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Patterns in trouble sleeping among women at mid-life: results from a British prospective cohort study
  1. S E Tom1,2,
  2. D Kuh2,
  3. J M Guralnik1,
  4. G D Mishra2
  1. 1
    Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland, USA
  2. 2
    Medical Research Council National Survey of Health and Development, Royal Free and University College Medical School, London, UK
  1. Correspondence to Dr S E Tom, Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Gateway Building, 3C309, 7201 Wisconsin Avenue, Bethesda, MD 20892-9205, USA; tomse{at}


Background: Although trouble sleeping is a common problem among women at mid-life, patterns in trouble sleeping relating to social and health-related risk factors are unclear. This analysis describes the dynamics of trouble sleeping among women at mid-life.

Methods: The National Survey of Health and Development is a nationally representative study of births in 1946 in England, Scotland, and Wales followed up through mid-life. Multistate life table analysis utilised 893 women interviewed annually between ages 48 to 54 years.

Results: Women spent an average of 2.6 years with trouble sleeping, and the average length of a continuous episode of trouble sleeping was 2.4 years. Among women who reported at least one episode, the average number of episodes was 1.5. Health-related risk factors at age 43 of number of physical conditions, anxiety and depression symptoms, use of prescription medication, and current or past trouble sleeping were related to increased total and per episode duration of trouble sleeping over the 7-year study interval and increased duration per episode. Differences associated with these risk factors ranged from 1.2 to 1.8 years for duration over the study interval and 0.5 to 0.8 years per episode. There was no association between average number of episodes per woman reporting at least one episode and these health-related risk factors at age 43.

Conclusions: This study provides support for association between increased duration of trouble sleeping, in total and per episode, and health risk factors at age 43, suggesting a long-term relationship between risk factors and sleep.

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  • Funding The Medical Research Council provided funding for the National Survey of Health and Development and financial support for GM and DK. Supported in part by the Intramural Research Program, National Institute on Aging, NIH.

  • Competing interests None declared.

  • Ethics approval North Thames Multicentre Research Ethics Committee.

  • Provenance and Peer review Not commissioned; externally peer reviewed.