Objective and Subjective Sleep Quality in Premenopausal, Perimenopausal, and Postmenopausal Women in the Wisconsin Sleep Cohort Study

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Abstract
Assess objectively measured sleep quality in premenopausal, perimenopausal, and postmenopausal women. Observational epidemiology study. Community-based. Probability sample of 589 premenopausal, perimenopausal, and postmenopausal women recruited from state employee records. None. 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. Sleep quality was not worse in perimenopausal or post-menopausal 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. Menopause is not associated with diminished sleep quality measured by polysomnography. Although perimenopausal and post-menopausal 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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