Table 5 Representative quotations from concept elicitation phase on sleep impacts and self-care

Sleep Impacts and Related Self-Care

“You have to either change the pillow or turn it over. Many times I have 4 pillows at night because … I knew that if I get so wet, I would just change the pillow.” –Dallas-1

“It got so bad to where I had to get in the shower at night and go back to bed. It was just a gross feeling.” –Dallas-7

“I sleep in a short-sleeve gown that I take off in the course of the night. I still wear socks…but in the course of the night… I may take one off because my body is so hot.” –Chicago-2

“My husband and I have to sleep in separate rooms because I have to have the fan.” –Chicago-4

“[B]eing sleep deprived touches so many other aspects of being able to function the next day … and then you can’t catch up on it. You never recoup that loss.” –Chicago-7

“I feel like … I’m sleeping in a kettle.” –France-6

“… last night I was a bit chilly, so its typical duvet on, duvet off, you know, through the night… just a few hours of really good sleep.” –UK-4

“The hot flash itself goes away rather quickly but the feeling of warmth and heat remain longer. It means that if I want to go back to sleep peaceful, it will take at least 20 minutes” –France-2

“I am waking up nearly every hour on the hour … I don’t think I have had a decent night’s sleep for about 6 months.” –UK-7

“What bothers me most today are the hot flashes and the fact that I do not sleep properly anymore … that makes me suffer.” –France-6

“I have three or four pillows so they remain cool … I keep switching between them … Even if it is −15 [degrees] outside, my window is open.” –France-1

“I was waking him all night really. I would suddenly say I am hot and I would throw the quilt off and of course my husband would wake up then as well, so I moved into a different bedroom.” –UK-1

Daytime Self-care Impacts and Strategies for Coping With VMS

“I turn the air conditioner on in the wintertime or a fan.” –Chicago-4

“I tend to dress in layers.” –Chicago-6

“If I’m going somewhere … I wait until the last minute before I get dressed.” –Dallas-4

“… you get so sweaty and you need to change your [underwear]. And how do you explain you need to change your panties? Like I’m changing a diaper.” –Dallas-1

“I have always got spare clothes at work in case I have like a really bad hot flush.” –UK-5

“I’ll take a shower … and then I’ll get my hot flash so I sweat… then I shower again.” –France-5

“I am always conscious of sweaty smell … and I think if your body is perspiring anyway you are worried about the smell.” –UK-8

“I always have tissues on me … I know that I have to wipe off … especially in public transportation.” –France-5