ABSTRACT

Background

Sleep disturbances are common during the menopausal transition and several factors can contribute to this increased incidence. This study examined the association between sleep reactivity, arousal predisposition, sleep disturbances, and menopause.

Methods

Data for this study were derived from a longitudinal, population-based study on the natural history of insomnia. A total of 873 women (40–60 years) were divided into two groups according to their menopausal status at baseline: reproductive (n = 408) and postmenopausal (n = 465). Participants were evaluated annually throughout the five-year follow-up period. Four questionnaires were used to examine sleep quality, insomnia severity, sleep reactivity, and arousal predisposition. The data were analyzed using two approaches: cross-sectional with a multivariate analysis and binary regression, and longitudinal with a linear mixed models using menopausal groups (3) x time (5) design.

Results

Cross-sectional analyses showed that postmenopausal women reported significantly more severe insomnia and poorer sleep quality than reproductive women. Sleep reactivity and arousal predisposition were significant predictors of sleep disturbances. Longitudinal analyses revealed increased sleep disturbances in the two years before and after the menopausal transition. Sleep reactivity and arousal predisposition did not moderate the temporal relationship between menopausal transition and sleep disturbances.

Conclusion

More sleep disturbances were reported during the menopausal transition, but those difficulties were not explained by sleep reactivity and arousal predisposition. These results suggest the involvement of other psychophysiological factors in the development of sleep disturbances during the menopause.

中文翻译：

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更年期过渡期间的睡眠障碍：睡眠反应和觉醒倾向的作用

摘要

背景

睡眠障碍在更年期过渡期间很常见，有几个因素可能导致这种发病率增加。这项研究检查了睡眠反应性、觉醒倾​​向、睡眠障碍和更年期之间的关系。

方法

本研究的数据来自一项关于失眠自然史的纵向、基于人群的研究。共有 873 名女性（40-60 岁）根据其基线绝经状态分为两组：生殖（n = 408）和绝经后（n = 465）。在五年的随访期间，参与者每年都会接受评估。四份问卷用于检查睡眠质量、失眠严重程度、睡眠反应和觉醒倾向。使用两种方法分析数据：采用多变量分析和二元回归的横断面分析，以及采用绝经组 (3) x 时间 (5) 设计的线性混合模型纵向分析。

结果

横断面分析表明，绝经后妇女比生育期妇女报告的失眠和睡眠质量明显更差。睡眠反应和觉醒倾向是睡眠障碍的重要预测因素。纵向分析显示在绝经过渡前后两年睡眠障碍增加。睡眠反应和觉醒倾向并没有缓和更年期过渡和睡眠障碍之间的时间关系。

结论

在更年期过渡期间报告了更多的睡眠障碍，但这些困难并不能用睡眠反应和觉醒倾向来解释。这些结果表明其他心理生理因素参与了绝经期间睡眠障碍的发展。