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

Objectives: To examine the factors associated with subjective sleep disturbance in middle-aged Hong Kong Chinese women. Methods: A total of 305 women aged 45-55 years were recruited at community-based women's clubs. Eligible subjects were of Chinese ethnicity and not taking oral contraceptives, hormone therapy or had received surgical removal of ovary. Standardized questionnaires, including sociodemographic, health and life-style variables, Pittsburgh Sleep Quality Index (PSQI), Greene Climacteric Scale (GCS) and Perceived Stress Scale were administered. Results: About 18% of the sample complained of difficulty initiating sleep, difficulty maintaining sleep or early morning awakening at least three times per week in the past month. About 26% of the women were poor sleepers as defined by a global PSQI score > 5. Sleep difficulty was one of the five most commonly reported climacteric symptoms. Cross-sectional analysis found that significantly more peri- and postmenopausal women had subjective sleep disturbance than premenopausal women. Multiple logistic regression analysis showed that women who had high levels of somatic complaints, psychological symptoms and perceived stress had a four to sixfold increased risk of reporting disturbed sleep. Menopausal status was not an independent predictor. Conclusions: Comparison of our findings with recent literatures suggested a lower prevalence of insomnia in Hong Kong Chinese middle-aged females than Caucasian women. Somatic complaints, psychological symptoms and perceived stress were independent risk factors for sleep disturbance. Clinicians should screen for sleep problems in middle-aged Chinese women with prominent somatic and psychological symptoms and perceived stress. (c) 2005 Elsevier Ireland Ltd. All rights reserved.