Sleep and Rest-Activity Rhythms for Women at Different Menopausal Statuses: the Role of Mental Health.

Objective: To examine how mental health interplays with menopausal status in relation to sleep patterns and rest-activity rhythms (RARs) among middle-aged women. Methods: This cross-sectional study recruited 87 women aged 45 to 60 years from community and a gynecology clinic in Taiwan. Participants wore actigraphy devices for 7 days and were also assessed with self-reported questionnaires. Hierarchical regression was used to examine the effects of menopausal status and mental health on sleep and RARs. Results: Perimenopausal and postmenopausal women had higher relative amplitude and interdaily stability of RARs than premenopausal women. There were no differences in actigraphy-based sleep parameters across menopausal statuses. There was no difference in depressive symptoms or loneliness across menopausal statuses. Higher levels of depressive symptoms were significantly associated with longer sleep latency (beta = 0.26, P = 0.022) and wake after sleep onset (beta = 0.28, P = 0.012), and lower sleep efficiency (beta = -0.30, P = 0.008) after adjusting for menopausal status and age. In addition, there was marginal significance of the positive association between loneliness and interdaily stability (beta = 0.18, P = 0.079). A moderating effect (beta menopausal status*loneliness = -0.40, P = 0.025) showed that lonelier premenopausal women exhibited greater relative amplitude (RA) of rest-activity rhythms, but lonelier menopausal women had lower RA of RAR. Conclusion: Mental health plays an important role for middle-aged women with different menopausal statuses in relation to sleep patterns and RARs.