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Are vasomotor symptoms associated with sleep characteristics among symptomatic midlife women? Comparisons of self-report and objective measures

Thurston, Rebecca C. PhD; Santoro, Nanette MD; Matthews, Karen A. PhD

doi: 10.1097/gme.0b013e3182422973
Original Articles
Editorial

Objective: Many women report vasomotor symptoms (VMS) and sleep problems during the menopausal transition. Although reported VMS are consistently related to reported sleep disturbance, findings using physiologic measures of VMS or sleep have been more mixed. Our objective was to examine whether more VMS during sleep are associated with poorer sleep among midlife women with VMS using physiologic measures of both VMS and sleep.

Methods: A subcohort of participants (N = 52) with VMS, a uterus and both ovaries, and free of medications affecting VMS from the Pittsburgh site of the Study of Women’s Health Across the Nation underwent four 24-hour periods of in-home ambulatory VMS and sleep measurement. Measures included sternal skin conductance for the measurement of VMS, actigraphy for assessing sleep, a VMS diary, and a sleep diary completed before bed and upon waking. Associations between VMS and sleep were evaluated using generalized estimating equations with covariates age, body mass index, medications affecting sleep, race, financial strain, and depressive symptoms.

Results: More VMS recalled upon waking were associated with significantly lower actigraphy-assessed sleep efficiency, significantly higher wakefulness after sleep onset, and somewhat longer sleep latency. Conversely, physiologically measured VMS and VMS reported during the night were largely unrelated to sleep characteristics.

Conclusions: Associations between VMS and sleep may depend more on the awareness of and recall of VMS rather than solely on their physiologic occurrence.

More vasomotor symptoms (VMS) recalled upon waking were associated with significantly lower actigraphic sleep efficiency, higher wakefulness after sleep onset, and somewhat longer sleep latency. Conversely, physiologically measured VMS and VMS reported during the night were largely unrelated to sleep characteristics.

From the 1Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA; 2Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; and 3Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Denver, CO.

Received October 4, 2011; revised and accepted November 14, 2011.

Funding/support: The Study of Women’s Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), Department of Health and Human Services, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women’s Health (ORWH; Grants NR004061, AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, and AG012495). This work was additionally supported by the NIH through the NIA (Grant AG029216 to R.C.T.).

The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH, or the NIH.

Financial disclosure/conflicts of interest: Dr. Santoro has stock options in Menogenix.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.menopause.org).

Address correspondence to: Rebecca C. Thurston, PhD, Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA. E-mail: thurstonrc@upmc.edu

© 2012 by The North American Menopause Society.