A CROSS-SECTIONAL STUDY ON MENOPAUSAL SYMPTOMS, SLEEP QUALITY, AND COGNITIVE FUNCTION IN WOMEN

Objective: This cross-sectional study investigated the relationships between menopausal symptoms, sleep quality, and cognitive function in women during the menopausal transition, examining whether sleep quality mediates the association between menopausal symptoms and cognitive performance. Methods: A sample of 586 women aged 40–60 years, stratified by menopausal stage (perimenopause or postmenopause), was recruited from a tertiary care hospital. Menopausal symptoms were assessed using the Menopause Rating Scale (MRS), sleep quality with the Pittsburgh Sleep Quality Index (PSQI), and cognitive function with the Montreal Cognitive Assessment (MoCA), Digit Span Test, and Trail Making Test (TMT). Multivariable linear regression and mediation analyses, adjusted for age, education, BMI, and psychological distress (Hospital Anxiety and Depression Scale), were conducted. Results: Participants (mean age 50.4 ± 5.2 years) reported moderate menopausal symptoms (MRS score 18.5 ± 7.9), with 62.8% experiencing poor sleep quality (PSQI >5). Postmenopausal women had higher MRS (20.1 ± 8.2 vs. 16.9 ± 7.3, p < 0.001) and PSQI scores (8.9 ± 4.3 vs. 7.5 ± 3.8, p = 0.002) than perimenopausal women. Higher MRS scores were associated with poorer sleep quality (β = 0.42, p < 0.001) and lower MoCA scores (β = -0.19, p = 0.01). Sleep quality partially mediated (34.8%) the relationship between menopausal symptoms and cognitive function (Sobel test, p = 0.01). Conclusion: Menopausal symptoms are associated with poorer sleep quality and cognitive performance, with sleep quality partially mediating this relationship. Interventions targeting sleep may mitigate cognitive challenges during menopause.