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Liu H, Wu Y, Zhu H, Wang P, Chen T, Xia A, Zhao Z, He D, Chen X, Xu J, Ji L. Association between napping and type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2024; 15:1294638. [PMID: 38590820 PMCID: PMC10999583 DOI: 10.3389/fendo.2024.1294638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/12/2024] [Indexed: 04/10/2024] Open
Abstract
As the incidence of type 2 diabetes mellitus (T2DM) is increasing rapidly and its consequences are severe, effective intervention and prevention, including sleep-related interventions, are urgently needed. As a component of sleep architecture, naps, alone or in combination with nocturnal sleep, may influence the onset and progression of T2DM. Overall, napping is associated with an increased risk of T2DM in women, especially in postmenopausal White women. Our study showed that napping >30 minutes (min) increased the risk of T2DM by 8-21%. In addition, non-optimal nighttime sleep increases T2DM risk, and this effect combines with the effect of napping. For nondiabetic patients, napping >30 min could increase the risks of high HbA1c levels and impaired fasting glucose (IFG), which would increase the risk of developing T2DM later on. For diabetic patients, prolonged napping may further impair glycemic control and increase the risk of developing diabetic complications (e.g., diabetic nephropathy) in the distant future. The following three mechanisms are suggested as interpretations for the association between napping and T2DM. First, napping >30 min increases the levels of important inflammatory factors, including interleukin 6 and C-reactive protein, elevating the risks of inflammation, associated adiposity and T2DM. Second, the interaction between postmenopausal hormonal changes and napping further increases insulin resistance. Third, prolonged napping may also affect melatonin secretion by interfering with nighttime sleep, leading to circadian rhythm disruption and further increasing the risk of T2DM. This review summarizes the existing evidence on the effect of napping on T2DM and provides detailed information for future T2DM intervention and prevention strategies that address napping.
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Affiliation(s)
- Hongyi Liu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Yingxin Wu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Hui Zhu
- Department of Internal Medicine, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Penghao Wang
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Tao Chen
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Anyu Xia
- Department of Clinical Medicine, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Zhijia Zhao
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Da He
- Department of Obstetrics and Gynecology, Yinzhou District Maternal and Child Health Care Institute, Ningbo, Zhejiang, China
| | - Xiang Chen
- Department of Obstetrics and Gynecology, Yinzhou District Maternal and Child Health Care Institute, Ningbo, Zhejiang, China
| | - Jin Xu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
- Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, China
| | - Lindan Ji
- Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, China
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
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Wang Y, Guan R, Zhong J, Shi Q, Ye Z, Pan L. Research progress on the treatment of perimenopausal insomnia with Chaihu Jia Longgu Muli decoction based on brain-intestine-bacteria axis: A review. Medicine (Baltimore) 2023; 102:e36537. [PMID: 38134054 PMCID: PMC10735104 DOI: 10.1097/md.0000000000036537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/17/2023] [Indexed: 12/24/2023] Open
Abstract
With the progress and rapid societal development, women are confronted with multifaceted pressures in their lives, encompassing familial and other domains. Furthermore, during the perimenopausal phase, endocrine equilibrium is disrupted, leading to the emergence of psychological and physiological health challenges. Insomnia is a prevalent symptom among perimenopausal individuals. The brain-gut-bacteria axis assumes a pivotal role in the prevention, diagnosis, and management of perimenopausal insomnia. Chaihu Jia Longgu Muli decoction is a commonly prescribed remedy for addressing perimenopopausal insomnia. Consequently, this paper aims to investigate the interplay between the brain-gut-bacteria axis, intestinal microbiota, and the pathogenesis of perimenopausal insomnia. The study focuses on examining the regulatory effects of Chaihu Jia Longgu Muli decoction on the nervous system, intestinal microbiota, and the hypothalamus-pituitary-adrenal axis. Additionally, it explores the mechanisms underlying Hujia Longgu Muli decoction in mitigating perimenopausal insomnia.
