Objective and subjective sleep quality in premenopausal, perimenopausal, and postmenopausal women in the Wisconsin Sleep Cohort Study

Sleep. 2003 Sep;26(6):667-72. doi: 10.1093/sleep/26.6.667.


Study objective: Assess objectively measured sleep quality in premenopausal, perimenopausal, and postmenopausal women.

Design: Observational epidemiology study.

Setting: Community-based.

Participants: Probability sample of 589 premenopausal, perimenopausal, and postmenopausal women recruited from state employee records.

Interventions: None.

Measurements and results: Menopausal status was determined by menstrual history, surgical history, and use of hormone replacement therapy. Sleep quality was objectively measured by full in-laboratory polysomnography and by self-reported sleep problems. Linear and logistic regression were used to estimate associations adjusted for potential confounding factors.

Objective: Sleep quality was not worse in perimenopausal or postmenopausal women, compared with premenopausal women. To the contrary, postmenopausal woman had more deep sleep (16% vs 13% stages 3/4, P < 0.001) and significantly longer total sleep time (388 minutes vs 374 minutes, P = 0.05). Menopausal status was moderately related to self-reported dissatisfaction with sleep but was not consistently associated with symptoms of insomnia or sleepiness.

Conclusions: Menopause is not associated with diminished sleep quality measured by polysomnography. Although perimenopausal and postmenopausal women, relative to premenopausal women, were less satisfied with their sleep, menopause was not a strong predictor of specific sleep-disorder symptoms. Symptoms and signs of sleep abnormalities in midlife women should not be attributed primarily to menopause before ruling out underlying sleep disorders.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Body Mass Index
  • Climacteric / physiology
  • Cohort Studies
  • Female
  • Humans
  • Middle Aged
  • Polysomnography
  • Population Surveillance
  • Postmenopause / physiology
  • Premenopause / physiology*
  • Probability
  • Sleep Apnea Syndromes / epidemiology
  • Sleep Initiation and Maintenance Disorders / diagnosis
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Stages / physiology
  • Vasomotor System / physiology