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Older Women With Diabetes Have an Increased Risk for Sleep Problems, Study Finds


During the menopause transition, women with type 2 diabetes are more likely to have sleep disturbances due to an alteration in their hormonal response to insulin.

Sleep-related issues are prominently higher in midlife women with type 2 diabetes, according to a study published this week in Menopause, the journal of The North American Menopause Society (NAMS).

The study examined the correlation between type 2 diabetes (T2D) and sleep-related symptoms among midlife women from 4 major racial groups in the United States.

T2D is highly prevalent during the menopausal transition through declining levels of estrogen and progesterone. As these hormones’ influence diminishes, cell responses to insulin alter due to fluctuations in the level of blood sugar which places postmenopausal women at an increased risk of diabetes.

Hormonal changes during the menopause transition are concurrently correlated to a negative impact on women’s quality of sleep. About 42% of premenopausal women and 60% of postmenopausal women have reportedly had sleep disturbances such as night sweats and hot flashes. T2D could intensify these sleep difficulties which could make diagnosed individuals require an additional dimension of care. Despite these correlations, the association between T2DM and sleep disturbances during the menopause transitions were overlooked.

The study’s data derived from 164 women of 2 larger internet survey studies, with 62 participants diagnosed with T2D and 102 without. Researchers aimed to explore 2 specific goals:

  • Differences in total numbers and total severity scores of sleep-related symptoms between midlife women with T2D and those without T2D (Aim 1)
  • Associations of T2D to the total numbers and total severity scores of sleep-related symptoms while considering other influencing factors on background characteristics, health status, and menopause status (Aim 2)

The total numbers and total severity scores in the participants revealed significantly higher numbers of sleep-related symptoms in those with T2D (9.95 ± 5.83) than those without (7.25 ± 6.08; t=2.81,P=0.006), and total severity in those with T2D (33.42 ± 22.41) than those without (21.87 ± 21.40; t=2.81,P=0.006).

Postmenopausal women also revealed stark differences in total numbers and total severity scores of sleep-related symptoms between those with and without T2D. Postmenopausal women with T2D had significantly higher total numbers (U=424.50, P=0.013) and total severity (U=319.00, P=0.005) of sleep-related symptoms than those without T2D (P<0.05). However, the difference between premenopausal and perimenopausal women with and without T2D, while still higher in participants with T2D, was not statistically significant (P<0.05).

The study revealed that Asian women were most prominently involved in sleep-related symptoms between those with and without T2D. Asian women were found to exhibit significantly higher total numbers (U=57.50, P=0.015) and total severity scores (U=53.50, P=0.010) than those without T2D (P<0.05) which was the only ethnical group to showcase significant differences of sleep-related symptoms between those with and without T2D.

NAMS medical director Stephanie Faubion, PhD, highlighted the importance of the findings and necessity for continued studies. “Further study is needed, given the limitations of the analysis, but this report highlights the fact that sleep problems are common in midlife women,” said Faubion. Overall statistics controlled for background, health status, and menopause status showcase the positive correlation for T2DM participants with sleep-related symptoms for total numbers (β=0.14, P=0.047) and total severity (β=0.18, P=0.014).

“Sleep is an important determinant of health, and women with poor sleep should be seen and evaluated for common and treatable sleep disorders such as insomnia, obstructive sleep apnea, and restless legs syndrome,” said Faubion.


Im EO, Yang YL, Liu J, et al. Sleep-related symptoms of midlife women with and without type 2 diabetes mellitus. [published online August 14, 2019]. Menopause. doi: 10.1097/GME.0000000000001383

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