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Affiliation(s)
- Yaolei Wang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Ruiqian Guan
- Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jifa Zhong
- Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Qingchun Shi
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Ziyu Ye
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Limin Pan
- The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
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3
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Zhang J, Jiang B. Influence of Melatonin Treatment on Emotion, Sleep, and Life Quality in Perimenopausal Women: A Clinical Study. JOURNAL OF HEALTHCARE ENGINEERING 2023; 2023:2198804. [PMID: 37854169 PMCID: PMC10581846 DOI: 10.1155/2023/2198804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 10/20/2023]
Abstract
Method 100 healthy perimenopausal women were recruited and randomly assigned to two groups, with 50 subjects in each group. In the control group, placebo was administrated daily for 3 cycles (4 weeks of treatment for 1 cycle and drug withdrawals for 1 week). The study group received 3 mg oral melatonin treatment daily in the same period of time. All subjects completed the study. We compared the uterine volume, endometrial thickness, LH (luteinizing hormone), FSH (follicle generating hormone), E2 (estradiol), and melatonin levels during daytime between the two groups before and after the study. Moreover, perimenopause syndrome, sleep, mood, and QoL were analyzed at the baseline and 3 cycles by the questionnaires of the Kupperman index, the Pittsburgh sleep quality index (PSQI), the Hamilton anxiety scale (HAMA), and the Hamilton depression scale (HAMD), as well as menopausal QoL (MENQOL), respectively. Any adverse reactions experienced by the subjects were also compared in the study. Finally, 91 participants (92%) completed the whole study, 47 and 44 in the study and control groups, respectively, and their data were considered in subsequent analyses. Results After therapy, the two groups were similar in the uterine volume and endometrial thickness. In contrast to the control group, the study group showed notably decreased LH and FSH levels. No notable difference was discovered in E2 and melatonin levels between the two groups in the study. Moreover, the study group exhibited a significantly lower score in the Kupperman index, PSQI, HAMA, HAMD, and MENQOL scale than the control group. Moreover, the two groups had no notable difference in adverse reactions. Conclusion Melatonin was a useful treatment to relieve climacteric symptoms and improve sleep, mood, and life quality in perimenopausal women without obvious adverse reactions.
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Affiliation(s)
- Jianfu Zhang
- Department of Pharmacy, Ningbo Women and Children's Hospital, Ningbo 315012, China
| | - Bengui Jiang
- Department of Gynecology, Ningbo Women and Children's Hospital, Ningbo 315012, China
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Kim NY, Yoo SK, Jin JC, Han S, Hong JS, Kim SM. Development and verification of the Menopause Emotional Symptom Questionnaire. Menopause 2023; 30:961-968. [PMID: 37490658 DOI: 10.1097/gme.0000000000002224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
OBJECTIVE A detailed, well-validated scale for measuring emotional symptoms in menopausal women is lacking. We aimed to develop the Menopause Emotional Symptom Questionnaire (MESQ) and to confirm its reliability and validity among Koreans. METHODS Eighteen primary items based on previous research results were selected using exploratory factor analysis and confirmatory factor analysis (CFA). New data, including answers to the novel MESQ, Menopause Rating Scale, Kupperman Index, Beck Depression Inventory-II, and Beck Anxiety Inventory, were collected from 200 perimenopausal women and 100 young men through a research company. Exploratory factor analysis and CFA were performed again to determine whether the MESQ accurately measures emotional symptoms in perimenopausal women. Receiver operating characteristic curve and k-means cluster analyses were used to identify the most appropriate cutoff value. RESULTS The MESQ showed high internal consistency (Cronbach α = 0.926), and the CFA revealed that the factor structure comprised two subscales: nine items for mood/anxiety symptoms and four items for sleep symptoms. A high correlation between the total MESQ score and total scores of the existing scales was confirmed, indicating high convergence validity. Comparison of the mean MESQ scores between men and women showed significant sex difference, indicating secure known-group validity. The cutoff point of the total MESQ score between the high-risk and low-risk groups was 26. CONCLUSIONS The novel MESQ has high validity and reliability, and this study confirmed that the MESQ is a valid tool for screening for and measuring emotional symptoms in menopausal women in Korea.
