for many women , the onset of menopause and symptoms associated with hormonal changes and cessation of ovulation can affect quality of life and perceptions of health and well - being . estrogen decline during menopause may cause various problems such as vasomotor instability , lowered psychometric functions , vaginal and urinary infections , and forgetfulness . the other symptoms include irregular menses , decreased fertility , vaginal dryness , hot flashes , sleep disturbances , mood swings , increased abdominal fat , hair thinning , and loss of breast fullness . sleep is an essential aspect of life , and insomnia is associated with negative health consequences including fatigue , impaired daytime function , reduced quality of life , and increased visits to health care providers . sleep disturbance is one of the important symptoms observed during menopause too also common and clinically important among elderly individuals . women tend to report sleep disturbances more often than do men of the same age further , insomnia is more common in patients with chronic medical problems and is observed in up to 69% of patients enrolled in primary care clinics . moreover , after menopause , the prevalence of habitual snoring and obstructive sleep apnea syndrome also increases in women . in contrast , a smaller percentage of adults report severe sleep problems ( 10%-15% ) , but the prevalence of severe chronic sleep problems increases to 25% among the elderly . kravitz ( 2003 ) reported that the rates of self - reported sleep difficulties increase during the menopausal transition . further , the overall prevalence of self - reported sleep difficulty was 38% , and in some studies , it was found to be the least prevalent in the premenopausal group ( 31% ) and most prevalent in the surgical menopausal group ( 48% ) . referring to study in west of tehran ( 2011 ) numerous national surveys have shown that approximately 30%-40% of adults experience sleep disturbances . also referring to study , which had done in west of tehran ( 2011 ) 70% of healthy menopause women experiences insomnia . the main findings of a study by young et al . , ( 2003 ) indicated that objectively measured sleep quality does not diminish with menopause , but the association of menopause with sleep quality differs with respect to objective and subjective measures . these findings indicated that menopausal women were more dissatisfied with the quality of sleep than were premenopausal women . various factors such as snoring , aging , hot flashes , and night sweats could influence the quality of sleep during menopause . based on the results of the aforementioned studies and due to the fact that sleep disturbance is one of the important symptoms observed during menopause and aging , this study was conducted to determine rate of self - reported sleep disturbance in west of tehran and its associated factors in 50 - 60-year - old women . this is a cross - sectional study conducted at four selected clinics of the tehran university of medical sciences in west of tehran , during march 2010 to june 2012 . this study is the first phase of a research proposal entitled  the effect of valerian and lemon balm on the sleep quality in menopausal women : a randomized placebo - controlled clinical trial .  in this phase , we were trying to screen menopause women to find those with sleep problems , for entering volunteers to the second phase of mentioned study . the inclusion criteria were as follows : generally healthy women between 50 - 60 years of age , postmenopausal for at least 1 year , and not undergoing hormone replacement therapy ; absence of a medical or psychiatric condition that could cause sleep disturbance ; and having scores of 5 or more by using pittsburgh sleep quality index ( psqi ) . the volunteers included 700 healthy menopause women , who were informed about the research and its purposes . volunteers who were undergoing hormone replacement therapy and/or indulged in tobacco , drugs , or alcohol consumption at the time of the study were excluded . thus , 700 volunteers were finally included in this study , and were requested to complete a questionnaire regarding their personal characteristics and psqi . the aim of the study was explained to the entire 700 volunteers , whom had qualified for the first phase of study filed in provided written informed consent , then interviewed by using a questionnaire , which had three main sections of personal characteristics , perception towards sexual satisfaction and psqi . the section on personal characteristics included the following 15 items : age ; partner 's age ; date of last menstruation ; family size ; number of children ; number of children living with the volunteers ; educational status ; economic status ; marital status ; occupational status ; partner 's occupational status ; average rate of daily consumption of tea , coffee , and colas . referring to their perception of sexual satisfaction the visual analog scale ( vas , scale ranging from 0 - 10 ) was used . the psqi section was a self - rated questionnaire that assessed sleep quality and disturbances over 1 month period . the composite scores provided information about subjective sleep quality , sleep latency , sleep duration , habitual sleep efficiency , sleep disturbances , sleep medication use , and daytime dysfunction . the scores from the seven components were then summed to yield a single psqi score . when this single global psqi score is greater than 5 , it is nearly 90% sensitive and specific with regard to diagnosing the post hoc cut - off score of 5 on the psqi produced a sensitivity of 89.6% and specificity of 86.5% of patients versus control subjects . the sample size was calculated based on 80% power and 5% type 1 error and it was determined that 700 subjects were needed for the study . therefore , we delivered the psqi questionnaire to 700 volunteers who met the inclusion criteria . descriptive statistics , including measures of mean and variance , were calculated for each volunteer 's main outcomes . to determine the correlation between the variables and sleep quality , inferential statistics such as pearson 's test , t - test , and one - way analysis of variance ( anova ) were used . this study was approved by the ethics committee of tehran university of medical science ( tums ) , the oldest and largest medical science university of iran . the members of the ethics committee follow the progression of the research from the first step of designing the research proposal to the presentation of the final report . the average age was 52.9  3.3 years , average menopause age was 47.4  3.8 years , average duration of menopause was 5.5  4.4 years , average family size was 4.4  2.06 members , average number of children was 4.8  2.02 , and average number of married children was 2.7  2.09 . all volunteers drank tea daily , and only 5% did not drink coffee and colas . the highest daily tea consumption was more than four cups per day ( 32.2% of the volunteers ) , and the highest daily coffee consumption was 71.4% . demographic characteristics of the participants regarding to psqi , which assesses sleep quality and sleep disturbances over one month period , the frequency of sleep disturbance was found to be 70% [ table 3 ] . sleep quality and frequency of sleep disturbance using psqi significant correlations with sleep disturbance just were observed for four characteristics of occupational status , educational status , husband 's occupational status , and economical status [ table 2 ] . sleep disturbance was not significantly correlated with age ; menopause age ; age of partner ; number of children ; family size ; and consumption of tea , coffee , and cola . this study investigated correlations between personal characteristics and self - reported sleep disturbance in 50 - 60-year - old menopausal women . the most important intervention factor for decrease in sleep quality in menopausal women is reduction in hormone levels . moreover , the unique hormonal and psychological changes that occur in middle - aged women at the time of menopause have a significant effect on sleep disturbance . in this study this may be because all the volunteers were postmenopausal with ages ranging from 50 - 60 years . in this study , sleep quality and the occupational status ( highest group were housewife ) were found to be correlated . furthermore , a correlation was identified between sleep quality and the husband 's occupational status , which may be because of lower economical statuses , may have poor access to medical care or having more family distress . ohayon et al . , ( 2005 ) reported that a high degree of education is associated with sleep difficulty and leshner et al . , ( 2005 ) determined , that being less educated is associated with a higher prevalence of insomnia . habte - gabr et al . , ( 1991 ) reported that individuals with lower educational statuses may have poor access to optimal medical care and have lifestyles that may result in an overall poor health status . we found a correlation between educational statuses and sleep quality , and our results were similar to those of the aforementioned studies . leshner et al . , ( 2005 ) indicated that lower income levels are associated with a higher prevalence of insomnia . in this study , the personal characteristics with the highest significant correlation with sleep are economic status , occupational status , husband 's occupational status , and educational status . our study population included 700 postmenopausal women . it would be helpful to conduct another study with higher number of menopausal women in all districts in tehran for finding sleep disturbance prevalence . since the highest groups of menopause was housewife and there was correlation between occupational status and sleep disturbance , it is necessary to do another research for finding its reason , also need to provide more educational and consultation for this high - risk group . the medical staff should be made aware of the personal characteristics of menopausal women , completion of the reproductive period and the commencement of menopause , and importance of sleep quality . proper planning to execute appropriate guidelines , along with counselling of qualified professionals in supervisory roles is also advisable . this approach could help menopausal women prevent psychological and social damage caused by sleep disturbance .
aims : to asses self - reported sleep disturbance and its associated factors in 50 - 60-year - old menopause women.settings and design : this cross sectional study included 700 healthy 50 - 60-year - old women volunteers who were postmenopausal for at least 1 year . 
 the volunteers were interviewed after providing informed consent . 
 the study questioner included two main aspects : personal characteristics and the pittsburgh sleep quality index ( psqi ) . 
 data were analyzed by using spss 14 software.results:the mean sleep scale score was 7.84  4.4 . 
 significant correlations had seen between sleep disturbance and characteristics of occupational status , educational status , husband 's occupational status , and economical status , and ( p = 0.002 ) . 
 there were no significant correlation between sleep disturbance and other personal characteristics , such as age ; partner 's age ; number of children ; family size ; consumption of tea , coffee , or cola.conclusions:sleep disturbance is common in menopausal women . 
 taking into account the sleep - related personal characteristics , suitable interventions should be taken to improve sleep quality , which is a very important for maintaining the quality of life .