Skip to main content

Sleep disturbance is associated with an increased risk of menstrual problems in female Chinese university students

Sleep and Breathing volume 24, pages 1719–1727 (2020)Cite this article

Abstract

Purpose

We aimed to investigate the association between sleep disturbance and menstrual problems in female Chinese university students.

Methods

A convenience sample of 1006 female university students participated in this study. Sleep duration, sleep quality, and insomnia symptoms were assessed by the Pittsburgh Sleep Quality Index and the Insomnia Severity Index. A structured questionnaire was used to assess participants’ demographics and menstrual characteristics.

Results

The prevalence rates of irregular menstrual cycle, heavy menstrual bleeding, menstrual flow length ≥ 7 days, period pain, and premenstrual syndrome were significantly higher in participants with sleep disturbance than those without sleep disturbance (all p < 0.05). After adjusting for potential confounding variables, poor sleep quality and insomnia symptoms were significantly associated with menstrual flow length ≥ 7 days (OR = 1.81, 95% CI = 1.23–2.68, OR = 1.67, 95% CI = 1.13–2.45), period pain (OR = 1.55, 95% CI = 1.02–2.35, OR = 1.56, 95% CI = 1.02–2.37), and premenstrual syndrome (OR = 1.71, 95% CI = 1.30–2.24, OR = 1.93, 95% CI = 1.46–2.56). In addition, poor sleep quality was significantly associated with heavy menstrual bleeding (OR = 1.75, 95% CI = 1.12–2.72), and insomnia symptoms were significantly associated with irregular menstrual cycle (OR = 1.36, 95% CI = 1.02–1.80). However, short sleep duration (≤ 6 h) was only associated with premenstrual syndrome.

Conclusion

Our results suggested that sleep disturbance is associated with menstrual problems among female university students. More attention should be paid to improving the sleep quality and insomnia symptoms in individuals with menstrual problems.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1

References

  1. Strine TW, Chapman DP, Ahluwalia IB (2005) Menstrual-related problems and psychological distress among women in the United States. J Womens Health 14(4):316–323

    Article  Google Scholar 

  2. Anastasakis E, Kingman CE, Lee CA, Economides DL, Kadir RA (2008) Menstrual problems in university students: an electronic mail survey. Vivo 22(5):617

    CAS  Google Scholar 

  3. Sahin S, Ozdemir K, Unsal A, Arslan R (2014) Review of frequency of dysmenorrhea and some associated factors and evaluation of the relationship between dysmenorrhea and sleep quality in university students. Gynecol Obstet Investig 78(3):179–185

    Article  Google Scholar 

  4. Cheng SH, Shih CC, Yang YK, Chen KT, Chang YH, Yang YC (2013) Factors associated with premenstrual syndrome &mdash; a survey of new female university students. Kaohsiung J Med Sci 29(2):100–105

    Article  Google Scholar 

  5. Rowland AS, Donna Day B, Stuart L, Ganesa W, Harlow SD, Michael A, Sandler DP (2002) Influence of medical conditions and lifestyle factors on the menstrual cycle. Epidemiology 13(6):668–674

    Article  Google Scholar 

  6. Liu K, He L, Tang X, Wang J, Li N, Wu Y, Marshall R, Li J, Zhang Z, Liu J (2014) Relationship between menopause and health-related quality of life in middle-aged Chinese women: a cross-sectional study. BMC Womens Health 14(1):7–7

    Article  Google Scholar 

  7. Kato I, Toniolo P, Koenig KL, Shore RE, Zeleniuch-Jacquotte A, Akhmedkhanov A, Riboli E (1999) Epidemiologic correlates with menstrual cycle length in middle aged women. Eur J Epidemiol 15(9):809–814

    CAS  Article  Google Scholar 

  8. Dorn LD, Sonya N, Bin H, Stephanie P, Jennifer H, Paula B, Susman EJ (2009) Menstrual symptoms in adolescent girls: association with smoking, depressive symptoms, and anxiety. J Adolesc Health 44(3):237–243

    Article  Google Scholar 

  9. Alger SE, Chambers AM, Cunningham T, Payne JD (2014) The role of sleep in human declarative memory consolidation. Curr Top Behav Neurosci 25:269–306

    Article  Google Scholar 

  10. Han-Na K, Juhee C, Yoosoo C, Seungho R, Hocheol S, Hyung-Lae K (2015) Association between personality traits and sleep quality in young Korean women. PLoS One 10(6):e0129599

    Article  Google Scholar 

  11. Bailey BW, Allen MD, LeCheminant JD, Tucker LA, Errico WK, Christensen WF, Hill MD (2014) Objectively measured sleep patterns in young adult women and the relationship to adiposity. Am J Health Promot 29(1):46–54

    Article  Google Scholar 

  12. Nam GE, Han K, Lee G (2017) Association between sleep duration and menstrual cycle irregularity in Korean female adolescents. Sleep Med 35:62–66

    Article  Google Scholar 

  13. Wang Y, Gu F, Deng M, Guo L, Lu C, Zhou C, Chen S, Xu Y (2016) Rotating shift work and menstrual characteristics in a cohort of Chinese nurses. BMC Womens Health 16(1):24

