A study shows insomnia symptoms will likely worsen later in the menopause cycle and may be worse if menopause is brought on by surgery. The new study coming out of the University of Pennsylvania was presented at the 2016 Annual Meeting of The North American Menopause Society (NAMS) in October 5.

If you’re a woman, you already likely know the bad news that as you transition from your reproductive years to your nonreproductive years (a phase called perimenopause), you may begin to experience sleep disturbances that can lead to additional health issues. In this study, 31% to 42% of perimenopausal women reported symptoms that met the criteria for nighttime insomnia disorder. Unlike other sleep-related studies, this study attempted to identify a stage of perimenopause during which insomnia symptoms become more prevalent.

The study performed secondary analysis of 10 years’ worth of data collected from the Study of Women’s Health Across the Nation (SWAN). The data confirmed that there are significant differences among the various perimenopause-stage groups with respect to the development of insomnia symptoms. Women who were in the early stage of perimenopause, for example, were 0.82 times less likely to develop insomnia symptoms than those who progressed from early to late to postmenopause. Of greater note is that those who progressed from early to late perimenopause are 0.70 times less likely to develop insomnia symptoms than those who progress from the early stage to surgical menopause.

“Very little research had been done to address insomnia in perimenopausal women as they transitioned to menopause,” says Colleen Ciano, PhD, RN, CNE, of the University of Pennsylvania School of Nursing and lead author of the study, in a release. “We now know that sleep disturbances are likely to worsen as women move through the transition and may likely be worst for women who are experiencing menopause as the result of surgery.”

“This study highlights the need for healthcare providers to screen for an insomnia disorder in the highest-risk groups and to be knowledgeable about the various interventions,” says JoAnn Pinkerton, MD, NAMS executive director.