Abstract
Sleep disorders that occur around the time of menopause are the main symptoms of climacteric syndrome, as well as being an effect of aging. The main cause of this problem is yet to be determined. We have therefore studied the frequency and severity of sleep disorders, using subjective rating scales correlated with other symptoms, and have assessed the effectiveness of hormone replacement therapy (HRT) by menopausal index and sleep log. We examined 275 patients, 77 with climacteric syndrome (C group : age range 46-55, mean 51.3 years), and 198 general gynecology patients with nonmenopausal symptoms (N group : age range 45-57, mean 52.7 years). The results were as follows: 1) In the C group, 37.8% of the patients had difficulty going to sleep (DCS) and 36.0% had difficulty staying asleep (DSA). In the N group, these figures were 12.4% and 10.4%, respectively. The number of patients affected was significantly higher in the C group than in the N group (p<0.001). These sleep disorders were found to be characteristic symptoms of climacteric syndrome. 2) There was a strong correlation (r>0.5) between the symptom of DCS and those of DSA, nervousness, irritability, melancholia, headache and palpitation call symptoms of menopause. There was a similar correlation between DSA and the symptoms of melancholia, nervousness and irritability. 3) HRT caused a marked improvement in those patients suffering from DCS (p<0.001) and DSA (p<0.005). 4) The sleep log evaluation showed that the ratio of deep sleep to total time in bed in the C group was significantly small (vs. N group) and the patients felt less refreshed for their sleep. In the C group, HRT caused an improvement sleep quality so that it equalled that of the N group. These results suggest that the main changes in the sleep patterns of menopausal women are linked to the rapid endocrinological changes of peri and post-menopause, in the same way as vasomotor symptoms such as, for example, hot flushes.
