Menopause Linked to Increase in Sleep-Onset Insomnia

Postmenopausal women more often have sleep-onset insomnia disorder and are more likely to screen positive for obstructive sleep apnea, according to a study published online in Menopause.

Sheida Zolfaghari, M.D., from McGill University in Montreal, and colleagues selected women aged 45 to 60 years with self-reported menopause status from the Canadian Longitudinal Study of Aging to compare sleep disorders according to menopause status. Data were included for 6,179 women: 60.1 and 39.9 percent were postmenopausal and pre/perimenopausal, respectively.

The researchers found that postmenopausal women more often reported requiring ≥30 minutes to fall asleep compared with pre/perimenopausal women (20.4 versus 15.5 percent; adjusted odds ratio, 1.24; 95 percent confidence interval [CI], 1.00 to 1.53); they were also more likely to meet criteria for possible sleep-onset insomnia disorder (10.8 versus 7.3 percent; adjusted odds ratio, 1.51; 95 percent CI, 1.07 to 2.12). The likelihood of screening positive for obstructive sleep apnea was increased for postmenopausal women (14.6 versus 10.4 percent; adjusted odds ratio, 1.48; 95 percent CI, 1.14 to 1.92). No differences were seen between the groups for sleep dissatisfaction, daytime somnolence disorder, sleep-maintenance insomnia disorder, restless legs syndrome, or rapid eye movement sleep behavior disorder.

"Postmenopausal status was associated with a higher occurrence of sleep-onset insomnia," the authors write. "Moreover, insomnia symptoms tended to begin in the years soon before and after menopause, indicating a temporal link between menopause and insomnia."

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