Menopause with diabetes tied to more severe sleep problems

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Reuters Health
Published : 12:09, Aug 25, 2019 | Updated : 12:15, Aug 25, 2019

DiabeticsWomen with type 2 diabetes may face more sleep issues and more severe sleep troubles during menopause than peers without diabetes, a small study suggests.

Among 164 middle-aged women who completed a survey, those with diabetes averaged 10 sleep-related symptoms while those without diabetes averaged about 7 - and symptoms were rated as more severe by women with diabetes, the study team reports in the journal Menopause.

“Sleep-related symptoms are one of the most frequently reported symptoms among midlife women in menopausal transition across racial/ethnic groups,” said Eun-Ok Im of the Duke University School of Nursing in Durham, North Carolina, who led the study.

About half of menopausal women with type 2 diabetes report sleep-related symptoms, compared to a quarter of midlife women without diabetes, Im said.

Night sweats, hot flashes and frequent urination associated with menopause could cause women to wake up several times during the night, and symptoms such as frequent urination could be related to diabetes, she added.

“If you have severe sleep-related symptoms, please consult with your healthcare providers to check if you have other underlying diseases, especially diabetes,” she told Reuters Health by email.

The survey included questions about health, menopause, sleep and background characteristics. Participants’ average age was 50, and more than half were overweight. About 20% were premenopausal, 35% were early or late menopausal and 46% were postmenopausal. And 38% had type 2 diabetes.

Im’s team found that the average number of sleep-related symptoms, such as headache, night sweats, anxiety, frequent urination and fatigue, was higher in those with type 2 diabetes than those without diabetes. Frequent urination, fatigue and numbness, in particular, were significantly more common in women with diabetes.

The average symptom severity score was also significantly higher with diabetes. For a list of 24 symptoms, rating every one with the highest severity score of 5 would produce a total score of 120. On average, women without diabetes had total symptom severity scores of 21.87 while those with diabetes averaged scores of 33.42.

Postmenopausal women tended to have significantly higher numbers of sleep symptoms and severity scores, the authors note, as did non-Hispanic Asian women with type 2 diabetes. In other racial and ethnic groups, there were no statistically meaningful differences between women with and without diabetes.

“Few studies have been done on the association between sleep-related symptoms and diabetes while considering menopausal status or racial/ethnic diversities,” Im said. “However, this could give some direction for future research or practice.”

Im and her colleagues have begun studying the effects of a technology-based physical activity program on sleep-related symptoms among menopausal women. The next step might be an exercise program for midlife women who have diabetes, she said.

“Regular physical activity may help to mitigate the tendency for weight gain and adverse changes in body composition and fat distribution that accompany ageing and the menopausal transition,” said Dr Hirohito Sone of Niigata University in Japan, who wasn’t involved in the study.

Before age 60, diabetes is less common among women than men, Sone noted. But women in their 60s and 70s are more likely than men to have diabetes, which may suggest that hormonal changes associated with menopause could be related to the risk of diabetes in women after menopause, he said.

“Further investigations are needed to determine whether different interventions for older postmenopausal women could control modifiable factors such as metabolically unhealthy obesity, dyslipidemia, hypertension and lifestyle,” Sone said.

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