    Article  Google Scholar 

  14. Negriff S, Dorn LD (2009) Morningness/eveningness and menstrual symptoms in adolescent females. J Psychosom Res 67(2):169–172

    Article  Google Scholar 

  15. Kabrita CS, Hajjar-Muça TA, Duffy JF (2014) Predictors of poor sleep quality among Lebanese university students: association between evening typology, lifestyle behaviors, and sleep habits. Nat Sci Sleep 6:11–18

    Article  Google Scholar 

  16. Sara A, Marcos B, Robert M (2009) Gender and socio-economic patterning of self-reported sleep problems in Britain. Soc Sci Med 68(2):281–289

    Article  Google Scholar 

  17. Beck F, Richard JB, Léger D (2013) Insomnia and total sleep time in France: prevalence and associated socio-demographic factors in a general population survey. Rev Neurol 169(12):956–964

    CAS  Article  Google Scholar 

  18. Zhang B, Wing YK (2006) Sex differences in insomnia: a meta-analysis. Sleep 29(1):85–93

    Article  Google Scholar 

  19. Judith O (2014) Insufficient sleep in adolescents and young adults: an update on causes and consequences. Pediatrics 134(3):e921

    Article  Google Scholar 

  20. Mortola JF, Girton L, Beck L, Yen S (1990) Diagnosis of premenstrual syndrome by a simple, prospective, and reliable instrument: the calendar of premenstrual experiences. Obstet Gynecol 76(2):302–307

    CAS  PubMed  Google Scholar 

  21. Russell K, Allan S, Beattie L, Bohan J, Macmahon K, Rasmussen S (2019) Sleep problem, suicide and self-harm in university students: a systematic review. Sleep Med Rev 4(44):58–69

    Article  Google Scholar 

  22. Khazaie H, Ghadami MR, Khaledi-Paveh B, Chehri A, Nasouri M (2016) Sleep quality in university students with premenstrual dysphoric disorder. Shanghai Arch Psychiatry 28(3):131–138

    PubMed  PubMed Central  Google Scholar 

  23. Baker FC, Driver HS (2007) Circadian rhythms, sleep, and the menstrual cycle. Sleep Med 8(6):613–622

    Article  Google Scholar 

  24. Yu M, Han K, Nam GE (2017) The association between mental health problems and menstrual cycle irregularity among adolescent Korean girls. J Affect Disord 210 (undefined):43–48

    Article  Google Scholar 

  25. Pei-Jen C, Pau-Chung C, Chia-Jung H, Li-Tan C (2010) Risk factors on the menstrual cycle of healthy Taiwanese college nursing students. Aust N Z J Obstet Gynaecol 49(6):689–694

    Google Scholar 

  26. Jappe LM, Li C, Crosby RD, Crow SJ, Peterson CB, Daniel LG, Engel SG, Wonderlich SA (2014) Stress and eating disorder behavior in anorexia nervosa as a function of menstrual cycle status. Int J Eat Disord 47(2):181–188

    Article  Google Scholar 

  27. Araujo P, Hachul H, Santos-Silva R, Bittencourt LRA, Tufik S, Andersen ML (2011) Sleep pattern in women with menstrual pain. Sleep Med 12(10):1028–1030

    CAS  Article  Google Scholar 

  28. Liu X, Chen H, Liu ZZ, Fan F, Jia CX (2017) Early menarche and menstrual problems are associated with sleep disturbance in a large sample of Chinese adolescent girls. Sleep 40(9) undefined

  29. Baker FC, Sassoon SA, Kahan T, Palaniappan L, Nicholas CL, Trinder J, Colrain IM (2012) Perceived poor sleep quality in the absence of polysomnographic sleep disturbance in women with severe premenstrual syndrome. J Sleep Res 21(5):535–545

    Article  Google Scholar 

  30. Romans SE, Kreindler D, Einstein G, Laredo S, Petrovic MJ, Stanley J (2015) Sleep quality and the menstrual cycle. Sleep Med 16(4):489–495

    Article  Google Scholar 

Download references

Funding

This work was financially supported by the National Natural Science Foundation of China (81700087).

Author information

Author notes

  1. Xiaocun Xing and Pei Xue contributed equally to this work.

Authors and Affiliations

  1. Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China

    Xiaocun Xing, Pei Xue, Junying Zhou & Xiangdong Tang

  2. Department of Psychology, The University of Hong Kong, Pokfulam Road, Hong Kong SAR

    Shirley Xin Li

  3. The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong SAR

    Shirley Xin Li

  4. Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China

    Junying Zhou

Authors
  1. Xiaocun Xing
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pei Xue
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shirley Xin Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Junying Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xiangdong Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Junying Zhou.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 25 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Xing, X., Xue, P., Li, S.X. et al. Sleep disturbance is associated with an increased risk of menstrual problems in female Chinese university students. Sleep Breath 24, 1719–1727 (2020). https://doi.org/10.1007/s11325-020-02105-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11325-020-02105-1

Keywords

  • Sleep
  • Menstruation
  • Insomnia
  • Dysmenorrhea
  • Premenstrual syndrome