RISK FACTORS FOR POOR SLEEP QUALITY AMONG MENOPAUSAL WOMEN IN MACAO: A CROSS-SECTIONAL STUDY IN THE GREATER BAY AREA Hao Iao LEE1, Cindy Sin U LEONG2*, Weng Ian Phoenix PANG3, Ion Meng WONG4, Jingwen CHEN5, Xin WANG6 1Department of Day Medical Center,

Abstract

Introduction and aim. Sleep disturbances are a pervasive challenge during the menopausal transition. Macao, a densely populated city, presents a unique environment with a 24-hour tourism industry and prevalent shift work, which may exacerbate sleep problems in midlife women. This cross-sectional study aimed to investigate the prevalence of poor sleep quality and identify its key determinants among menopausal women in Macao.

Material and methods. A total of 360 menopausal women aged 45–59 years were recruited via a street-intercept survey. Sleep quality was assessed using the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), and data on sociodemographics, lifestyle, health status, and menopausal symptoms (Greene Climacteric Scale) were collected. Data were analyzed using descriptive statistics, chi-square tests, ANOVA, and stepwise logistic regression.

Results. The mean PSQI score for the sample was 8.07 ± 3.77, with 75.3% (n=271) of participants classified as poor sleepers. Logistic regression identified five significant predictors of poor sleep quality: difficulty falling asleep (OR = 4.54, 95% CI: 2.70–7.65, p < .001), feeling tired/lacking energy (OR = 2.24, 95% CI: 1.33–3.76, p = .002), having no regular exercise habit (OR = 2.23, 95% CI: 1.16–4.31, p = .017), experiencing muscle/joint pain (OR = 1.71, 95% CI: 1.10–2.64, p = .017), and being in a later menopausal stage (OR = 1.55, 95% CI: 1.03–2.34, p = .034). Women with severe menopausal symptoms had significantly worse mean PSQI scores than those with milder symptoms (9.71 vs. 4.00, p < .001).

Conclusion. These findings highlight a high prevalence of poor sleep quality in Macau's menopausal women, determined by a complex interplay of specific menopausal symptoms, modifiable lifestyle factors, and physiological progression through menopause, underscoring the need for integrated public health and clinical interventions.