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Affiliation(s)
- Na Yeon Kim
- From the Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Seo-Koo Yoo
- School of Social Welfare, Soongsil University, Seoul, Republic of Korea
| | - Jae-Chan Jin
- School of Social Welfare, Soongsil University, Seoul, Republic of Korea
| | - Seunga Han
- Department of Political Science, Vanderbilt University, Nashville, TN
| | - Ji Sun Hong
- From the Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Sun Mi Kim
- From the Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
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Baker FC. Optimizing sleep across the menopausal transition. Climacteric 2023; 26:198-205. [PMID: 37011660 PMCID: PMC10416747 DOI: 10.1080/13697137.2023.2173569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/19/2023] [Indexed: 04/05/2023]
Abstract
Women frequently experience sleep disturbances, particularly night-time awakenings, as they transition menopause and enter postmenopause. Sleep is essential for optimal functioning and health. Persistent and distressing sleep disturbances across menopause can negatively impact daytime functioning and productivity, and increase risk for mental and physical health conditions. While multiple factors can disturb sleep, two unique factors in the context of menopause are vasomotor symptoms and the changing reproductive hormone environment. Vasomotor symptoms are associated with sleep disturbances and contribute significantly to awakenings and amount of time spent awake during the night. Even after accounting for vasomotor and depressive symptoms, lower estradiol and higher follicle stimulating hormone levels, indicative of menopause, are associated with sleep disturbance, particularly awakenings, suggesting that the hormone environment may directly affect sleep. Management strategies for clinically significant menopausal sleep disturbances include cognitive behavioral therapy for insomnia, which is effective and durable in treating menopausal insomnia. Hormone therapy alleviates sleep disturbances, particularly in the presence of disruptive vasomotor symptoms. Sleep disturbances have a significant impact on women's functioning and health, and there is a need for further research of the underlying mechanisms to advance effective preventative and treatment strategies that ensure optimal health and well-being of midlife women.
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Affiliation(s)
- F C Baker
- Center for Health Sciences and Human Sleep Research Program, SRI International, Menlo Park, CA, USA
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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6
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Lahiani M, Ben Waer F, Bouchaala F, Laatar R, Rebai H, Sahli S. Time-of-Day Effect on Postural Balance and Its Associations with Menopausal Symptoms in Postmenopausal Women. Percept Mot Skills 2023; 130:5-26. [PMID: 36240107 DOI: 10.1177/00315125221133599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Postmenopausal women suffer from postural balance issues. During a 24-hour time span, postural performance undergoes radical changes as influenced by the circadian rhythm. In this study, we aimed to investigate time-of-day effects on postural balance in postmenopausal women and balance relationships with menopausal symptoms. Two groups of women, aged 40-50 years, participated in this study: a menopausal group and a control group. We evaluated their postural balance and menopausal symptoms (mood, sleepiness and fatigue) in five sessions over the course of a day: at 06:00 hours, at 10:00, at 14:00, at 18:00 and at 22:00. The results showed that postural balance (center of pressure area (CoParea)) values of postmenopausal women were significantly worse (p < .05) at 22:00. Moreover, at this time-of-day, participants in the menopausal group were more tired, less vigilant and experienced a lower mood. We found negative correlations between postural balance and both mood and fatigue levels. However, there was no time-of-day effect on postural balance, mood, fatigue, and sleepiness among participants in the control group. Thus, time-of-day should be considered a factor to control when assessing postural balance and designing intervention studies for postmenopausal women; and it is important for these women to be cautious of fall risks at night, as they are then less stable than at other times-of-day.
