Objective: The aim of this study was to determine the role of personality factors in the development of DSM-IV insomnia coincident with perimenopause.
Methods: Perimenopausal women (35 women with DSM-IV insomnia and 28 women with self-reported normal sleep) underwent clinical assessments and completed menopause-related questionnaires, the NEO Five Factor Inventory and the Structured Interview for DSM-IV Personality. Logistic regressions determined whether personality factors and hot flash–related interference were associated with an insomnia diagnosis concurrent with the menopausal transition.
Results: Women with insomnia reported higher neuroticism, lower agreeableness, and lower conscientiousness than controls on the NEO Five Factor Inventory. Moreover, women with insomnia were more likely to meet DSM-IV criteria for cluster C personality disorders, particularly obsessive-compulsive personality disorder, on the Structured Interview for DSM-IV Personality. Women with insomnia were more likely to have had a past depressive episode and a history of severe premenstrual symptoms. Findings from regressions revealed that higher neuroticism and greater interference from hot flashes were associated with insomnia classification even after controlling for history of depression, suggesting that sensitivity to hot flashes and a greater degree of neuroticism are independent contributors toward establishing which women are most likely to have sleep problems during perimenopause.
Conclusions: Findings show the relevance of personality factors, particularly neuroticism and obsessive-compulsive personality, to a woman’s experience of insomnia as she goes through the menopausal transition.