Vasomotor and depression symptoms may be associated with different sleep disturbance patterns in postmenopausal women.

OBJECTIVE: This study aims to explore the association of vasomotor symptoms (VMS) and depression symptoms with different symptoms of subjective sleep disturbance in postmenopausal women. METHODS: This is a cross-sectional study of 163 postmenopausal women (not taking hormone therapy) attending a university menopause clinic. Measures included the Athens Insomnia Scale, Greene Climacteric Scale, and Symptom Checklist-90-Revised depression subscale. Covariate-adjusted ordinal logistic regression was used to investigate the association of VMS and depression with each item of the Athens Insomnia Scale. RESULTS: Controlling for confounding factors, we found VMS to be significantly associated with awakenings during the night (odds ratio [OR], 1.85; P < 0.001), overall quality of sleep (OR, 2.00; P < 0.001), well-being during the day (OR, 1.63; P = 0.008), functioning capacity during the day (OR, 1.72; P = 0.01), and sleepiness during the day (OR, 1.66; P = 0.03); whereas we found Symptom Checklist-90-Revised depression subscale scores to be associated with sleep induction (OR, 2.09; P < 0.001), final awakening earlier than desired (OR, 2.21; P < 0.001), total sleep duration (OR, 1.62; P = 0.01), overall quality of sleep (OR, 1.64; P = 0.009), well-being during the day (OR, 1.67; P = 0.006), functioning capacity during the day (OR, 1.68; P = 0.01), and sleepiness during the day (OR, 1.57; P = 0.04). CONCLUSIONS: VMS and depression symptoms are associated with different patterns of sleep disturbance. Although both symptoms are related to sleep quality, daytime functioning, and daytime well-being, depression is uniquely associated with difficulty falling asleep and waking up earlier than desired, whereas VMS are related to frequent awakenings during sleep. The findings are limited by the cross-sectional design and relatively small sample size of the study. Recommendations for future research are discussed to guide this line of inquiry and to gain a better understanding of the complex relationship between climacteric and mood symptoms and their contribution to the development of sleep disturbances during menopause.

Additive effect of depressed mood and vasomotor symptoms on postmenopausal insomnia.

OBJECTIVE: The aim of this study was to investigate the role of vasomotor and mood symptoms on insomnia in postmenopausal women. METHODS: One hundred sixty-three postmenopausal women, not receiving hormone therapy, attending a menopause clinic at the University of Athens, Greece, were included in this cross-sectional study. Climacteric symptoms were assessed by Greene's scale, whereas psychological morbidity was measured by Zung Self-Assessment Depression Scale, Symptom Checklist-90-R, and Athens Insomnia Scale. RESULTS: Vasomotor symptoms were significantly associated with insomnia (P = 0.001). When depressive symptomatology was added to the logistic regression analysis, the predictive ability of the model was significantly improved as defined by the increase in the log likelihood (P < 0.001) and the increase in the area under the receiver operating characteristic curve. CONCLUSIONS: Insomnia in postmenopausal women attending a menopause clinic is related both to the effects of vasomotor symptoms and depressive symptomatology. Mood symptoms seem to affect sleep independently of vasomotor symptoms, suggesting that depression should be carefully assessed and treated in postmenopausal women with insomnia.

Quality of life and psychological symptoms in Greek postmenopausal women: association with hormone therapy.

Quality of life (QoL) in menopause is influenced by many parameters, including vasomotor symptoms, psychological status and culture. The aim of the present study was to examine the association of hormone therapy (HT) with QoL and psychological symptoms in Greek postmenopausal women. The study assessed 216 postmenopausal women (mean age 54.5 years) attending a university menopause clinic in Greece. Fifty-three were users of HT and 163 were not. QoL was evaluated by the Utian Quality of Life Scale (UQOL) and psychological symptoms were assessed by the Symptom Checklist-90-R (SCL-90-R). Women on HT were younger and more educated than women not using HT. Adjusting the analysis for the women's characteristics, HT users had better total UQOL scores than non-users (p < 0.05). Marital status and education had independent effects on QoL, with married and more educated women scoring higher (p < 0.05). Assessment of psychological symptomatology, after adjustment for sociodemographic variables across the different dimensions, revealed that HT users had better SCL-90-R scores than non-users for obsessionality, interpersonal sensitivity and for the general index (p < 0.05). Concluding, even though the impact of sociodemographic and lifestyle variables must be factored into the assessment of QoL, HT use is independently related to an improvement in the total score and in most domains of QoL, and has a significant positive effect on many aspects of psychological well-being in Greek postmenopausal women.