Type 2 diabetes worsens sleep-related disturbances in menopause
Postmenopausal women with type 2 diabetes reported more sleep-related symptoms, such as frequent urination, excessive thirst and anxiety, and they rated those symptoms as more severe when compared with postmenopausal women without diabetes, according to findings published in Menopause.
“Sleep disturbances during the menopausal transition could make those with [type 2 diabetes] require an additional dimension of care,” Eun-Ok Im, PhD, MPH, FAAN, associate dean for research development and regulatory affairs at Duke University School of Nursing in Durham, North Carolina, and colleagues wrote in the study background. “For instance, sleep disturbances during the menopausal transition could make women feel excessive daytime fatigue, perceive it as a sign of hypoglycemia and eat extra calories, which subsequently increases their blood glucose. Furthermore, sleep is recommended as one of the major factors to consider in prevention and management of [type 2 diabetes].”
In a secondary analysis, Im and colleagues analyzed data from 164 women aged 40 to 60 years who participated in two internet-based survey studies assessing racial differences in menopausal symptoms and attitudes toward physical activity (mean age, 50 years; mean BMI, 29.1 kg/m²; 45.7% postmenopausal; 70% married; 73% employed). The cohort included a balance of racial groups, with 26.2% identifying as Hispanic, 26.8% identifying as white, 22.6% black and 24.4% Asian. Participants answered questions on background characteristics, health status and menopause status and completed the 24-item Sleep Index for Midlife Women, a subscale of the Midlife Women’s Symptom Index. The mean score of perceived general health was 3.4 on a 5-point Likert scale, and more than 88% of participants had access to health care; more than half the cohort were classified as having overweight or obesity.
Within the cohort, 37.8% reported having a diagnosis of type 2 diabetes. For participants with and without type 2 diabetes, the mean number of sleep-related symptoms was 8.27 (range, 0-24); mean total severity score of sleep-related symptoms was 26.24 (range, 0-99).
Researchers found that participants with type 2 diabetes reported more sleep-related symptoms vs. those without diabetes (mean, 9.95 vs. 7.25; P = .006). Total severity scores for sleep-related symptoms were also higher for participants with type 2 diabetes vs. those without diabetes (mean, 33.42 vs. 21.87; P = .001).
When stratified by menopausal status, researchers found that postmenopausal women with type 2 diabetes reported more sleep-related symptoms vs. postmenopausal women without diabetes (P = .013), as well as higher total severity scores (P = .005); however, between-group differences did not rise to significance among pre- and perimenopausal women.
In analyses stratified by race, researchers found that Asian women with type 2 diabetes reported more sleep-related symptoms (P = .015) and higher total severity scores (P = .01) vs. Asian women without diabetes; however, there were no between-group differences among other racial groups with vs. without diabetes.
In analyses controlling for background characteristics, health status and menopause status, a diagnosis of type 2 diabetes was positively associated with total number of sleep-related symptoms (P = .047) and with total severity of sleep-related symptoms (P = .014).
“Researchers and health care providers need to assess sleep-related symptoms when they provide care for midlife women with [type 2 diabetes], and they need to provide guidelines for improving sleep-related symptoms during their menopause transition,” the researchers wrote. “Finally, racial/ethnic differences in sleep-related symptoms between those with [type 2 diabetes] and those without [type 2 diabetes] need to be further investigated because significant racial/ethnic differences were found only among [non-Hispanic] Asian women.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.