Elsevier

Maturitas

Volume 74, Issue 4, April 2013, Pages 346-351
Maturitas

Prevalence of insomnia and related factors in a large mid-aged female Colombian sample

https://doi.org/10.1016/j.maturitas.2013.01.009Get rights and content

Abstract

Objective

To assess the prevalence of insomnia and related factors in a large cohort of mid-aged Colombian women of different ethnical background.

Methods

This cross-sectional study involved 1325 women aged 40–59 of 3 ethnical groups: Mestizo (70.0%), Black (11.5%) and Zenú indigenous (18.5%), who completed the items of the Athens Insomnia Scale (AIS), the Menopause Rating Scale (MRS) and a general questionnaire containing personal socio-demographic data.

Results

Median [interquartile range] age of the whole sample was 48.0 [10.0] years. A 43.4% were postmenopausal, 51.7% had increased body mass index values, 18.2% had hypertension and 5.1% used hormone therapy. A 27.5% displayed insomnia (AIS total score ≥6). Significant Spearman rho correlations were found between total AIS and MRS scores (total and subscales). Multiple linear regression analysis found that higher total AIS scores (more insomnia) correlated with tobacco consumption and higher MRS psychological and somatic subscale scores (more severe symptoms). Age, ethnicity and partner and menopausal status were excluded from the final regression model.

Conclusions

In this large mid-aged Colombian cohort insomnia was present in nearly one third of cases, related to smoking habit and the severity of somatic and psychological menopausal symptoms and independent of ethnics and menopausal status.

Introduction

Low quality of sleep and insomnia are frequent during the menopausal transition [1], [2], [3], [4], [5]. Independent of objective sleep assessment [6], insomnia has been defined as a subjective alteration associated to the onset or maintenance of sleep [7], [8], [9]. Insomnia may lead to other problems such as daytime sleepiness, work difficulties, memory reduction, risk of accidents, mood changes, increased cardiovascular risk and a state of chronic inflammation [3], [10], [11], [12], [13], [14], [15].

Prevalence of insomnia may vary considerably in accordance to definition criteria, research study design and methodology [2], [3], [5], [16]. It is more prevalent in women than in men and related to health disorders and demographical, behavioral, and cultural aspects [2], [16], [17], [18]. Rate may vary from 9 to 56.6% among mid-aged women [2], [3], [4], [5], [6], [17], [19], [20], [21]. The influence of ethnics over sleep performance has been studied among mid-aged US Caucasian, Black and immigrant women from different world regions [22], [23]. Hispanic immigrant is a heterogeneous denomination for different ethnical backgrounds which have in common the Spanish language. Sleep, ethnics and the menopause have been analyzed among Hispanic immigrant women, with limited information regarding insomnia available from mid-aged Hispanic women living in their original cultural and traditional lifestyle [3], [5], [19], [22], [23]. Thus, the aim of the present research was to assess the prevalence of insomnia and related risk factors in a large cohort of mid-aged Colombian women of different ethnical background using the Athens Insomnia Scale (AIS).

Section snippets

Study design and participants

A cross-sectional study was carried out from February 2009 to March 2011 among Colombian women aged 40–59 years who were requested to fill out the AIS, the Menopause Rating Scale (MRS) and a questionnaire containing personal data. Women were either mestizo (also called Hispanic), indigenous (direct descendants of native Zenú) or black (direct African descendants). Mestizo women were recruited from urban and surrounding peripheral areas (Barranquilla and Cartagena in the Atlantic coast and Cali

Results

During the study period, a total of 1412 women were asked to participate, 0.06% provided incomplete data, leaving 1325 surveys for final analysis. For the whole sample median [IQR] age and educational level was 48 [10] and 11 [6] years, respectively. The majority of women were mestizo (70.0%), 67.4% consumed coffee, 10.2% were current smokers, 43.4% were postmenopausal and only 5.1% were on HT for the menopause (Table 1). A 27.5% displayed insomnia (AIS of ≥6.0) and 8.2% severe menopausal

Discussion

The present investigation assessed insomnia and menopausal symptoms in a large sample of mid-aged Colombian women. Nearly one fourth of women displayed insomnia with less than 10% presenting severe menopausal symptoms and receiving HT. Prevalence of insomnia was somewhat lower than that reported among mid-aged women living in Latin America [19] and the US [22], [33], [34].

