Menopause Transition Associated With Worsening Insomnia
Women who experienced surgical menopause were more likely to suffer worse insomnia symptoms after 10 years of follow-up.
Worsening insomnia has been linked to later stages of perimenopause, according to research presented at the North American Menopause Society (NAMS) 2016 Annual Meeting.
Colleen L. Ciano, PhD, RN, CNE, of the University of Pennsylvania School of Nursing, and colleagues conducted a secondary analysis on 10 years of data from the Study of Women's Health across the Nation (SWAN). DSM-V criteria were applied to categorize insomnia disorder, which the researchers measured over time to determine if perimenopausal stage — early vs late — or surgical menopause affected annually measured insomnia symptoms.
Dr Ciano and colleagues analyzed data from a diverse group of middle-aged women (n=3302; age 45.9±2.69 years, 28% African American, 50% Caucasian, 10% Asian, and 12% Hispanic). A total of 187 (6%) of the participants were identified as pre-perimenopausal or perimenopausal at baseline.
The researchers found a significant difference among the perimenopausal groups. Women in the early stage were 0.82 times less likely to develop insomnia, compared with women progressing from the early to late stage (95% CI, 0.70-0.96; P =.015), 0.48 times less likely than those progressing from early to late stage to surgical menopause (95% CI, 0.25-0.94, P =.034), 0.79 times less likely than those progressing from early to postmenopausal (95% CI, 0.67-0.93; P =.005), and 0.65 times less likely than those progressing from early to surgical menopause (95% CI, 0.51-0.83; P <.001).
Additionally, results showed that progression from early to late perimenopause was associated with a 0.70 times lower likelihood of developing insomnia disorder, compared with progression from early to late surgical menopause (95% CI, 0.53-0.94; P =.016). Progression from early to late postmenopausal stage was also associated with a 0.769 lower likelihood of developing insomnia, compared with progression from early to surgical menopause (95% CI, 0.63-0.98; P =.036).
After 10 years, the researchers found that women who progressed from early to late perimenopause were 3 times more likely to experience nighttime insomnia symptoms at the end of the follow-up period, compared with the beginning (95% CI, 1.84-5.06; P <.001).
The researchers concluded that perimenopause “predisposes women to develop nighttime insomnia symptoms,” noting that the stage of perimenpause directly impacted insomnia development.
“Very little research had been done to address insomnia in perimenopausal women as they transitioned to menopause. We now know that sleep disturbances are likely to worsen … and may likely be worst for women who are experiencing menopause as the result of a surgery,” Dr Ciano said in a press release.
“This study highlights the need for health care providers to screen for an insomnia disorder in the highest-risk groups, and to be knowledgeable about the various interventions,” JoAnn V. Pinkerton, MD, NCMP, executive director of NAMS, added in the release.
Disclosures: This study received funding from a postdoctoral research fellowship sponsored by NIH Grant #T32NR009356 at the University of Pennsylvania. Dr Ciano reports no conflicts of interest. Dr Pinkerton reports relationships with Henry Stewart, Pfizer, and TherapeuticsMD.
- Ciano CL, King T, Sawyer AM. Abstract S-11. Perimenopausal stage influences the prevalence of nighttime insomnia symptoms. Presented at: NAMS 2016 Annual Meeting; October 5-8, 2016; Orlando, FL.
- New study shows insomnia symptoms worsen throughout menopause transition [press release]. Cleveland, OH: NAMS Press Room; October 5, 2016. http://www.menopause.org/docs/default-source/2016-docs/perimenopausal-stage-influences-insomnia-symptoms-9-15-16-km.pdf. Accessed October 7, 2016.