Highlights
- •Sleep disturbance significantly increases after premenopausal RRSO (p < 0.001).
- •Risk factors include severe vasomotor symptoms, obesity and smoking.
- •Hormone therapy reduces but does not resolve sleep disturbance after RRSO.
Abstract
Objective
Sleep difficulties impair function and increase the risk of depression at menopause
and premenopausal oophorectomy may further worsen sleep. However, prospective data
are limited, and it remains uncertain whether Hormone Therapy (HT) improves sleep.
This prospective observational study measured sleep quality before and up to 12 months
after risk-reducing salpingo-oophorectomy (RRSO) compared to a similar age comparison
group who retained their ovaries.
Methods
Ninety-five premenopausal women undergoing RRSO and 99 comparisons were evaluated
over a 12-month period using the Pittsburgh Sleep Quality Index (PSQI).
Results
Almost half reported poor sleep quality at baseline. Overall sleep quality was not
affected by RRSO until 12 months (p = 0.007). However, sleep disturbance increased by 3 months and remained significantly
elevated at 12 months (p < 0.001). Trajectory analysis demonstrated that 41% had increased sleep disturbance
after RRSO which persisted in 17.9%. Risk factors for sleep disturbance included severe
vasomotor symptoms, obesity and smoking. Around 60% initiated HT after RRSO. Sleep
quality was significantly better in HT users vs non users (p = 0.020) but HT did not restore sleep quality to baseline levels.
Conclusions
Overall sleep quality is not affected by RRSO, but new onset sleep disturbance is
common, particularly in those with severe vasomotor symptoms. Clinicians should be
alert to new-onset sleep disturbance and the potential for HT to improve sleep quality.
Keywords
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Article info
Publication history
Published online: June 08, 2021
Accepted:
May 31,
2021
Received:
February 4,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
