NCHS Data Brief ■ No. 286 ■ September 2017

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Sleep Duration and Quality Among Women Aged 40–59, 

by Menopausal Status

Anjel Vahratian, Ph.D.

Key findings

Data from the National 

Health Interview Survey, 

2015

● Among those aged

40–59, perimenopausal women

(56.0%) were more likely than

postmenopausal (40.5%) and

premenopausal (32.5%) women

to sleep less than 7 hours, on

average, in a 24-hour period.

● Postmenopausal women

aged 40–59 were more likely

than premenopausal women

aged 40–59 to have trouble

falling asleep (27.1% compared

with 16.8%, respectively),

and staying asleep (35.9%

compared with 23.7%), four

times or more in the past week.

● Postmenopausal women

aged 40–59 (55.1%) were more

likely than premenopausal

women aged 40–59 (47.0%) to

not wake up feeling well rested

4 days or more in the past

week.

Sleep duration and quality are important contributors to health and 

wellness. Insufficient sleep is associated with an increased risk for chroni

conditions such as cardiovascular disease (1) and diabetes (2). Women may 

be particularly vulnerable to sleep problems during times of reproductive 

hormonal change, such as after the menopausal transition. Menopause is “the 

permanent cessation of menstruation that occurs after the loss of ovarian 

activity” (3). This data brief describes sleep duration and sleep quality among 

nonpregnant women aged 40–59 by menopausal status. The age range selected 

for this analysis reflects the focus on midlife sleep health. In this analysis,

74.2% of women are premenopausal, 3.7% are perimenopausal, and 22.1% are 

postmenopausal.

Keywords: insufficient sleep • menopause • National Health Interview Survey

Perimenopausal women were more likely than 

premenopausal and postmenopausal women to sleep less 

than 7 hours, on average, in a 24-hour period.

 
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NCHS Data Brief ■ No. 286 ■ September 2017

More than one in three nonpregnant women aged 40–59 slept less than 7 hours, on average, in a 

24-hour period (35.1%) (Figure 1). Perimenopausal women were most likely to sleep less than

7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and

40.5% of postmenopausal women. Postmenopausal women were significantly more likely tha

premenopausal women to sleep less than 7 hours, on average, in a 24-hour period.

The percentage of women aged 40–59 who had trouble falling asleep

four times or more in the past week varied by menopausal status. 

Nearly one in five nonpregnant women aged 40–59 had trouble falling asleep four times o

more in the past week (19.4%) (Figure 2). The percentage of women in this age group who 

had trouble falling asleep four times or more in the past week increased from 16.8% among 

premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal 

women. Postmenopausal women were significantly more likely than premenopausal women t

have trouble falling asleep four times or more in the past week. 

 
NCHS Data Brief ■ No. 286 ■ September 2017

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The percentage of women aged 40–59 who had trouble staying asleep

four times or more in the past week varied by menopausal status.

More than one in four nonpregnant women aged 40–59 had trouble staying asleep four times or 

more in the past week (26.7%) (Figure 3). The percentage of women aged 40–59 who had trouble 

staying asleep four times or more in the past week increased from 23.7% among premenopausal, 

to 30.8% among perimenopausal, and to 35.9% among postmenopausal women. Postmenopausal 

women were significantly more likely than premenopausal women to have trouble staying asleep

four times or more in the past week.

 
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NCHS Data Brief ■ No. 286 ■ September 2017

The percentage of women aged 40–59 who did not wake up feeling 

well rested 4 days or more in the past week varied by menopausal status.

Nearly one in two nonpregnant women aged 40–59 did not wake up feeling well rested 4 days or 

more in the past week (48.9%) (Figure 4). The percentage of women in this age group who did 

not wake up feeling well rested 4 days or more in the past week increased from 47.0% among 

premenopausal women to 49.9% among perimenopausal and 55.1% among postmenopausal 

women. Postmenopausal women were significantly more likely than premenopausal women t

not wake up feeling well rested 4 days or more in the past week.

 
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NCHS Data Brief ■ No. 286 ■ September 2017

Summary

This report describes sleep duration and sleep quality among U.S. nonpregnant women aged 

40–59 by menopausal status. Perimenopausal women were most likely to sleep less than 7 hours, 

on average, in a 24-hour period compared with premenopausal and postmenopausal women. 

In contrast, postmenopausal women were most likely to have poor-quality sleep. A greater 

percentage of postmenopausal women had frequent trouble falling asleep, staying asleep, and 

not waking well rested compared with premenopausal women; the percentage of perimenopausal 

women with poor-quality sleep was between the percentages for the other two groups in all three 

categories. Sleep duration changes with advancing age (4), but sleep duration and quality are also 

influenced by concurrent changes in women’s reproductive hormone levels (5). Because sleep is 

critical for optimal health and well-being (6), the findings in this report highlight areas for further 

research and targeted health promotion. 

