Department of Psychology, Sungshin University, Seoul, Republic of Korea.
Korea University Ansan Hospital, Institute of Human Genomic Study, Ansan, Korea.
Menopause. 2019 Apr;26(4):357-364. doi: 10.1097/GME.0000000000001257.
Women who undergo surgical menopause (SM) experience a relatively more acute and precipitous drop of estrogen compared with women who experience natural menopause (NM). Few studies, however, have compared sleep quality in women who experience natural versus SM.
Participants were 526 postmenopausal women (mean age 60.2 ± 7.64). All participants completed self-report questionnaires about insomnia symptoms, sleep-interfering behaviors, depression, sleep quality, and gynecological history. Analysis of covariance was conducted to compare women who experienced NM versus SM on sleep variables. Logistic regression analysis was used to determine whether NM or SM groups predicted insomnia status. Regression-based moderation analysis was conducted to explore the moderating effect of type of menopause on the relationship between sleep-interfering behaviors and insomnia symptoms.
Among the sample, 81.6% (n = 429) reported going through NM and 18.4% (n = 97) reported going through SM. The SM group was significantly younger by 7.2 years (P < 0.001). Women in the SM group reported significantly worse sleep quality (P = 0.007), especially for sleep duration (P = 0.001) and habitual sleep efficiency (P = 0.010) compared with women in the NM group. Regression analysis indicated that individuals in the SM group were 2.131 (95% CI 1.055-4.303) times more likely to have insomnia compared with the NM group (P = 0.027). In addition, women in the SM group who displayed more sleep-interfering behaviors also had a higher severity of insomnia symptoms compared with women who experience NM (ß = 0.26, P = 0.03).
Menopause can be both physically and psychologically challenging, but women who undergo SM experience worse sleep quality compared with women who experience NM, and may benefit from behavioral interventions.
与经历自然绝经（NM）的女性相比，接受手术绝经（SM）的女性体内雌激素水平会经历更急剧、更陡峭的下降。然而，鲜有研究比较经历自然绝经和 SM 的女性的睡眠质量。
参与者为 526 名绝经后女性（平均年龄 60.2±7.64 岁）。所有参与者均完成了关于失眠症状、干扰睡眠行为、抑郁、睡眠质量和妇科病史的自我报告问卷。采用协方差分析比较经历 NM 和 SM 的女性在睡眠变量上的差异。采用逻辑回归分析确定 NM 或 SM 组是否预测失眠状态。采用基于回归的调节分析来探讨绝经类型对干扰睡眠行为与失眠症状之间关系的调节作用。
在样本中，81.6%（n=429）报告经历 NM，18.4%（n=97）报告经历 SM。SM 组的年龄显著年轻 7.2 岁（P<0.001）。与 NM 组相比，SM 组的女性睡眠质量明显更差（P=0.007），尤其是在睡眠时间（P=0.001）和习惯性睡眠效率（P=0.010）方面。回归分析表明，与 NM 组相比，SM 组的个体发生失眠的可能性高 2.131 倍（95%CI 1.055-4.303）（P=0.027）。此外，与经历 NM 的女性相比，SM 组中表现出更多干扰睡眠行为的女性也有更严重的失眠症状（β=0.26，P=0.03）。
绝经既会带来身体上的挑战，也会带来心理上的挑战，但与经历 NM 的女性相比，经历 SM 的女性睡眠质量更差，可能受益于行为干预。
