TY - JOUR
T1 - The role of sleep difficulties in the vasomotor menopausal symptoms and depressed mood relationships
T2 - An international pooled analysis of eight studies in the InterLACE consortium
AU - Chung, Hsin Fang
AU - Pandeya, Nirmala
AU - Dobson, Annette J.
AU - Kuh, Diana
AU - Brunner, Eric J.
AU - Crawford, Sybil L.
AU - Avis, Nancy E.
AU - Gold, Ellen B.
AU - Mitchell, Ellen S.
AU - Woods, Nancy F.
AU - Bromberger, Joyce T.
AU - Thurston, Rebecca C.
AU - Joffe, Hadine
AU - Yoshizawa, Toyoko
AU - Anderson, Debra
AU - Mishra, Gita D.
N1 - Funding Information:
National Institute of Nursing Research (NINR) and the NIH Office of Research on Women's Health (ORWH) (Grants U01NR004061
Publisher Copyright:
Copyright © Cambridge University Press 2018Â.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Background Many women experience both vasomotor menopausal symptoms (VMS) and depressed mood at midlife, but little is known regarding the prospective bi-directional relationships between VMS and depressed mood and the role of sleep difficulties in both directions.Methods A pooled analysis was conducted using data from 21 312 women (median: 50 years, interquartile range 49-51) in eight studies from the InterLACE consortium. The degree of VMS, sleep difficulties, and depressed mood was self-reported and categorised as never, rarely, sometimes, and often (if reporting frequency) or never, mild, moderate, and severe (if reporting severity). Multivariable logistic regression models were used to examine the bi-directional associations adjusted for within-study correlation.Results At baseline, the prevalence of VMS (40%, range 13-62%) and depressed mood (26%, 8-41%) varied substantially across studies, and a strong dose-dependent association between VMS and likelihood of depressed mood was found. Over 3 years of follow-up, women with often/severe VMS at baseline were more likely to have subsequent depressed mood compared with those without VMS (odds ratios (OR) 1.56, 1.27-1.92). Women with often/severe depressed mood at baseline were also more likely to have subsequent VMS than those without depressed mood (OR 1.89, 1.47-2.44). With further adjustment for the degree of sleep difficulties at baseline, the OR of having a subsequent depressed mood associated with often/severe VMS was attenuated and no longer significant (OR 1.13, 0.90-1.40). Conversely, often/severe depressed mood remained significantly associated with subsequent VMS (OR 1.80, 1.38-2.34).Conclusions Difficulty in sleeping largely explained the relationship between VMS and subsequent depressed mood, but it had little impact on the relationship between depressed mood and subsequent VMS.
AB - Background Many women experience both vasomotor menopausal symptoms (VMS) and depressed mood at midlife, but little is known regarding the prospective bi-directional relationships between VMS and depressed mood and the role of sleep difficulties in both directions.Methods A pooled analysis was conducted using data from 21 312 women (median: 50 years, interquartile range 49-51) in eight studies from the InterLACE consortium. The degree of VMS, sleep difficulties, and depressed mood was self-reported and categorised as never, rarely, sometimes, and often (if reporting frequency) or never, mild, moderate, and severe (if reporting severity). Multivariable logistic regression models were used to examine the bi-directional associations adjusted for within-study correlation.Results At baseline, the prevalence of VMS (40%, range 13-62%) and depressed mood (26%, 8-41%) varied substantially across studies, and a strong dose-dependent association between VMS and likelihood of depressed mood was found. Over 3 years of follow-up, women with often/severe VMS at baseline were more likely to have subsequent depressed mood compared with those without VMS (odds ratios (OR) 1.56, 1.27-1.92). Women with often/severe depressed mood at baseline were also more likely to have subsequent VMS than those without depressed mood (OR 1.89, 1.47-2.44). With further adjustment for the degree of sleep difficulties at baseline, the OR of having a subsequent depressed mood associated with often/severe VMS was attenuated and no longer significant (OR 1.13, 0.90-1.40). Conversely, often/severe depressed mood remained significantly associated with subsequent VMS (OR 1.80, 1.38-2.34).Conclusions Difficulty in sleeping largely explained the relationship between VMS and subsequent depressed mood, but it had little impact on the relationship between depressed mood and subsequent VMS.
KW - Depressed mood
KW - hot flushes
KW - menopausal transition
KW - night sweats
KW - sleep difficulties
KW - vasomotor menopausal symptoms
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U2 - 10.1017/S0033291718000168
DO - 10.1017/S0033291718000168
M3 - Article
C2 - 29429422
AN - SCOPUS:85041893600
SN - 0033-2917
VL - 48
SP - 2541
EP - 2549
JO - Psychological Medicine
JF - Psychological Medicine
IS - 15
ER -
