Does menopause influence nocturnal awakening with headache?

ABSTRACT

Objective The aim of the present study was to assess whether menopausal status influences the occurrence of nocturnal awakening with headache (NAH) in the female population of Sao Paulo, Brazil. We also examined the relationship of this complaint to sociodemographic determinants, hot flushes, sleep quality and parameters, anxiety and depressive symptoms, somnolence and fatigue according to menopausal status.

Methods The female population of the Sao Paulo Epidemiologic Sleep Study (EPISONO) (n = 576) was divided according to menopausal status (pre-, peri-, early and late menopause) based on questionnaires and hormonal blood measures. The complaint of waking up because of a headache at least once a week was assessed by the UNIFESP Sleep questionnaire. Additionally, hot flushes, sleep complaints, anxiety and depressive symptoms, somnolence and fatigue were assessed by specific questionnaires. A full-night polysomnography assessed sleep parameters.

Results The prevalence of NAH in women in the Sao Paulo population was 13.3%. Perimenopause was associated with a higher risk of having NAH (odds ratio 13.9; 95% confidence interval 4.3–45.2). More complaints of NAH were observed in obese women. All the groups with NAH showed more hot flushes, worse subjective sleep quality, more complaints of insomnia, anxiety symptoms and fatigue.

Conclusions We observed a constellation of symptoms in women according to menopausal status and NAH that included hot flushes, sleep complaints, more anxiety symptoms and fatigue. Moreover, some of these symptoms were more frequent in perimenopausal women with NAH. Therefore, we concluded that menopausal status influences NAH and the women in perimenopause presented a high risk of having this complaint.

Key words::

• NOCTURNAL AWAKENING
• HEADACHE
• WOMEN
• MENOPAUSE
• HOT FLUSHES
• SLEEP
• INSOMNIA
• FATIGUE

ACKNOWLEDGEMENTS

The authors would like to thank Altay Lino de Souza and Laura de Siqueira Castro for their valuable suggestions and statistical analyses. All the efforts of the AFIP staff, and particularly those of Roberta Siuffi, are deeply appreciated.

Conflict of interest The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Source of funding This work was supported by grants from the Associaçao Fundo de Incentivo a Pesquisa (AFIP) and FAPESP (#07/50525-1 to RS-S and CEPID no. 98/14303-3 to ST). S.T. and L.B. received the CNPq fellowship.