Menstrual status in women and sleep-related outcomes

Background: There is limited knowledge about how menstrual status may influence sleep related outcomes. We aimed to investigate whether irregular menstruation and menopause affect sleep related symptoms including insomnia and gastroesophageal reflux, Methods: A population-based sample of 8588 women aged 25-55 years answering the Respiratory Health In Northern Europe (RHINE) postal questionnaire were analyzed. Logistic regression models were adjusted for BMI, age, smoking history and socioeconomic status. Results: Women reporting irregular menstruations had significantly more sleep-related symptoms (reflux after going to bed OR=1.67 [1.30 - 2.15], difficulty falling asleep (DIS) 1.42 [1.11 - 1.80], difficulty maintaining sleep (DMS) 1.44 [1.23 - 1.70], excessive daytime sleepiness (EDS) 1.27 [1.08 - 1.48] and early morning awakening (EMA) 1.45 [1.15 - 1.82]) than women menstruating regularly. Menopausal women had significantly higher risk of sleep-related symptoms (reflux after going to bed OR=1.43 [1.07 - 1.90], DIS 2.04 [1.58 - 2.63], DMS 1.87 [1.57 – 2.23], EDS 1.44 [1.21 - 1.73] and EMA 1.73 [1.38 - 2.17]) than premenopausal women. Conclusions: Sleep quality among women was significantly related to menstrual status; women with irregular menstruations and menopausal women suffered from more sleep-related symptoms with insomnia and gastroesophageal reflux.