0831 Hot Flashes and Insomnia Throughout the Life Span of Women from the Episono Cohort

Abstract

Abstract Introduction Hormonal changes may trigger sleep disturbances in women. Insomnia affects one in every three-to-four of them, most likely during pre to post menopause, and especially in association with hot flashes. Thus, the present study aimed to investigate the occurrence of hot flashes among women with and without insomnia and on different reproductive stages. Methods Sampling procedure was a three-stage clustering of the population of Sao Paulo, Brazil according to gender, age (20-80 years), and socio-economic status. A total of 574 women were interviewed, underwent polysomnographic recording (PSG), and had fasting-blood samples collected. Hormone levels and a gynecological questionnaire were used to classify reproductive stages. Premenopausal women were classified either in the follicular, luteal, or periovulatory stage or as anovulatory or under hormonal contraceptives; whereas those menopausal were classified in perimenopause or in early or late stages. Individuals reporting frequent and persistent insomnia symptoms accompanied by relevant daytime impairment were classified with insomnia syndrome. Objective insomnia was defined by increased sleep onset latency and/or awake after sleep onset, decreasing sleep duration. Results The final sample included 550 women, representing 53% of the EPISONO cohort (n=1,042). Hot flashes were reported by 9% of the premenopausal women (n=339) and by 42% of the menopausal. Complaints were more frequent among women in perimenopause (67%) and those in use of hormonal therapy (60%), and it tended to decrease in later stages (33%); whereas before menopause, hot flashes were especially reported by anovulatory women (26%), while significantly less by those using contraceptives (6%). Hot flashes were associated with a 2-fold increase in insomnia symptoms and while it predicted objective sleep alterations among premenopausal women, they did not after menopause, when alterations in sleep were better explained by an effect of aging. Conclusion Our current findings suggest that hot flashes are associated with irregular menstrual cycles among premenopausal women, and particularly with early stages of menopause, predicting both subjective and objective sleep alterations. Support This research was supported by fellowships from Associação Fundo de Incentivo à Pesquisa (AFIP) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) - Finance Code 001.