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Good night's sleep complicated by menopause

The value of a good night's sleep can't be underestimated. Unfortunately, sleep complaints are common during the menopause transition. A Canadian study compared sleep quality, sleep duration, and sleep disorders between postmenopausal and pre/perimenopausal women and documented increased sleep problems postmenopause. 

Sleep disorders are one of more common complaints during menopause, affecting 40% to 60% of perimenopausal and postmenopausal women. Not only do they impair a woman's quality of life, but they also can lead to major health problems such as cardiovascular disease, diabetes, depression, and anxiety.

Multiple specific sleep disorders are also age related, including obstructive sleep apnea, periodic leg movements during sleep, rapid eye movement sleep behavior, and change in the normal sleep cycle. Although multiple studies have already examined age-related sleep problems, few considered the effect of menopause status. This new study involving more than 6,100 Canadian women sought to demonstrate how sleep was affected as a woman progressed through the menopause transition.

Researchers confirmed that, compared with premenopausal and perimenopausal women, postmenopausal women required more time to fall asleep (in excess of 30 min) and were more likely to suffer from sleep-onset insomnia disorder and obstructive sleep apnea.



Sleep complaints are common during the menopause transition. However, it is difficult to disentangle changes in sleep related to aging from those directly due to menopause. We compared sleep disorders in 45 to 60-year-old women in a large population-based study, according to menopausal status.


Women aged between 45 and 60 years who self-reported menopausal status were selected from the Canadian Longitudinal Study of Aging, excluding those with prior hysterectomy. Participants completed assessments for overall sleep satisfaction, hours of daily sleep, sleep-onset insomnia, sleep-maintenance insomnia, daytime somnolence, rapid eye movement sleep behavior disorder (RBD), restless leg syndrome (RLS), and obstructive sleep apnea (OSA). Each sleep variable was compared between postmenopausal and pre/perimenopausal women using multivariate regression, adjusting for potential confounders.


Among 6,179 women included, 3,713 (60.1%; age 55.7 ± 3.3 years) were postmenopausal and 2,466 (39.9%) were pre/perimenopausal (age 49.80 ± 3.1 years). Compared with pre/perimenopausal women, postmenopausal women were more often reported requiring ≥30 minutes to fall asleep (20.4% vs 15.5%; adjusted odds ratio [AOR] 1.24, 95% confidence interval [CI] 1.00-1.53) and were more likely to meet criteria for possible sleep-onset insomnia disorder (10.8% vs 7.3%; AOR 1.51, 95% CI 1.07-2.12). Postmenopausal women were also more likely to screen positive for OSA (14.6% vs 10.4%; AOR 1.48, 95% CI 1.14-1.92). The two groups did not differ on sleep dissatisfaction (32.4% vs 29%), daytime somnolence disorder (1.6% vs 1.3%), sleep-maintenance insomnia disorder (17% vs 14.5%), RLS (23.5% vs 20.9%), or RBD (3.9% vs 4.0%).


Menopause is associated with increased sleep-onset insomnia. Postmenopausal women also are more likely to screen positive for OSA. However, menopausal status is not associated with sleep maintenance, somnolence, or RLS, and RBD.


Zolfaghari S, Yao C, Thompson C, Gosselin N, Desautels A, Dang-Vu TT, Postuma R, Carrier J. Effects of menopause on sleep quality and sleep disorders Canadian Longitudinal Study on Aging. Menopause: December 13, 2019 - Volume Publish Ahead of Print - Issue - p doi: 10.1097/GME.0000000000001462

Content created 19 December 2019

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