Kravitz Howard M, Ganz Patricia A, Bromberger Joyce, Powell Lynda H, Sutton-Tyrrell Kim, Meyer Peter M
Department of Psychiatry, Rush Medical College, Chicago, IL, USA.
Menopause. 2003 Jan-Feb;10(1):19-28. doi: 10.1097/00042192-200310010-00005.
To compare age-adjusted and ethnic differences in prevalences of sleep difficulty at various stages of the menopausal transition and to determine the relative contribution of other factors, including vasomotor symptoms, sociodemographics, and psychological and physical health factors, to self-reported sleep difficulty in middle-aged women.
A community-based survey of women's health and menopausal symptoms was conducted between November 1995 and October 1997 at each of the seven US sites participating in the Study of Women's Health Across the Nation. A multiethnic sample of 12,603 Caucasian, African American, Chinese, Japanese, and Hispanic women aged 40 to 55 years was categorized into six groups: premenopausal, early perimenopausal, late perimenopausal, naturally postmenopausal, surgically postmenopausal, and postmenopausal receiving hormone replacement therapy. The women were asked whether they had experienced difficulty sleeping in the past 2 weeks.
Difficulty sleeping was reported by 38%. Age-adjusted rates were highest in the late perimenopausal (45.4%) and surgically postmenopausal (47.6%) groups. Among ethnic groups, rates ranged from 28% in Japanese women to 40% in Caucasian women. In the multivariate analysis, menopausal status was significantly associated with difficulty sleeping. Ethnicity, vasomotor and psychological symptoms, self-perceived health and health behaviors, arthritis, and education also were significantly associated with difficulty sleeping.
These results suggest that stage of the menopausal transition, independent of other potential explanatory factors, is associated with self-reported sleep difficulty. Older age per se was not significantly associated with difficulty sleeping.
比较绝经过渡各阶段睡眠困难患病率的年龄调整差异和种族差异，并确定血管舒缩症状、社会人口统计学以及心理和身体健康因素等其他因素对中年女性自我报告的睡眠困难的相对影响。
1995年11月至1997年10月期间，在美国参与全国女性健康研究的七个地点，对女性健康和绝经症状进行了一项基于社区的调查。对12603名年龄在40至55岁之间的白种人、非裔美国人、华裔、日裔和西班牙裔女性的多民族样本进行分类，分为六组：绝经前、围绝经期早期、围绝经期晚期、自然绝经后、手术绝经后以及接受激素替代疗法的绝经后女性。询问这些女性在过去2周内是否有睡眠困难。
38%的女性报告有睡眠困难。年龄调整后的患病率在围绝经期晚期（45.4%）和手术绝经后组（47.6%）最高。在不同种族中，患病率从日本女性的28%到白种女性的40%不等。在多变量分析中，绝经状态与睡眠困难显著相关。种族、血管舒缩和心理症状、自我感知的健康和健康行为、关节炎以及教育程度也与睡眠困难显著相关。
这些结果表明，绝经过渡阶段，独立于其他潜在解释因素，与自我报告的睡眠困难相关。年龄本身与睡眠困难无显著关联。