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Gordon JL, Nowakowski S, Gurvich C. Editorial: The Psychology of Menopause. Front Glob Womens Health 2022; 2:828676. [PMID: 35128528 PMCID: PMC8812523 DOI: 10.3389/fgwh.2021.828676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 12/24/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jennifer L. Gordon
- Department of Psychology, University of Regina, Regina, SK, Canada
- *Correspondence: Jennifer L. Gordon
| | - Sara Nowakowski
- Health Services Research, Baylor College of Medicine, Houston, TX, United States
| | - Caroline Gurvich
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
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Nowakowski S, Levy-Meeks ME, Dawson DB, Meers JM, Stout-Aguilar JS, Kilic GS, Borahay MA. Association of preoperative sleep pattern with posthysterectomy pain: a pilot study. J Clin Sleep Med 2021; 16:1901-1908. [PMID: 32776870 DOI: 10.5664/jcsm.8730] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
STUDY OBJECTIVES To evaluate the association of preoperative sleep pattern with posthysterectomy pain perception and satisfaction with surgery. METHODS This pilot study included women undergoing minimally invasive hysterectomy for benign conditions. Sleep quality, insomnia severity, and insomnia risk were assessed pre- and postoperatively via standard questionnaires. Total sleep time, wake after sleep onset, and sleep efficiency were measured before and after hysterectomy using daily sleep diaries and wrist-worn actigraphy. Pain perception and satisfaction with hysterectomy were assessed postoperatively. Repeated-measures analysis of variance, Pearson's correlation, and linear regression were used for analysis. RESULTS Twenty women participated; of them 16 had complete data and were analyzed. Total sleep time increased from 384 ± 102 minutes before to 468 ± 96 minutes after surgery (P = .023). Wake after sleep onset, a measure of sleep fragmentation, increased from 26 ± 15.1 minutes before to 52 ± 22.9 minutes after surgery (P = .014). Pearson's correlation showed preoperative total sleep time was inversely correlated with postoperative pain intensity (r = -.92, P = .01). Preoperative wake after sleep onset was positively correlated with postoperative pain intensity (r = .86, P = .008). Preoperative insomnia severity and insomnia risk were positively associated with postoperative pain and pain behaviors (β = 0.41, P < .05; β = 0.55, P < .01, respectively). Finally, preoperative sleep efficiency was positively associated with overall satisfaction with hysterectomy (β = 0.39, P < .05). CONCLUSIONS Sleep duration and fragmentation increase following hysterectomy. Shorter, more fragmented preoperative sleep is associated with greater postoperative pain intensity. Better preoperative sleep was associated with more satisfaction after hysterectomy. Further studies are needed to determine if preoperative sleep interventions such as cognitive behavioral therapy improve pain perception and satisfaction after hysterectomy.
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Affiliation(s)
- Sara Nowakowski
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas.,Department of Medicine, Baylor College of Medicine, Houston, Texas.,Center for Innovation in Quality, Effectiveness, and Safety, Michael E. DeBakey Virginia Medical Center, Houston, Texas.,South Central Mental Illness Research, Education, and Clinical Center, Houston, Texas
| | - Melanie E Levy-Meeks
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Darius B Dawson
- Department of Medicine, Baylor College of Medicine, Houston, Texas.,Center for Innovation in Quality, Effectiveness, and Safety, Michael E. DeBakey Virginia Medical Center, Houston, Texas.,South Central Mental Illness Research, Education, and Clinical Center, Houston, Texas
| | - Jessica M Meers
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas.,Department of Psychology, University of Houston, Houston, Texas
| | - Jacqueline S Stout-Aguilar
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas.,School of Nursing, University of Texas Medical Branch, Galveston, Texas
| | - Gokhan S Kilic
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Mostafa A Borahay
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas.,Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland
