Poor sleep in relation to natural menopause: a population-based 14-year follow-up of midlife women.
Poor sleep in relation to natural menopause: a population-based 14-year follow-up of midlife women.
复制标题
与自然更年期相关的睡眠不佳：中年妇女的14年随访。
DOI：
10.1097/gme.0000000000000392
复制
发表时间：
2015-07
期刊：
影响因子：
--
通讯作者：
Pien GW
中科院分区：
文献类型：
--
作者：
Freeman EW;Sammel MD;Gross SA;Pien GW
评估中年女性与末次月经 (FMP) 相关的中度/重度睡眠不佳的患病率和预测因素。年度评估是在 255 名女性的人群中进行的。所有患者在队列入组时均处于绝经前，并在 16 年随访期间达到自然绝经。结果衡量标准是睡眠不良的严重程度，由参与者在 16 年来的年度访谈中报告并根据 FMP 进行评估。中度/重度睡眠不足的年度患病率大致在 28% 至 35% 之间，相对于总体样本的 FMP，任何年份都没有显着差异。当以绝经前基线对睡眠状态进行分层时，绝经前睡眠状态强烈预测 FMP 周围的睡眠质量不佳。在调整分析中，与基线时没有睡眠不良的女性相比，绝经前中度/重度睡眠不良的女性在更年期前后出现中度/重度睡眠不良的可能性大约高出 3.5 倍（OR 3.58，95% CI：2.50-5.11，P<0.0001），而绝经前轻度睡眠不良的女性在绝经前后出现中度/重度睡眠不良的可能性大约高出 1.5 倍。更年期（OR 1.57，95% CI： 0.99-2.47，P=0.053）。在绝经前基线没有睡眠不良的女性中，睡眠不良与相对于 FMP 的时间之间没有显着相关性。潮热与睡眠不良显着相关（OR 1.79，95% CI：1.44-2.21，调整分析中 P<0.0001），但与基线睡眠严重程度没有交互作用（交互作用 P=0.25），表明无论基线睡眠状态如何，潮热都会导致睡眠不良。研究结果显示，中年女性中度/重度睡眠质量不佳的患病率很高，只有一小部分“高危”亚组的睡眠质量相对于 FMP 显着增加。绝经前基线的睡眠状态和并发的潮热强烈且一致地预示着绝经过渡期的睡眠质量不佳。总体而言，睡眠质量不佳在 FMP 前后并没有增加，并且经常发生在没有潮热的情况下，这表明一般健康女性在更年期过渡期间的睡眠困难不仅仅与卵巢衰退有关。
To estimate the prevalence and predictors of moderate/severe poor sleep in relation to the final menstrual period (FMP) of mid-life women. Annual assessments were conducted in a population-based cohort of 255 women. All were premenopausal at cohort enrollment and reached natural menopause during the 16-year follow-up. The outcome measure was the severity of poor sleep, as reported by the participants in annual interviews for 16 years and evaluated in relation to the FMP. The annual prevalence of moderate/severe poor sleep largely ranged from about 28% to 35%, with no significant differences in any year relative to the FMP for the sample overall. When sleep status was stratified at the premenopausal baseline, the premenopausal sleep status strongly predicted poor sleep around the FMP. Women with moderate/severe poor sleep when premenopausal were approximately 3 ½ times more likely to have moderate/severe poor sleep around menopause compared to those with no poor sleep at baseline in adjusted analysis (OR 3.58, 95% CI: 2.50-5.11, P<0.0001), while mild poor sleepers premenopause were approximately 1 ½ times more likely to have moderate/severe poor sleep around menopause (OR 1.57, 95% CI: 0.99-2.47, P=0.053). There was no significant association between poor sleep and time relative to the FMP among women who had no poor sleep at the premenopausal baseline. Hot flashes were significantly associated with poor sleep (OR 1.79, 95% CI: 1.44-2.21, P<0.0001 in adjusted analysis), but had no interaction with baseline sleep severity (interaction P=0.25), indicating that hot flashes contributed to poor sleep regardless of baseline sleep status. The findings showed a high prevalence of moderate/severe poor sleep in mid-life women, with only a small “at risk” subgroup having a significant increase in poor sleep in relation to the FMP. Sleep status at the premenopausal baseline and concurrent hot flashes strongly and consistently predicted poor sleep in the menopause transition. Overall, poor sleep did not increase around the FMP and frequently occurred in the absence of hot flashes, indicating that sleep difficulties in the menopause transition in generally healthy women were not simply associated with ovarian decline.