, Martica H.

AU - Matthews, Karen A.

AU - Sowers, Mary Fran R

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N2 - Study Objectives: Examine age-adjusted odds and racial/ethnic differences in self-reported difficulties falling and staying asleep and early morning awakening in midlife women to determine whether difficulty sleeping increased with progression through the menopausal transition. Design: Longitudinal analysis. Setting: Community-based. Participants: 3,045 Caucasian, African American, Chinese, Japanese, and Hispanic women, aged 42-52 years and pre-or early peri-menopausal at baseline, participating in the Study of Women's Health Across the Nation (SWAN). Interventions: None. Measurements and Results: Self-reported number of nights of difficulty falling asleep, staying asleep, and early morning awakening during the previous 2 weeks were obtained at baseline and 7 annual assessments. Random effects logistic regression was used to model associations between each of the 3 sleep measures and the menopausal transition, defined by bleeding patterns, vasomotor symptoms (VMS), and estradiol (E2) and follicle stimulating hormone (FSH) serum levels. Adjusted odds ratios (ORs) for difficulty falling asleep and staying asleep increased through the menopausal transition, but decreased for early morning awakening from late perimenopause to postmenopause. Naturally and surgically postmenopausal women using hormones, compared with those who were not, generally had lower ORs for disturbed sleep. More frequent VMS were associated with higher ORs of each sleep difficulty. Decreasing E2 levels were associated with higher ORs of trouble falling and staying asleep, and increasing FSH levels were associated with higher ORs of trouble staying asleep. Racial/ethnic differences were found for staying asleep and early morning awakening. Conclusions: Progression through the menopausal transition as indicated by 3 menopausal characteristics-symptoms, bleeding-defined stages, and endogenous hormone levels-is associated with self-reported sleep disturbances.

AB - Study Objectives: Examine age-adjusted odds and racial/ethnic differences in self-reported difficulties falling and staying asleep and early morning awakening in midlife women to determine whether difficulty sleeping increased with progression through the menopausal transition. Design: Longitudinal analysis. Setting: Community-based. Participants: 3,045 Caucasian, African American, Chinese, Japanese, and Hispanic women, aged 42-52 years and pre-or early peri-menopausal at baseline, participating in the Study of Women's Health Across the Nation (SWAN). Interventions: None. Measurements and Results: Self-reported number of nights of difficulty falling asleep, staying asleep, and early morning awakening during the previous 2 weeks were obtained at baseline and 7 annual assessments. Random effects logistic regression was used to model associations between each of the 3 sleep measures and the menopausal transition, defined by bleeding patterns, vasomotor symptoms (VMS), and estradiol (E2) and follicle stimulating hormone (FSH) serum levels. Adjusted odds ratios (ORs) for difficulty falling asleep and staying asleep increased through the menopausal transition, but decreased for early morning awakening from late perimenopause to postmenopause. Naturally and surgically postmenopausal women using hormones, compared with those who were not, generally had lower ORs for disturbed sleep. More frequent VMS were associated with higher ORs of each sleep difficulty. Decreasing E2 levels were associated with higher ORs of trouble falling and staying asleep, and increasing FSH levels were associated with higher ORs of trouble staying asleep. Racial/ethnic differences were found for staying asleep and early morning awakening. Conclusions: Progression through the menopausal transition as indicated by 3 menopausal characteristics-symptoms, bleeding-defined stages, and endogenous hormone levels-is associated with self-reported sleep disturbances.

KW - Estradiol

KW - Follicle stimulating hormone

KW - Longitudinal study

KW - Menopausal transition

KW - Race/ethnicity

KW - Sleep difficulties

KW - Vasomotor symptoms

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