(PS2-48) The Impact of Anxiety Sensitivity on the Relationship Between Vasomotor Symptoms and Sleep Quality in Menopause

Background: Sleep disturbance during menopause has been well-documented. A variety of menopausal symptoms have been implicated in poor sleep, and in particular vasomotor symptoms (Utian, 2005). For example, studies have shown hot flashes to be associated with sleep difficulties and worse sleep quality during menopause (Baker et al., 2018; Depree et al., 2023). It is likely that people who are particularly sensitive to and attentive toward physiological arousal symptoms would experience hot flash symptoms as amplified, and therefore potentially more impactful in disrupting sleep. Anxiety sensitivity is a construct that identifies fear of anxiety and anxiety-related symptoms (Reiss, 1991). People high in anxiety sensitivity tend to be more aware of symptoms of physiological arousal and fear the potential consequences of them. Not surprisingly, research has shown that women who are high in anxiety sensitivity experience more menopause-related distress (Muslic & Jokic-Begic, 2016). Given that symptoms of a hot flash (e.g., sweating, heart racing) are quite similar to the somatic symptoms of anxiety, it stands to reason that people high in anxiety sensitivity might be particularly in tune to (and fear the consequences of) the somatic sensations that come with hot flashes. Given that hot flashes often occur at night and disrupt sleep (Savard et al., 2013), we hypothesized that women high in anxiety sensitivity would show a stronger association between hot flash symptom severity and sleep disturbance.

Methods: 227 menopausal women, recruited primarily through ResearchMatch, completed a survey investigating physical and emotional symptoms of menopause. Participants were between the ages of 42 and 60, and they were in either peri- or early-post menopause. Vasomotor symptoms were measured by combining the vasomotor symptom items from a newly developed Menopause Symptom Questionnaire (see Provolo et al, 2023). Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI; Buysse, 1989). Anxiety sensitivity was measured with the Anxiety Sensitivity Index (ASI; Reiss et al., 1986). Participants completed the survey online.

Results & Conclusions: We used a linear regression to investigate the potential moderating effect of anxiety sensitivity on the relationship between vasomotor symptoms and sleep quality. There was a significant interaction effect, such that women who reported higher anxiety sensitivity showed a stronger positive relationship between vasomotor symptoms and sleep disruption. Hence, it appears that anxiety sensitivity might worsen the impact of hot flash symptoms as women are trying to sleep. It might be helpful to target anxiety sensitivity in cognitive treatments of menopausal distress.