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