ObjectiveMenopause is a significant period in a woman's life that can be natural or surgical. We aimed to assess the association between the type of menopause and sleep quality, especially in elderly women.MethodThis was a cross-sectional study using data from the first phase of the Ardakan Cohort Study on Ageing (ACSA) of 50 and above years of menopausal women, distributed into two groups of natural and surgical menopause. Three questionnaires were used to assess sleep quality, including Pittsburgh Sleep Quality Index (PSQI), Berlin questionnaire, and Epworth Sleepiness Scale. Multiple regression models were used to assess the association between the type of menopause and sleep quality. P-value less than 0.05 was considered significant.ResultsIn total, 2,532 menopausal and postmenopausal women were included in the study, of which 669 (26.4%) had surgical menopause. The mean of the PSQI score for participants with surgical menopause was 9.29 +/- 4.30 compared to 8.78 +/- 4.10 for participants with natural menopause (P-value = 0.001). 37.1% of participants with natural menopause had sleep-disordered breathing according to the Berlin questionnaire despite 43.9% among participants with surgical menopause (P-value = 0.007). The multivariable regression models showed that surgical menopause was not significantly associated with the PSQI score differences, Epworth score, or Berlin score compared to natural menopause (OR:0.89, 1.13, and 0.85; CI 95%: 0.13-1.19, 0.68-1.86, and 0.68-1.07 respectively).ConclusionThe findings suggest that the type of menopause is not associated with sleep quality. However, further studies employing objective sleep assessments are necessary to validate these results and guide clinicians and individuals in refraining from prioritizing the type of menopause as a significant risk factor for poor sleep quality.