Cross-ethnical differences in relation to depth of sleep and REM characteristics have been reported [35]. Reports indicate

Contributors

AMC and FRPL were involved in conception and design of the analysis. AMC, YRP and MMF were responsible of data acquisition. AMFA and PC performed the statistical analysis. FRPL and PC did the drafting of the manuscript. All authors were involved in critically revising the manuscript for its intellectual content; and the final approval of the manuscript was done by all authors.

Competing Interest

Authors declare to have no financial or personal relationships with other people or organizations that could inappropriately influence (bias) the results presented in this manuscript. This study was not supported by the industry.

Funding

This study was funded by the CAVIMEC (Calidad de Vida en la Menopausia y Etnias Colombianas) research project sponsored through a grant to A.M-C provided by the Vice-Rectoría de Investigación de la Universidad de Cartagena, Cartagena, Colombia.

References (61)

  • C.R. Soldatos et al.

    The diagnostic validity of the Athens Insomnia Scale

    Journal of Psychosomatic Research

    (2003)
  • U. Rao et al.

    Relationship between ethnicity and sleep patterns in normal controls: implications for psychopathology and treatment

    Journal of Psychiatric Research

    (1999)
  • K.F. Chung et al.

    Subjective sleep disturbance and its correlates in middle-aged Hong Kong Chinese women

    Maturitas

    (2006)
  • M.E. Ruiter et al.

    Normal sleep in African-Americans and Caucasian-Americans: a meta-analysis

    Sleep Medicine

    (2011)
  • P. Llaneza et al.

    Sexual function assessment in postmenopausal women with the 14-item changes in sexual functioning questionnaire

    Journal of Sexual Medicine

    (2011)
  • P. Polo-Kantola

    Sleep problems in midlife and beyond

    Maturitas

    (2011)
  • M. Basta et al.

    Chronic insomnia and stress system

    Sleep Medicine Clinics

    (2007)
  • M.L. Okun et al.

    Subjective sleep disturbance during a smoking cessation program: associations with relapse

    Addictive Behaviors

    (2011)
  • A. Jaehne et al.

    How smoking affects sleep: a polysomnographical analysis

    Sleep Medicine

    (2012)
  • M. Puckeridge et al.

    Incorporation of caffeine into a quantitative model of fatigue and sleep

    Journal of Theoretical Biology

    (2011)
  • M.V. Vitiello et al.

    Age-related sleep change: gender and estrogen effects on the subjective-objective sleep quality relationships of healthy, non complaining older men and women

    Journal of Psychosomatic Research

    (2004)
  • L.E. Hollander et al.

    Sleep quality, estradiol levels, and behavioral factors in late reproductive age women

    Obstetrics and Gynecology

    (2001)
  • F.R. Pérez-López

    Sleep disorders. The Menopause

    (1992)
  • M.M. Ohayoon

    Epidemiology of insomnia: what we know and what we still need to learn

    Sleep Medicine Reviews

    (2002)
  • Monterrosa-Castro A, Marrugo-Flórez M, Romero-Pérez I, Fernández-Alonso AM, Chedraui P, Pérez-López FR. Assessment of...
  • R.R. Rosa et al.

    Reported chronic insomnia is independent of poor sleep as measured by electroencephalography

    Psychosomatic Medicine

    (2000)
  • T. Roth et al.

    Definition, prevalence, etiology, and consequences

    Journal of Clinical Sleep Medicine

    (2007)
  • WHO. The International Classification of Diseases, 10. Classification of Mental and Behavioural Disorders. F-51...
  • DSM-IV-TR Diagnostic criteria for primary insomnia....
  • D. Lorton et al.

    Bidirectional communication between the brain and the immune system: implications for physiological sleep and disorders with disrupted sleep

    Neuroimmunomodulation

    (2006)
  • Cited by (13)

    • Instruments to study sleep disorders in climacteric women

      2016, Sleep Science
      Citation Excerpt :

      These scales must have been validated in populations and checked in the age groups. Since the high prevalence of SD in climacteric is necessary to know the differences among scales that are available to study adequately these women, and to establish the deterioration of the quality of sleep or the presence of any different types of SD [18–21]. The aim is to identify and to describe the different scales that have been used to assess SD in climacteric.

    • Prevalence of sleep complaints in Colombia at different altitudes

      2016, Sleep Science
      Citation Excerpt :

      The percentage of the insomniac population that took some sleeping medication was 15% [22] a figure similar to that found in this study. It has also been addressed by Monterrosa et al in a study in female population where they found an insomnia prevalence of 27.5% [24]. Rueda et al. have conducted a population survey in Bucaramanga investigating only for insomnia, finding a prevalence of 26.2% [25].

    View all citing articles on Scopus
    View full text