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Association between common mental disorders, sleep quality, and menopausal symptoms: a population-based study in Southern Brazil

Neutzling AL1Leite HM1Paniz VMV1de Bairros FS1,2Dias da Costa JS1Olinto MTA1,3.

Menopause. 2020 Apr;27(4):463-472. doi: 10.1097/GME.0000000000001524.




To investigate the association between common mental disorders (CMD), sleep quality, and moderate and severe menopausal symptoms in adult women in southern Brazil.


This cross-sectional, population-based study investigated a representative sample of 393 women (age 40-69 years) living in an urban area. A standardized and pretested questionnaire that included the Self-Reporting Questionnaire-20 for CMD (Self-Reporting Questionnaire-20 ≥7), the Pittsburgh Sleep Quality Index-BR for sleep disorders (Pittsburgh Sleep Quality Index >5), and the Menopause Rating Scale for moderate/severe menopausal symptoms (Menopause Rating Scale >8) was used for data collection. Unadjusted and adjusted prevalence ratios and 95% confidence intervals (95% CIs) were estimated using robust Poisson regression.


The prevalence of moderate/severe menopausal symptoms in the sample was 58.0% (95% CI 53.0-63.0), the prevalence of CMD was 40.2% (95% CI 35.3-45.2), and the prevalence of poor sleep quality was 49.4% (95% CI 44.3-54.5). CMD and poor sleep quality occurred simultaneously in 34.4% of participants (95% CI 29.6-39.3). Moderate/severe menopausal complaints were significantly more prevalent in women with CMD (P < 0.001) and poor sleep quality (P < 0.001); the presence of both CMD and poor sleep quality increased the likelihood of moderate/severe menopausal complaints threefold. After adjustment, CMD and poor sleep quality remained strongly and significantly associated with moderate/severe menopausal complaints (P < 0.001).


Considering the complex time-course relationship between CMD, sleep quality, and menopausal symptoms, longitudinal studies should follow women with these issues throughout the menopausal period to identify a possible temporal link between exposures and outcome.