Summary
The Tom et al study reveals that menopause status is imperfectly related to perceived sleep quality in women transitioning through to menopause. In the women classed by how bothersome they reported their sleep to be, menopause status (assumed HPO axis hormone changes) seemed to highly affect the odds of reporting sleep distress in a portion (one group and the smallest group). Perhaps, equivocal findings from other studies regarding menopausal transition status and perceived sleep quality stem from inadequate characterization of contributing factors and identification of clusters of factors as defining of subgroups. As I have editorially commented before, in the context of transition to menopause, multiple factors in varying configurations in different women are likely to be explanatory for what contributes to perceived sleep quality. Such factors will include a variety of psychosocial ones (eg, life strain, affectivity, social milieu, and family history) along with biological factors (eg, genetic propensity, anthropometrics, and hormonal fluctuations).

###
Shaver, Joan L.F. PhD, RN, FAAN
University of Arizona, Tucson, Arizona
Financial disclosure/conflicts of interest: None reported.

###

REFERENCES

1. Tom SE, Kuh D, Guralnik JM, Mishra G. Self-reported sleep difficulty during the menopausal transition: results from a prospective cohort study. Menopause 2010;17:1128-1135.
2. Dijk DJ. Slow-wave sleep deficiency and enhancement: implications for insomnia and its management. World J Biol Psychiatry 2010;11:22-28.
3. Pinkerton JV, Stovall DW. Reproductive aging, menopause, and health outcomes. Ann N Y Acad Sci 2010;1204:169-178.
4. Hale GE, Burger HG. Hormonal changes and biomarkers in late reproductive age, menopausal transition and menopause. Best Pract Res Clin Obstet Gynaecol 2009;23:7-23.
5. Soules MR, Sherman S, Parrott E, et al. Executive summary: Stages of Reproductive Aging Workshop (STRAW). Climacteric 2001;4:267-272.
6. Soares CN, Zitek B. Reproductive hormone sensitivity and risk for depression across the female life cycle: a continuum of vulnerability? J Psychiatry Neurosci 2008;33:331-343.
7. Moe KE. Hot flashes and sleep in women. Sleep Med Rev 2004;8:487-497.
8. Pien GW, Sammel MD, Freeman EW, Lin H, DeBlasis TL. Predictors of sleep quality in women in the menopausal transition. Sleep 2008;31:991-999.