0829 Associations Between Sleep Disturbances, Vasomotor Symptoms and Health-Related Quality of Life in the Menopausal Transition and Early Postmenopause

Abstract Introduction his analysis of the Study of Women’s Health Across the Nation (SWAN) evaluated associations between self-reported sleep disturbances and/or vasomotor symptoms (VMS) and health-related quality of life (HRQoL) in menopausal women. Methods We used data from the baseline and first 10 annual follow-up visits (1999–2008) of SWAN. Among 2066 participants who had reached natural menopause, we reassigned the visit closest to final menstrual period (FMP) as FMP 0; and visits 5 years either side from FMP -5 to FMP +5. Sleep disturbances (multiple awakenings a night/trouble falling asleep/waking up earlier than planned ≥3–4 nights/week in the past 2 weeks), VMS (hot flashes/night sweats ≥1–5 days in the past 2 weeks), and HRQoL were assessed at each visit. HRQoL was based on mean scores of three Short-Form Health Survey (SF-36) subscales: role limitations due to physical health (RLPH), role limitations due to emotional problems (RLEP), and energy/fatigue (EF); scores range from 0–100 (higher scores indicating better HRQoL). Women were grouped by VMS only, sleep disturbances only, both, or neither symptom. Mixed models for repeated measures evaluated associations between sleep disturbances and/or VMS and HRQoL over time, adjusted for confounders including sociodemographic and lifestyle factors. Results Mean (standard deviation) age at FMP 0 was 51 (2.6) years. On the RLPH subscale, women with sleep disturbances only, VMS only, or both consistently scored lower than those with neither symptom (reference group). Mean (95% confidence interval [CI]) differences were -3.30 (-5.03, -1.56), -1.56 (-3.48, 0.37), and -4.76 (-6.45, -3.07), respectively. A similar pattern was observed on the RLEP and EF subscales. For RLEP, mean (95% CI) differences vs. reference group were -2.47 (-4.03, -0.90) for sleep disturbances only, -1.32 (-3.06, 0.42) for VMS only, and -1.80 (-3.32, -0.29) for both. For EF, differences were -2.55 (-3.41, -1.70), -0.44 (-1.38, 0.50), and -3.70 (-4.55, -2.86), respectively. Conclusion Sleep disturbances were associated with lower HRQoL, which was most notable when sleep disturbances co-occurred with VMS on the RLPH and EF subscales. Results suggest a need for effective measures to manage these symptoms in menopausal women. Support (if any) ponsored by Bayer. Medical writing assistance (Highfield, Oxford, UK) funded by Bayer.