Sleep disorders in menopause: preliminary data from sicily in a multicenter italian study.

ABSTRACT Introduction Menopause in the female life cycle is a special period due to important hormonal, physical and phychological changes. Sleep is altered in 30% to 50% of this population, the most common causes being hot flashes, mood and sleep related breathing disorders (SRBD). We aimed at evaluating the prevalence, symptoms, risk factors and comorbidity of sleep disorders in a population of working women employed in two main Sicilian hospitals. Methods Questionnaires were sent out to all employed women, age 45-55. Subjects filling correctly the questionnaire were enrolled in our study. Questions included screening on menarche, menstrual cycle, fertility, parity, and menopause, life habits, personal medical and sleep history and related treatment. Self-administered scales evaluated: sleep quality (PSQI), excessive daytime sleepiness (EDS) by the Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HARS), quality of life (SF-36 2v), IRLS diagnostic interview and Rating Scale. Uni and multivariate analysis were applied. Results Only 92 women out of 1000 probands completed their questionnaire. Mean age was 50.4 years, mean BMI 25.06, mean parity index 2.8; 37.6% menopausal. Migraine, hypertension, cardiac or thyroid disorders respectively in 57.6%, 16.5%, 2.8%, 8.3%; HRT in 16.9%. 22.8% reported snoring, 16.7% apneas, 2.8% sleepwalking, 28.2% periodic leg movements during sleep. 59.2% reported impaired sleep quality, 11% EDS (ESS≥10), 14.1% RLS symptoms with a mean IRLS-RS 16.2. BDI indicated a mood alteration in 35.8%. Unfortunately answers on hot flashes occurrence were incomplete and not suitable for statistical evaluation. Multivariate analysis showed a positive correlation of BDI score with hypertension (p=0.005, OR 1.1) and RLS (p=0.001, OR 1.1). Conclusion Our preliminary data indicated insufficient awareness/education and/or stigmata about hot flashes and relatively high rate of SRBD and RLS, the latter significantly associated with depression and hypertension.