Sleep disturbance in healthy middle-aged women.

OBJECTIVES: The objectives of the study were to (a) describe the sleep patterns of a sample of healthy middle-aged women, (b) to characterize the psychological, behavioral and biological profiles of middle-aged women who report sleep disturbance, and (c) to determine the influence of change in menopausal status on the quality and quantity of self-reported sleep.

METHODS: A total of 521 women of varying menopausal status were evaluated in a clinic setting. Measurements included blood pressure, height, weight, waist/hip ratio, and self-reported sleep disturbances, demographic and family characteristics, psychosocial questionnaires, physical activity and nutritional intake. The women who were premenopausal at this initial visit were later evaluated, in an identical protocol, when they became postmenopausal.

RESULTS: A total of 42% of the women reported some type of sleep disturbance. Trouble sleeping was associated with higher levels of anxiety, depression, stress, tension and public self-consciousness. Women with trouble falling asleep had higher systolic and diastolic blood pressures and greater waist/hip ratios. Women who woke earlier than desired had higher systolic and diastolic blood pressures. Sleep disturbance was independent of menopausal status in cross-sectional analyses. In longitudinal analyses, the transition from pre- to postmenopausal status was associated with a significant increase in sleep disturbance in women who chose to not take hormone replacement therapy.

CONCLUSIONS: There is a high level of sleep disturbance in middle-aged women. Sleep disturbance is associated with worse mood, higher blood pressure and higher waist/hip ratios. Transition into postmenopausal status is associated with deleterious changes in sleep patterns among women who do not take hormone replacement therapy.