Subjective Sleep in Premenopausal and Postmenopausal Women During Workdays and Leisure Days: A Sleep Diary Study

Laura Lampio, MD, Tarja Saaresranta, MD, PhD, Olli Polo, MD, PhD, Päivi Polo-Kantola, MD, PhD


Menopause. 2013;20(6):655-660. 

In This Article

Abstract and Introduction


Objective. This study aims to evaluate subjective sleep in premenopausal and postmenopausal women by assessing differences between workdays and leisure days.

Methods. Ninety-one regularly working women—of which 58 were premenopausal (aged 44-48 y) and 33 were postmenopausal (aged 53-58 y)—were recruited. A 14-day sleep diary was used to investigate total sleep time (TST), nocturnal sleep time (ST), sleep latency, and number of awakenings after workdays and leisure days.

Results. TST (P = 0.002 during the 14-d period, P < 0.001 during workdays) and ST (P < 0.001 and P < 0.001) were shorter, and the number of awakenings (P = 0.033 and P = 0.043) during the entire 14-day period and after workdays was higher in postmenopausal women than in premenopausal women. No differences were observed during leisure days. Falling asleep took longer in postmenopausal women during the entire 14-day period (P = 0.011), during workdays (P = 0.040), and during leisure days (P = 0.010). After adjustment for the depression score, TST and ST during the 14-day period (P = 0.006 for TST, P = 0.004 for ST) and during workdays (P < 0.001 and P < 0.001) remained shorter in postmenopausal women.

Conclusions. Self-reported sleep problems are more common in postmenopausal women than in premenopausal women, and the difference is more pronounced during workdays than during leisure days. These observations suggest that postmenopausal women have the capacity for good sleep but are more vulnerable to sleep problems related to work-related stress.


Women are 1.3 to 1.8 times more likely to report sleep problems, such as difficulty initiating or maintaining sleep, early morning awakening, and/or experiencing nonrestorative sleep, than men.[1] In a study with more than 12,700 participants, moderate insomnia occurred in 23% of women aged 35 to 49 years and in 25% of women aged 50 to 64 years, whereas severe insomnia occurred in 12% of women aged 35 to 49 years and in 15% of women aged 50 to 64 years.[2]

Sleep problems increase during the menopausal transition.[3,4,5] Several factors are involved. Nocturnal vasomotor symptoms, hot flashes, and sweating are all associated with decreased sleep quality,[6,7,8] although some postmenopausal women without vasomotor symptoms report disordered sleep.[1] In addition, depression,[9] sleep-disordered breathing,[10,11] or aging[12] may contribute to decreased sleep quality.

Sleep problems decrease work productivity and performance, increase absenteeism, and increase the risk for accidents.[13,14,15] After menopause, women may continue to work for more than 10 years. Maintaining restorative sleep is therefore part of maintaining one’s ability to work after menopause. There have been few studies about sleep during workdays and leisure days among regularly working participants.[16] Furthermore, none of the previous studies assessed either sex differences or the importance of menopause. Therefore, the aim of our study was to evaluate whether subjective sleep varies between premenopausal and postmenopausal women during workdays and leisure days. Our hypothesis was that postmenopausal women sleep worse during both workdays and leisure days.