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Landolt S, Rosemann T, Blozik E, Brüngger B, Huber CA. Benzodiazepine and Z-Drug Use in Switzerland: Prevalence, Prescription Patterns and Association with Adverse Healthcare Outcomes. Neuropsychiatr Dis Treat 2021; 17:1021-1034. [PMID: 33880026 PMCID: PMC8052118 DOI: 10.2147/ndt.s290104] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/02/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aimed to give a nationwide comprehensive picture of the prevalence and prescription patterns of benzodiazepines (BZ) and Z-drugs (ZD) in Switzerland and to analyze the association with adverse health care outcomes. PATIENTS AND METHODS A population-based, cross-sectional study was conducted, using a large health insurance database in Switzerland. Records from all adult patients with ≥1 prescription for a benzodiazepine and/or a Z-drug in 2018 were included. We calculated the prevalence of BZ and ZD user (extrapolated to the Swiss general population), the number of prescriptions and the type of provider (among each BZ and ZD only user). Multivariate logistic regression models were performed to estimate the association between drug prescription and the risk of hospitalization in different healthcare settings. RESULTS Of a total of 844'692 patients, 95'179 had ≥1 BZ and/or ZD prescription in 2018. The extrapolated one-year prevalence for the general Swiss population was 8.1% for a BZ prescription, 3.5% for a ZD prescription, and 10.5% for a BZ and/or ZD prescription, and continuously increased with age. The majority of the elderly (over 65 years) had ≥1 prescription (BZ: 51.9%; ZD: 56.9%; BZ and/or ZD: 53.5). The proportion of patients with ≥6 prescriptions per year was 23.1% for BZ only user and 35.2% for ZD only user. Most patients had ≥1 prescription from a general practitioner. Regression models showed a higher likelihood to be admitted to acute care, psychiatry, rehabilitation, or nursing home with ≥1 prescription for a benzodiazepine and/or a Z-drug. CONCLUSION This study is the first to give a nationwide overview of the current use of benzodiazepines and Z-drugs in Switzerland based on health insurance claims data. The results revealed a remarkably high prevalence among the general Swiss population, especially in older generations. The negative consequences of heavy BZ and ZD use are a crucial public health problem, that should be addressed.
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Affiliation(s)
- Salome Landolt
- Institute of Primary Care, University of Zürich, University Hospital Zürich, Zürich, Switzerland
| | - Thomas Rosemann
- Institute of Primary Care, University of Zürich, University Hospital Zürich, Zürich, Switzerland
| | - Eva Blozik
- Institute of Primary Care, University of Zürich, University Hospital Zürich, Zürich, Switzerland.,Department of Health Sciences, Helsana Insurance Group, Zürich, Switzerland
| | - Beat Brüngger
- Department of Health Sciences, Helsana Insurance Group, Zürich, Switzerland
| | - Carola A Huber
- Institute of Primary Care, University of Zürich, University Hospital Zürich, Zürich, Switzerland.,Department of Health Sciences, Helsana Insurance Group, Zürich, Switzerland
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10
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Kalmbach DA, Kingsberg SA, Roth T, Cheng P, Fellman-Couture C, Drake CL. Sexual function and distress in postmenopausal women with chronic insomnia: exploring the role of stress dysregulation. Nat Sci Sleep 2019; 11:141-153. [PMID: 31686931 PMCID: PMC6709826 DOI: 10.2147/nss.s213941] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 06/24/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Menopause triggers changes in sexual function and many women develop sexual problems. Insomnia is common in postmenopausal women, and disturbed sleep has been linked to poor sexual health. Thus, postmenopausal women with insomnia may be especially vulnerable to developing sexual difficulties. This study estimated rates of sexual distress in postmenopausal women with chronic insomnia and explored associations between various facets of sexual health, insomnia symptoms, and insomnia-related stress dysregulation. DESIGN Cross-sectional. SETTING Large multi-site health system in the US. PARTICIPANTS 150 postmenopausal women diagnosed with DSM-5 chronic insomnia disorder (56.44±5.64 years) completed measures of sexual distress, sexual function, hot flashes, insomnia symptoms, depression, and stress dysregulation in the forms of cognitive-emotional arousal (worry, rumination), sleep reactivity, and somatic hyperarousal. RESULTS Nearly half of the sample endorsed clinically significant sexual distress (46.9%). Insomnia symptoms were largely associated with poor sexual arousal, orgasmic dysfunction, sexual distress, and sexual dissatisfaction. Insomnia-related stress dysregulation was similarly associated with these facets of sexual health but was also linked to problems with low desire and greater vaginal pain during sex. Hot flashes and depression were negatively associated with sexual health. CONCLUSION Postmenopausal women with chronic insomnia endorse high rates of sexual distress. Although compromised sexual function appears directly related to poor sleep itself, our data suggest that stress dysregulation may play vital role in sexual problems endorsed by postmenopausal insomniacs, particularly regarding low desire and vaginal pain. Prospective research is needed to characterize the evolution of these co-occurring symptoms.
