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Insomnia rates are high during the perimenopause. (More than a in 10 Women Report Problems).

BERLIN -- Pervasive sleep problems afflict women in their 40s to mid-50s, with more than 4 in 10 reporting some type of difficulty related to insomnia, Finnish investigators reported at the 10th World Congress on the Menopause.

More than 3,400 respondents in five age groups (41, 45, 49, 51, and 54 years) completed questionnaires that revealed widespread sleep problems, including self-described "poor sleep quality" in 7% and "rather poor sleep quality" in 29%. Women also reported having trouble falling asleep, nodding off during the day, and feeling tired when they awakened.

"Climacteric insomnia seems to be of a complex origin," Dr. Tiina Vaari of Hyvinkaa (Finland) Hospital noted in a poster presentation.

Younger women reported less trouble falling asleep and more morning sleepiness than older women. Older women, on the other hand, reported more problems with snoring.

Age, socioeconomic status, education, and employment all had an effect on sleep problems, but mental health emerged as the most important risk factor for poor sleep.

Women with any diagnosis of a mental disorder were more than three times as likely to report the use of sleeping pills than other women. They also were nearly twice as likely to have difficulty falling asleep at night and staying awake during the daytime.

The study did not report specific details about the types or duration of the subjects' mental illnesses, although that may be the subject of future research, Dr. Vaari said in an interview at the meeting, sponsored by the International Menopause Society.

Some sleep-related problems were pervasive across all age groups.

Nocturnal awakenings, for example, affected more than 40% of women in every age category Having daytime naps increased steadily in women from the 45-year-old age group to the 54-year-old age group. Snoring was reported to be a problem for 20%-30% of women of all ages, with the highest rates m 54-year-olds.

Somatic illnesses contributed to poor sleep.

Not surprisingly cardiovascular disease correlated significantly to breathing problems.

Women with pulmonary disease also suffered disproportionately with sleep difficulties, including overall poor sleep quality, daytime tiredness, and the tendency to fall asleep during leisure time.

As women's body mass index increased, their sleep quality declined. Obese women had significantly more breathing pauses and snoring problems, and they reported they needed daytime naps.

More educated women reported a better overall quality of sleep than those with fewer years of schooling. They were less likely to report falling asleep at work, taking naps, using sleeping pills, having breathing problems, or snoring, Dr. Vaari commented.

Although hormone replacement therapy (HRT) has been postulated to aid in smoothing over menopause-related sleep problems, current use of HRT had no effect on sleeping patterns of the women surveyed. In fact, former and current users of HRT were more likely to take daytime naps and report breathing problems than women who had never taken HRT.
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Author:Bates, Betsy
Publication:OB GYN News
Date:Oct 15, 2002
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