Sleep researchers know that overall sleep quality decreases with age for men and women, but a UCSF Fresno study found a surprising steep decline in sleep quality for women after age 50, and the abrupt drop is likely related to menopause.
According to the research, sleep quality in women declined by 50% at age 51.
“The sleep quality is amazing how it dropped, just by that mark, between age 50 and 51 for women,” said Lourdes DelRosso, MD, PhD, MS, UCSF professor of Family Medicine at the Fresno regional campus, program director of the UCSF Fresno Sleep Medicine Fellowship, and Inspire Health Sleep Medicine physician. Dr. DelRosso supervised the study, “Sex-specific changes in sleep quality with aging: Insights from wearable device analysis,” which was authored by Jonathan Tam, DO, a UCSF Fresno resident in Internal Medicine.
The 2024 study in the Journal of Sleep Research, points to menopause corresponding with the sharp deterioration in sleep for women at age 51. The average age of menopause (when menstrual periods stop permanently) is 51 years for women in the United States. Menopausal symptoms have been found to affect sleep quality, Dr. DelRosso said. Hot flashes have been associated with frequent awakenings and depressive symptoms have been associated with difficulty falling asleep and waking up earlier.
“There is more correlation with age 51 and with menopause than with anything else, so that’s why we’re putting our money this is related to menopause more than anything else,” Dr. DelRosso said. “But we know there could be other contributors as well.”
The study compared the Sleep Quality Index, Arousal index, sleep efficiency and the sleep apnea-hyponea index of men and women divided by age groups of 18-40 years, 41-50 years, 51-60 years, 61-70 years and older than 70 years. The study subjects wore a SleepImage Ring at home to monitor and analyze sleep quality. According to the study, it may be the first to evaluate sleep quality differences in men and women by age groups and through information collected from a wearable device.
The study identified sleep apnea (a disorder in which breathing stops and starts repeatedly during sleep) increased with age in men and women. But the steep decline in sleep quality for women at age 51 “was not explained by arousals (brain awakenings during the night) alone or by the increase of sleep apnea,” Dr. DelRosso said. “We can only extrapolate that this is attributed to menopause, and anything related to hormonal changes that happen at this age,” she said.
The study team analyzed sleep quality in 1,444 subjects (704 women and 740 men). The 50% drop in sleep quality for women at age 51 was “very dramatic, very strong, and this is 704 women. This is not small numbers,” Dr. DelRosso said.
Dr. DelRosso said more studies are needed to understand why the decline in sleep quality is so steep for women after age 50. “This study was with a home test, we’re looking now to see how it correlates when someone sleeps in a lab,” she said. “There are a lot of questions we still have, and we need to answer.”
Women experiencing sleep disruptions due to menopause can seek help for hot flashes, depression and other symptoms, Dr. Del Rosso said. “There are counselors, professionals, your doctor to help you with your hot flashes. You don’t have to suffer through that.”
Dr. DelRosso, Director of World Sleep Academy - World Sleep Society and Co-Chair of World Sleep Day - "Make Sleep Health a Priority,” said there are changes that can be made to improve sleep quality.
Dr. DelRosso, for example, sleeps with a silk eye mask. “It helps me relax. It keeps everything dark and probably helps in producing melatonin (a hormone the body naturally produces to regulate sleep-wake cycles).”
Other tips for better sleep quality:
- Be sure you have a cool, nice temperature to sleep comfortably.
- Keep your bedroom clean.
- Use your bed only for sleeping. Do not read in bed or watch TV, for example.
