Role of age, menopausal status, and symptoms in midlife women: Examination of sleep patterns and rest-activity circadian rhythms

Szu Yu Hou, Ching Ju Chiu, Jeanne Laraine Shea, Chih Liang Wang, Hsiao Han Tang, Po Ching Kuo, Yi Chieh Yang, Chih Hsing Wu

Research output: Contribution to journalArticlepeer-review


Background: Midlife women experience menopausal transition at different ages with a variety of symptoms. This study aimed to identify the effects of age, menopausal status, and symptoms in women on their actigraphy-based sleep patterns and circadian rhythms. Methods: A total of 87 women aged 45–60 from the community and a gynecology clinic in Taiwan who had their sleep and circadian rhythms recorded with a 7-day actigraphy were analyzed. Multiple linear regression was used to estimate the association of age, menopausal status, and symptoms with sleep parameters and circadian rhythms. Results: A sleep efficiency below 85 % was observed in 46.0 % of women, and those with severe somatic-vegetative or psychological symptoms tended to have problems with sleep latency (β = 0.22 and β = 0.42, respectively) and efficiency (β = −0.26 and β = −0.36, respectively). Women with more severe urogenital symptoms only experienced significantly longer sleep latency (β = 0.33). There was a weak correlation between circadian rhythms and symptoms. Additionally, perimenopausal (β = 0.30 and β = 0.35, respectively) and late postmenopausal (β = 0.67 and β = 0.59, respectively) women had higher relative amplitude and stability in circadian rhythms than premenopausal women. Age had no significant effect on sleep parameters or circadian rhythms. Conclusions: Premenopausal women had the most unstable day-to-day rhythms compared to their peri- and postmenopausal counterparts. Women with higher somatic-vegetative, psychological, and urogenital symptoms showed greater sleep problems. Psychological symptoms (e.g., depression, irritability, anxiety, exhaustion) were the strongest predictors for all sleep parameters. The mechanisms underlying these associations warrant investigation.

Original languageEnglish
Pages (from-to)172-179
Number of pages8
JournalSleep Medicine
Publication statusPublished - 2024 Jan

All Science Journal Classification (ASJC) codes

  • General Medicine


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