Sleep Quality Index as a Tool to Assess Sleep Disturbances in Postmenopausal Women

Abstract

Background: Sleep disturbances are among the most prevalent complaints during the menopausal transition, significantly impacting the quality of life and wellbeing of women. Hormonal shifts, particularly the decline in estrogen and progesterone, disrupt circadian rhythms and thermoregulation, increasing vulnerability to poor sleep. The present study aims to evaluate sleep quality and its determinants among postmenopausal women using a standardized tool.
Methods: A hospital-based cross-sectional analytical study will be conducted over six months (December 2025 to May 2026) at the Department of Obstetrics and Gynaecology and the Menopause Clinic of Sree Balaji Medical College and Hospital, Chennai. The study will involve 200 postmenopausal women aged 45–65 years with natural menopause. Sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI), where a global score >5 indicates poor sleep quality. Statistical analysis will be performed using IBM SPSS Version 27, utilizing chi-square tests and binary logistic regression to identify predictors of sleep disturbances.
Results: The mean age of participants was predominantly between 45–65 years.The study concluded that 54% of the 200 postmenopausal participants experienced poor sleep quality, as indicated by a global Pittsburgh Sleep Quality Index (PSQI) score exceeding 5. Multivariable logistic regression identified several significant independent predictors of these sleep disturbances, with vasomotor symptoms emerging as the most potent factor, associated with more than triple the odds of poor sleep (adjusted OR = 3.36). Additionally, the analysis revealed that psychiatric illness (OR = 2.74), a sedentary lifestyle (OR = 2.45), diabetes mellitus (OR = 2.21), genitourinary symptoms (OR = 1.98), and hypertension (OR = 1.88) were all statistically significant contributors to diminished sleep quality. These results demonstrate that over half of the postmenopausal women in the study population suffer from impaired sleep, driven by a complex interplay of physiological menopausal symptoms, underlying chronic health conditions, and lifestyle factors.
Conclusion: The study concludes that sleep disturbances are highly prevalent among postmenopausal women, with 54% of the participants experiencing poor sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI). The research successfully identifies that sleep impairment in this demographic is not an isolated issue but is significantly driven by a combination of physiological menopausal symptoms—most notably vasomotor and genitourinary symptoms—and underlying health conditions such as diabetes and hypertension. Furthermore, the strong association between a sedentary lifestyle and poor sleep highlights a critical, modifiable factor for intervention. These findings emphasize the necessity of incorporating formal sleep assessments into routine menopausal care and suggest that a multidisciplinary approach, focusing on symptom management and lifestyle modification, is essential to improving the overall quality of life and long-term health outcomes for women in the postmenopausal phase.