A multinational study of sleep disorders during female mid-life.

Although sleep disturbances are common during female mid-life, few studies have described in detail the prevalence of this problem and related risk factors. To determine the prevalence of sleep disturbances in mid-aged women using validated tools. Assessment of determinants capable of influencing the prevalence of insomnia and poor sleep quality was also performed. A total of 6079 women aged 40-59 of 11 Latin American countries were invited to fill out the Athens Insomnia Scale (AIS), the Pittsburgh Sleep Quality Index (PSQI), the Goldberg Anxiety and Depression Scale, the Menopause Rating Scale (MRS), the Brief Scale of Abnormal Drinking and a general socio-demographic questionnaire. Overall, 56.6% of surveyed women suffered of either insomnia, poor sleep quality, or both. Specifically, 43.6% and 46.2% presented insomnia and poor sleep quality in accordance to the AIS and the PSQI respectively. The prevalence of insomnia increased with female age (from 39.7% in those aged 40-44 to 45.2% in those aged 55-59, p<0.0001) and menopausal stage (from 39.5% in premenopausal aged 40-44 to 46.3% in late postmenopausal ones, p<0.0001). "Awakening during the night" (AIS: Item 2) was the most highly rated of all items and contributing in a higher degree (mean 16%) to the total score of the scale in all menopausal phases. Sleep quality also worsened with age and menopausal status, impairment particularly affecting sleep efficiency and latency and the increased use of hypnotics. Vasomotor symptoms (VMS), depressive mood and anxiety were associated to sleep disturbances. Women presenting sleep disturbances displayed a 2-fold increase in the severity of menopausal symptoms (higher total MRS scores) which was translated into a 6-8 times higher risk of impaired quality of life. Logistic regression analysis determined that female age, the presence of chronic disease, troublesome drinking, anxiety, depression, VMS, drug use (hypnotics and hormone therapy) were significant risk factors related to the presence of sleep disturbances. Higher educational level related to less insomnia and better sleep quality. Insomnia and poor sleep quality were highly prevalent in this mid-aged female sample in which the influence of age and the menopause was only modest and rather linked to menopausal symptoms already occurring since the premenopause.

Blümel JE ，Cano A ，Mezones-Holguín E ，Barón G ，Bencosme A ，Benítez Z ，Bravo LM ，Calle A ，Flores D ，Espinoza MT ，Gómez G ，Hernández-Bueno JA ，Laribezcoa F ，Martino M ，Lima S ，Monterrosa A ，Mostajo D ，Ojeda E ，Onatra W ，Sánchez H ，Tserotas K ，Vallejo MS ，Witis S ，Zúñiga MC ，Chedraui P ... -  《-》

A large multinational study of vasomotor symptom prevalence, duration, and impact on quality of life in middle-aged women.

Blümel JE ，Chedraui P ，Baron G ，Belzares E ，Bencosme A ，Calle A ，Danckers L ，Espinoza MT ，Flores D ，Gomez G ，Hernandez-Bueno JA ，Izaguirre H ，Leon-Leon P ，Lima S ，Mezones-Holguin E ，Monterrosa A ，Mostajo D ，Navarro D ，Ojeda E ，Onatra W ，Royer M ，Soto E ，Tserotas K ，Vallejo S ，Collaborative Group for Research of the Climacteric in Latin America (REDLINC) ... -  《-》

Factors relating to insomnia during the menopausal transition as evaluated by the Insomnia Severity Index.

Although the menopause associates to poor sleep quality, insomnia severity data in the menopausal transition is scarce or lacking. To assess insomnia prevalence, severity and related factors in mid-aged women. In this cross-sectional study 340 women (40 to 59 years) completed the Insomnia Severity Index (ISI) and a general questionnaire containing personal/partner data. Hot flush presence and intensity was also assessed with the Menopause Rating Scale (MRS). Median age of the sample was 48.0 years, with 63.5% having lower education and 52.9% being postmenopausal. At the moment of the survey 7.1% were on hormone therapy, 8.2% on phytoestrogens and 2.1% on psychotropic drugs. A 63.8% were abdominally obese (waist circumference > 88 cm) and 65.5% sedentary. According to item 1 of the MRS, 60.9% presented hot flushes, graded in 17.4% as severe-very severe. Regarding the partner (n=255), erectile dysfunction was present in 23.9%, premature ejaculation 37.6%, 35.3% abused alcohol and 42.4% were faithful. The ISI tool displayed a high internal consistency (alpha Cronbach coefficient=0.87), identifying 41.5% of women with some degree of insomnia (Total ISI score ≥8) further categorized as sub-threshold or mild (32.0%), moderate (7.4%) and severe (2.1%). Multiple linear regression analysis obtained two best fit models predicting total ISI scores, one not including and one including partner data. In the first model, hot flush severity, psychotropic use and sedentarism displayed significant positive correlations with total ISI scores. In the second, hot flush intensity, psychotropic drug use and male erectile dysfunction positively correlated whereas partner faithfulness inversely with ISI scores. In this mid-aged series insomnia severity was related to female and partner factors; several of which are susceptible of intervention.

Arakane M ，Castillo C ，Rosero MF ，Peñafiel R ，Pérez-López FR ，Chedraui P ... -  《-》

Menopausal symptoms appear before the menopause and persist 5 years beyond: a detailed analysis of a multinational study.

Blümel JE ，Chedraui P ，Baron G ，Belzares E ，Bencosme A ，Calle A ，Danckers L ，Espinoza MT ，Flores D ，Gomez G ，Hernandez-Bueno JA ，Izaguirre H ，Leon-Leon P ，Lima S ，Mezones-Holguin E ，Monterrosa A ，Mostajo D ，Navarro D ，Ojeda E ，Onatra W ，Royer M ，Soto E ，Tserotas K ，Vallejo MS ，Collaborative Group for Research of the Climacteric in Latin America (REDLINC) ... -  《-》

Assessment of insomnia and related risk factors in postmenopausal women screened for the metabolic syndrome.

Sleep disturbances are common during female mid-life. Nevertheless, there is limited available information linking sleep characteristics to the menopause and the metabolic syndrome (METS). To assess insomnia prevalence and related risk factors in postmenopausal women screened for the METS. In this cross sectional study 204 natural postmenopausal women participating in a METS screening program filled out the Athens insomnia scale (AIS), the hospital anxiety and depression scale (HADS) and a general socio-demographic questionnaire. Criteria of the Adult Treatment Panel III (ATP-III) were used to define the METS. Median age of the whole sample was 56 years. A 50.5% of women had the METS, 57.4% hot flushes, 58.3% were abdominally obese, 51.5% hypertension, 25.0% hyperglycemia, 15.7% depressed mood and 29.9% anxiety. A 33.8% presented insomnia according to the AIS (scores 6 or more). The AIS displayed a high internal consistency as computed Cronbach's alpha was determined to be 0.86. Multiple linear regression analysis determined that male premature ejaculation, female psychotropic drug use, hot flush intensity, mood morbidity (higher total HADS scores) and higher parity positively and significantly correlated to higher AIS scores (more insomnia). In this postmenopausal sample insomnia was not related to the METS or its components yet to other psycho-somatic female and partner issues.

Chedraui P ，San Miguel G ，Villacreses D ，Dominguez A ，Jaramillo W ，Escobar GS ，Pérez-López FR ，Genazzani AR ，Simoncini T ，Research Group for the Omega Women's Health Project ... -  《-》