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Affiliation(s)
- David A Kalmbach
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Sheryl A Kingsberg
- Departments of Reproductive Biology and Psychiatry, Case Western Reserve University, Cleveland, OH, USA
| | - Thomas Roth
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Philip Cheng
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Cynthia Fellman-Couture
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Christopher L Drake
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
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11
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Lee J, Han Y, Cho HH, Kim MR. Sleep Disorders and Menopause. J Menopausal Med 2019; 25:83-87. [PMID: 31497577 PMCID: PMC6718648 DOI: 10.6118/jmm.19192] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/22/2019] [Accepted: 04/17/2019] [Indexed: 01/18/2023] Open
Abstract
Sleep disorders are one of the main symptoms of menopause. Symptoms of sleep disorders that menopausal women complain about include falling asleep, frequent awakening and/or early morning awakening. There are many possible causes of sleep disorders in postmenopausal women, including vasomotor symptoms, ovarian hormone changes, restless legs syndrome, periodic leg movement syndrome, and obstructive sleep apnea. In this review, we discuss the relationship between menopause and sleep disorders.
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Affiliation(s)
- Jinju Lee
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Youngsin Han
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Hee Cho
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Mee-Ran Kim
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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12
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Lin J, Chen L, Ni S, Ru Y, Ye S, Fu X, Gan D, Li J, Zhang L, Han S, Zhu S. Association between sleep quality and bone mineral density in Chinese women vary by age and menopausal status. Sleep Med 2018; 53:75-80. [PMID: 30447403 DOI: 10.1016/j.sleep.2018.09.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/24/2018] [Accepted: 09/17/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Sleep quality is closely related to bone health. Aging and estrogen deficiency are known determinants of poor sleep quality and osteoporosis. However, the impact of aging and menopause on the associations between sleep quality and bone mineral density (BMD) remains unclear. This study aimed to examine the association between sleep quality and BMD in Chinese women vary by age groups and menopausal status. METHODS A total of 2067 women aged 18-80 years were included. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and the score >7 was indicative of poor sleep quality. BMD was determined using the dual-energy X-ray absorptiometry. Participants were categorized into three age groups. Multiple linear regression models were conducted to evaluate the associations between sleep quality and BMD. Covariates included in the models were age, menopausal status, weight, height, percent body fat, physical activity, alcohol drinking, calcium supplement use, marital status, education and metabolic diseases. RESULTS We observed that poor sleep quality was correlated to low total BMD and legs BMD in middle-aged women after adjusting for potential confounders. Furthermore, when we reran the regression models based on menopausal status in middle-aged women, significant associations between BMD and sleep quality were observed in premenopausal and early postmenopausal groups. CONCLUSION Our findings showed a more robust association between sleep quality and BMD in premenopausal and early menopausal groups. Further studies should be conducted to explore whether sleep quality intervention would improve bone health of women in these periods and prevent osteoporosis in their late life.
