CHICAGO – Almost 40% of women report sleep problems in midlife, and since hormone therapy benefits sleep, cessation of that therapy might have the opposite effect. A study of 1,704 women from the Group Health Research Institute of Seattle confirms that it does.
Dr. Sarah E. Tom
“Sleep problems were related to the suspension of hormone therapy for 1 or 2 months,” investigator Sarah E. Tom, Ph.D., formerly of the institute, said of the study’s findings. “Women who are discontinuing hormone therapy may benefit from alternative sleep management strategies immediately following discontinuation.” Dr. Tom presented her data at the annual meeting of the North American Menopause Society.
This was a secondary analysis of data from the READ study (Radiological Evaluation and Breast Density), a trial designed to test whether short-term suspension of hormone therapy resulted in better screening mammography performance. The trial recruited women aged 45-80 years from Group Health, a nonprofit health care system based in Washington state. The recruits were due for a screening mammography, and reported on use of hormone therapy for 2 years. They were randomized to continue hormone therapy or to suspend it for either 1 or 2 months prior to mammography.
The survey used a questionnaire that asked about the number of days subjects had various sleep complaints, including trouble falling asleep and waking while sleeping.
Various confounding variables, including alcohol consumption, body mass index, age, race, and ethnicity were considered, Dr. Tom said.
Of the 1,704 women, 1,405 had complete information on all variables. Of this group, 518 were randomized to continue hormone therapy, 452 to suspend therapy for 1 month, and 435 to suspend it for 2 months.
Demographic profiles were similar across all randomization groups. In the group continuing hormone therapy, for example, the median age was 58, more than 90% were white, and more than 50% used estrogen only. Sleep problems were comparable in the groups suspending therapy for 1 month or 2 months.
“For the group randomized to a 2-month suspension, they had an increase of about 0.7 days with trouble with their sleep, compared to women who were randomized to continue hormone therapy,” Dr. Tom said. Waking while sleeping was one of the most frequently reported problems, she said, and about 35% of women in the two sleep cessation groups reported using sleep aids in the previous week.
The study concluded that sleep problems were related to suspension of hormone therapy for 1 or 2 months. Dr. Tom said differences were modest but persistent across sleep items, and were similar for the 1- and 2-month suspension groups.
Dr. Tom disclosed no significant financial relationships. This study was sponsored by the Department of Defense, the National Institute on Aging, and the Group Health Research Institute.