Definitions

Menopausal status: A three-level categorical variable was created from a series of questions that 

asked women: 1) “How old were you when your periods or menstrual cycles started?”; 2) “Do 

you still have periods or menstrual cycles?”; 3) “When did you have your last period or menstrual 

cycle?”; and 4) “Have you ever had both ovaries removed, either as part of a hysterectomy or 

as one or more separate surgeries?” Women were postmenopausal if they a) had gone without a 

menstrual cycle for more than 1 year or b) were in surgical menopause after the removal of their 

ovaries. Women were perimenopausal if they a) no longer had a menstrual cycle and b) their last 

menstrual cycle was 1 year ago or less. Premenopausal women still had a menstrual cycle.

Not waking feeling well rested: Determined by respondents who answered 3 days or less on the 

questionnaire item asking, “In the past week, on how many days did you wake up feeling well 

rested?”

Short sleep duration: Determined by respondents who answered 6 hours or less on the 

questionnaire item asking, “On average, how many hours of sleep do you get in a 24-hour 

period?”

Trouble falling asleep: Determined by respondents who answered four times or more on the 

questionnaire item asking, “In the past week, how many times did you have trouble falling 

asleep?”

Trouble staying asleep: Determined by respondents who answered four times or more on the 

questionnaire item asking, “In the past week, how many times did you have trouble staying 

asleep?”
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NCHS Data Brief ■ No. 286 ■ September 2017

Data source and methods

Data from the 2015 National Health Interview Survey (NHIS) were used for this analysis. NHIS 

is a multipurpose health survey conducted continuously throughout the year by the National 

Center for Health Statistics. Interviews are conducted in person in respondents’ homes, but 

follow-ups to complete interviews may be conducted over the telephone. Data for this analysis 

came from the Sample Adult core and cancer supplement sections of the 2015 NHIS. For more 

information about NHIS, including the questionnaire, visit the NHIS website: https://www.cdc.

gov/nchs/nhis/index.htm. 

All analyses used weights to produce national estimates. Estimates on sleep duration and quality 

in this report are nationally representative of the civilian, noninstitutionalized nonpregnant 

female population aged 40–59 living in households across the United States. The sample design 

is described in more detail elsewhere (7). Point estimates and their estimated variances were 

calculated using SUDAAN software (8) to account for the complex sample design of NHIS. 

Linear and quadratic trend tests of the estimated proportions across menopausal status were tested 

in SUDAAN via PROC DESCRIPT using the POLY option. Differences between percentages

were evaluated using two-sided significance tests at the 0.05 level

About the author

Anjel Vahratian is with the National Center for Health Statistics, Division of Health Interview 

Statistics. The author gratefully acknowledges the assistance of Lindsey Black in the preparation 

of this report.
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NCHS Data Brief ■ No. 286 ■ September 2017

References

1. Ford ES. Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled

cohort risk equations among US adults. J Am Heart Assoc 3(6):e001454. 2014.

2. Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB. Associations between selfreported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose,

insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes

6(4):338–50. 2014.

3. American College of Obstetrics and Gynecology. ACOG Practice Bulletin No. 141:

Management of menopausal symptoms. Obstet Gynecol 123(1):202–16. 2014.

4. Black LI, Nugent CN, Adams PF. Tables of adult health behaviors, sleep: National Health

Interview Survey, 2011–2014. 2016. Available from: https://ftp.cdc.gov/pub/Health_Statistics/

NCHS/NHIS/SHS/2011-2014_AHB_Table_SLP-1.pdf.

5. Santoro N. Perimenopause: From research to practice. J Women’s Health (Larchmt)

25(4):332–9. 2016.

6. Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended

amount of sleep for a healthy adult: A joint consensus statement of the American Academy of

Sleep Medicine and Sleep Research Society. J Clin Sleep Med 11(6):591–2. 2015.

7. Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health

Interview Survey, 2006–2015. National Center for Health Statistics. Vital Health Stat 2(165).

2014.

8. RTI International. SUDAAN (Release 11.0.0) [computer software]. 2012.
NCHS Data Brief ■ No. 286 ■ September 2017

Suggested citation

Vahratian A. Sleep duration and quality 

among women aged 40–59, by menopausal 

status. NCHS data brief, no 286. Hyattsville, 

MD: National Center for Health Statistics. 

2017.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Interview Statistics

Marcie L. Cynamon, Director

Stephen J. Blumberg, Ph.D., Associate 

Director for Science

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