Background. Subjective sleep disturbances increase during menopause. Some problems commonly encountered during menopause, such as hot flushes and sweating at night, can cause women to have difficulty in sleeping. These complaints can influence quality of life of menopausal women. Methods. This cross-sectional study was performed on menopausal women attending health centers in Qazvin for periodic assessments. We measured excessive daytime sleepiness by Epworth sleepiness scale (ESS), obstructive sleep apnea (OSA) by the Berlin questionnaire, and insomnia by the insomnia severity index (ISI). We evaluate quality of life by the Menopause specific quality of life questionnaire (MENQOL). Results. A total of 380 menopausal women entered the study. Mean age of participated women was 57.6 ± 6.02. Mean duration of menopause was 6.3 ± 4.6. The frequency of severe and moderate insomnia was 8.4% (32) and 11.8% (45). Severe daytime sleepiness (ESS？≥？10) was present in 27.9% (80) of the participants. Multivariate analytic results show that insomnia and daytime sleepiness have independent negative impact on each domain and total score of MENQOL questionnaire. Conclusion. According to our findings, EDS and insomnia are frequent in menopausal women. Both EDS and insomnia have significant quality of life impairment. 1. Introduction Across the lifespan, sleep disturbances are more prevalent in women than men. Pregnancy, menstrual-related fluctuations, and the menopause may cause high prevalence of sleep disturbances in women [1–3]. Sleep disorders are more common during the menopausal transition as compared to premenopausal years [4]. During the menopause, progressive decline in estrogen and progesterone levels are frequently related to vasomotor symptoms, night sweats, fatigue, mood alterations, irritability, headache, palpitation, and sleep disorders [5, 6]. These symptoms may be subtle to severe and disabling. Sleeping disturbances are among the most frequent health complaints of women during menopause. They include disorders such as difficulty of falling asleep, fractioned sleep, night-time awakening, inability of resuming sleep, problems in waking up, fatigue, and daytime sleepiness [7, 8]. Insomnia is a common disorder in menopausal women with the prevalence of 28–63% based on different studies [9]. Many women, during the menopause, achieve less than 6？h of sleep on a regular basis, becoming at higher risk for short-term and long-term problems. The main effects of short-term sleep deprivation include anxiety, drowsiness, memory and cognitive impairment, and stressed
References
[1]
P. A. Minarik, “Sleep disturbance in midlife women,” Journal of Obstetric, Gynecologic, and Neonatal Nursing, vol. 38, no. 3, pp. 333–343, 2009.
[2]
C. M. Morin, R. R. Bootzin, D. J. Buysse, J. D. Edinger, C. A. Espie, and K. L. Lichstein, “Psychological and behavioral treatment of insomnia: update of the recent evidence (1998–2004),” Sleep, vol. 29, no. 11, pp. 1398–1414, 2006.
[3]
M. M. Ohayon, “Epidemiology of insomnia: what we know and what we still need to learn,” Sleep Medicine Reviews, vol. 6, no. 2, pp. 97–111, 2002.
[4]
C. A. Landis and K. E. Moe, “Sleep and menopause,” Nursing Clinics of North America, vol. 39, no. 1, pp. 97–115, 2004.
[5]
R. Luoto, “Hot flushes and quality of life during menopause,” BMC Women's Health, vol. 9, article 13, 2009.
[6]
N. Kalleinen, O. Polo, S. L. Himanen, A. Joutsen, A. S. Urrila, and P. Polo-Kantola, “Sleep deprivation and hormone therapy in postmenopausal women,” Sleep Medicine, vol. 7, no. 5, pp. 436–447, 2006.
[7]
R. R. Freedman, “Hot flashes: behavioral treatments, mechanisms, and relation to sleep,” The American Journal of Medicine, vol. 118, no. 12, supplement 2, pp. 124s–130s, 2005.
[8]
H. Xu, R. C. Thurston, K. A. Matthews et al., “Are hot flashes associated with sleep disturbance during midlife? Results from the STRIDE cohort study,” Maturitas, vol. 71, no. 1, pp. 34–38, 2012.
[9]
H. Hachul, L. R. A. Bittencourt, J. M. Soares, S. Tufik, and E. C. Baracat, “Sleep in post-menopausal women: differences between early and late post-menopause,” European Journal of Obstetrics & Gynecology and Reproductive Biology, vol. 145, no. 1, pp. 81–84, 2009.
[10]
M. Arakane, C. Castillo, M. F. Rosero, R. Pe？afiel, F. R. Pérez-López, and P. Chedraui, “Factors relating to insomnia during the menopausal transition as evaluated by the Insomnia Severity Index,” Maturitas, vol. 69, no. 2, pp. 157–161, 2011.
[11]
R. D. Chervin, “Sleepiness, fatigue, tiredness, and lack of energy in obstructive sleep apnea,” Chest, vol. 118, no. 2, pp. 372–379, 2000.
