Review| Volume 79, ISSUE 4, P401-412, December 2014

Download started.


A systematic review of the longitudinal relationships between subjective sleep disturbance and menopausal stage

Published:September 29, 2014DOI:


      • Self-reported sleep disturbance is a core menopausal symptom.
      • Methodological quality of included studies is overall high.
      • Cultural impact on sleep disturbance and menopausal transition remains unknown.


      Sleep disturbance is a common complaint for women going through the menopausal transition. A previous systematic review and meta-analysis of cross-sectional studies showed a small but significant relationship between self-reported sleep disturbance and menopausal stage and highlighted a possible influence of culture. However, the longitudinal relationship between self-reported sleep disturbance and menopausal transition has not been explored. This paper aimed to review literature on the longitudinal relationship between self-reported sleep disturbance and menopausal transition among community dwelling midlife women. Multiple electronic databases were systematically searched. Literature published prior to 2013 was reviewed. A narrative synthesis was used to analyse the results due to high level of heterogeneity across the included studies. Overall, review of eligible studies showed a small increased risk of self-reported sleep disturbance as women go through the menopausal transition after adjustment of potential confounders. Although the methodological quality of the majority of included studies was classified as high, the impact of culture on this relationship could not be explored, as all of the included studies were conducted in western countries. Like vasomotor symptoms, self-reported sleep disturbance is one of the core menopausal symptoms. Management strategies should be put in place to help women manage sleep disturbance to prevent complications and to improve health related quality of life.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Maturitas
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Phillips B.A.
        • Collop N.A.
        • Drake C.
        • Consens F.
        • Vgontzas A.N.
        • Weaver T.E.
        Sleep disorders and medical conditions in women.
        J Womens Health. 2008; 17: 1191-1199
        • Lindberg E.
        • Janson C.
        • Gislason T.
        • Bjornsson E.
        • Hetta J.
        • Boman G.
        Sleep disturbances in a young adult population: can gender differences be explained by differences in psychological status.
        Sleep. 1997; 20: 381-387
        • Polo-Kantola P.
        Sleep problems in midlife and beyond.
        Maturitas. 2011; 68: 224-232
        • Guidozzi F.
        Sleep and sleep disorders in menopausal women.
        Climacteric. 2013; 16: 214-219
        • Ameratunga D.
        • Goldin J.
        • Hickey M.
        Sleep disturbance in menopause.
        Intern Med J. 2012; 42: 742-747
        • Joffe H.
        • Massler A.
        • Sharkey K.M.
        Evaluation and management of sleep disturbance during the menopause transition.
        Semin Reprod Med. 2010; 28: 404-421
        • Xu Q.
        • Lang C.P.
        Examining the relationship between subjective sleep disturbance and menopause: a systematic review and meta-analysis.
        Menopause, 2014
        • Higgins J.P.
        • Thompson S.G.
        • Deeks J.J.
        • Altman D.G.
        Measuring inconsistency in meta-analyses.
        BMJ. 2003; 327: 557-560
        • Berecki-Gisolf J.
        • Begum N.
        • Dobson A.J.
        Symptoms reported by women in midlife: menopausal transition or aging.
        Menopause. 2009; 16: 1021-1029
        • Dennerstein L.
        • Lehert P.
        • Guthrie J.R.
        • Burger H.G.
        Modeling women's health during the menopausal transition: a longitudinal analysis.
        Menopause. 2007; 14: 53-62
        • Kravitz H.M.
        • Zhao X.
        • Bromberger J.T.
        • Gold E.B.
        • Hall M.H.
        • Matthews K.A.
        • et al.
        Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women.
        Sleep. 2008; 31: 979-990
        • Owens J.F.
        • Matthews K.A.
        Sleep disturbance in healthy middle-aged women.
        Maturitas. 1998; 30: 41-50
        • Pien G.W.
        • Sammel M.D.
        • Freeman E.W.
        • Lin H.
        • DeBlasis T.L.
        Predictors of sleep quality in women in the menopausal transition.
        Sleep. 2008; 31: 991-999
        • Woods N.F.
        • Mitchell E.S.
        Sleep symptoms during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women's Health Study.
        Sleep. 2010; 33: 539-549
        • Young T.
        • Rabago D.
        • Zgierska A.
        • Austin D.
        • Laurel F.
        Objective and subjective sleep quality in premenopausal, perimenopausal, and postmenopausal women in the Wisconsin Sleep Cohort Study.
        Sleep. 2003; 26: 667-672
        • Tom S.E.
        • Kuh D.
        • Guralnik J.M.
        • Mishra G.D.
        Self-reported sleep difficulty during the menopausal transition: results from a prospective cohort study.
        Menopause. 2010; 17: 1128-1135
        • Twisk J.W.R.
        Applied longitudinal data analysis for epidemiology: a practical guide.
        Cambridge University Press, New York, NY2003
        • Bhattacharya S.M.
        • Jha A.
        A comparison of health-related quality of life (HRQOL) after natural and surgical menopause.
        Maturitas. 2010; 66: 431-434