[12]
P. S. Eichling and J. Sahni, “Menopause related sleep disorders,” Journal of Clinical Sleep Medicine, vol. 1, no. 3, pp. 291–300, 2005.
[13]
F. Kapsimalis and M. H. Kryger, “Gender and obstructive sleep apnea syndrome, part 1: clinical features,” Sleep, vol. 25, no. 4, pp. 409–416, 2002.
[14]
T. Young, D. Rabago, A. Zgierska, D. Austin, and L. Finn, “Objective and subjective sleep quality in premenopausal, perimenopausal, and postmenopausal women in the Wisconsin Sleep Cohort Study,” Sleep, vol. 26, no. 6, pp. 667–672, 2003.
[15]
G. W. Pien, M. D. Sammel, E. W. Freeman, H. Lin, and T. L. DeBlasis, “Predictors of sleep quality in women in the menopausal transition,” Sleep, vol. 31, no. 7, pp. 991–999, 2008.
[16]
P. Chedraui, F. R. Pérez-López, M. Mendoza et al., “Factors related to increased daytime sleepiness during the menopausal transition as evaluated by the Epworth Sleepiness Scale,” Maturitas, vol. 65, no. 1, pp. 75–80, 2010.
[17]
B. Fortner, E. Stepanski, S. Wang, et al., “Sleep and quality of life in breast cancer patients,” Journal of Pain and Symptom Management, vol. 24, no. 5, pp. 471–480, 2002.
[18]
C. Koopman, B. Nouriani, V. Erickson et al., “Sleep disturbances in women with metastatic breast cancer,” The Breast Journal, vol. 8, no. 6, pp. 362–370, 2002.
[19]
C. Piperidou, A. Karlovasitou, N. Triantafyllou et al., “Influence of sleep disturbance on quality of life of patients with epilepsy,” Seizure, vol. 17, no. 7, pp. 588–594, 2008.
[20]
M. J. Hynninen, S. Pallesen, and I. H. Nordhus, “Factors affecting health status in COPD patients with co-morbid anxiety or depression,” International Journal of Chronic Obstructive Pulmonary Disease, vol. 2, no. 3, pp. 323–328, 2007.
[21]
S. Timur and N. H. Sahin, “Effects of sleep disturbance on the quality of life of Turkish menopausal women: a population-based study,” Maturitas, vol. 64, no. 3, pp. 177–181, 2009.
[22]
S. Taavoni, N. Ekbatani, and H. Haghani, “Sleep disturbances and its related factors in menopausal women,” Behbood, vol. 15, no. 4, pp. 272–277, 2011.
[23]
H. Fallahzadeh, “Quality of life after the menopause in Iran: a population study,” Quality of Life Research, vol. 19, no. 6, pp. 813–819, 2010.
[24]
Z. Yazdi, Kh. Sadeghniiat-Haghighi, M. A. Zohal, and Kh. Elmizadeh, “Validity and reliability of the Iranian version of the Insomnia Severity Index,” The Malaysian Journal of Medical Sciences, vol. 19, no. 4, pp. 32–37, 2012.
[25]
Kh. Sadeghniiat Haghighi, A. Montazeri, A. K. Mehrizi et al., “The Epworth Sleepiness Scale: translation and validation study of the Iranian version,” Sleep and Breathing, vol. 17, no. 1, pp. 419–426, 2012.
[26]
R. Ghanei, M. Hemmati, and S. Ghosi, “Obstructive sleep apnea and metabolic syndrome in hemodialysis patients,” Urmia Journal of Medical Sciences, vol. 22, no. 4, pp. 339–345, 2011 (Persian).
[27]
H. Fallahzade, A. Dehghani Tafti, M. Dehghani Tafti, F. Hoseini, and H. Hoseini, “Factors affecting quality of life after menopause in women, Yazd 2008,” Journal of Shaheed Sadoghi University of Medical Sciences, vol. 18, no. 6, pp. 552–558, 2011 (Persian).
[28]
H. Joffe, A. Massler, and K. M. Sharkey, “Evaluation and management of sleep disturbance during the menopause transition,” Seminars in Reproductive Medicine, vol. 28, no. 5, pp. 404–421, 2010.
[29]
M. B. Scharf, M. D. McDannold, R. Stover, N. Zaretsky, and D. V. Berkowitz, “Effects of estrogen replacement therapy on rates of cyclic alternating patterns and hot-flush events during sleep in postmenopausal women: a pilot study,” Clinical Therapeutics, vol. 19, no. 2, pp. 304–311, 1997.
[30]
C. R. Schubert, K. J. Cruickshanks, D. S. Dalton, B. E. K. Klein, R. Klein, and D. M. Nondahl, “Prevalence of sleep problems and quality of life in an older population,” Sleep, vol. 25, no. 8, pp. 889–893, 2002.