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Affiliation(s)
- Jie Lin
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Lijin Chen
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Saili Ni
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yuan Ru
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Sunyue Ye
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaohua Fu
- Department of Reproductive Endocrinology, Zhejiang People's Hospital, Hangzhou, Zhejiang, China
| | - Da Gan
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jiayu Li
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Liang Zhang
- Department of Health, Lanxi City, Zhejiang, China
| | - Shuang Han
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shankuan Zhu
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China.
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Effects of night-time on-call work on heart rate variability before bed and sleep quality in visiting nurses. Int Arch Occup Environ Health 2018; 91:695-704. [DOI: 10.1007/s00420-018-1317-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 05/22/2018] [Indexed: 01/17/2023]
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Baker FC, de Zambotti M, Colrain IM, Bei B. Sleep problems during the menopausal transition: prevalence, impact, and management challenges. Nat Sci Sleep 2018; 10:73-95. [PMID: 29445307 PMCID: PMC5810528 DOI: 10.2147/nss.s125807] [Citation(s) in RCA: 133] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
A substantial number of women experience sleep difficulties in the approach to menopause and beyond, with 26% experiencing severe symptoms that impact daytime functioning, qualifying them for a diagnosis of insomnia. Here, we review both self-report and polysomnographic evidence for sleep difficulties in the context of the menopausal transition, considering severity of sleep complaints and links between hot flashes (HFs) and depression with poor sleep. Longitudinal population-based studies show that sleep difficulties are uniquely linked with menopausal stage and changes in follicle-stimulating hormone and estradiol, over and above the effects of age. A major contributor to sleep complaints in the context of the menopausal transition is HFs, and many, although not all, HFs are linked with polysomnographic-defined awakenings, with HF-associated wake time contributing significantly to overall wakefulness after sleep onset. Some sleep complaints may be comorbid with depressive disorders or attributed to sleep-related breathing or movement disorders, which increase in prevalence especially after menopause, and for some women, menopause, age, and environmental/behavioral factors may interact to disrupt sleep. Considering the unique and multifactorial basis for sleep difficulties in women transitioning menopause, we describe clinical assessment approaches and management options, including combination treatments, ranging from cognitive behavioral therapy for insomnia to hormonal and nonhormonal pharmacological options. Emerging studies suggest that the impact of severe insomnia symptoms could extend beyond immediate health care usage and quality of life issues to long-term mental and physical health, if left untreated in midlife women. Appropriate treatment, therefore, has immediate benefit as well as advantages for maintaining optimal health in the postmenopausal years.
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Affiliation(s)
- Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA.,Brain Function Research Group, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, USA.,Melbourne School of Psychological Sciences, University of Melbourne
| | - Bei Bei
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University.,Centre for Women's Mental Health, Department of Psychiatry, University of Melbourne, Royal Women's Hospital, Melbourne, VIC, Australia
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15
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Longtime napping is associated with cardiovascular risk estimation according to Framingham risk score in postmenopausal women. Menopause 2016; 23:950-6. [DOI: 10.1097/gme.0000000000000661] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Vasomotor and depression symptoms may be associated with different sleep disturbance patterns in postmenopausal women. Menopause 2016; 22:1053-7. [PMID: 25783470 DOI: 10.1097/gme.0000000000000442] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aims to explore the association of vasomotor symptoms (VMS) and depression symptoms with different symptoms of subjective sleep disturbance in postmenopausal women. METHODS This is a cross-sectional study of 163 postmenopausal women (not taking hormone therapy) attending a university menopause clinic. Measures included the Athens Insomnia Scale, Greene Climacteric Scale, and Symptom Checklist-90-Revised depression subscale. Covariate-adjusted ordinal logistic regression was used to investigate the association of VMS and depression with each item of the Athens Insomnia Scale. RESULTS Controlling for confounding factors, we found VMS to be significantly associated with awakenings during the night (odds ratio [OR], 1.85; P < 0.001), overall quality of sleep (OR, 2.00; P < 0.001), well-being during the day (OR, 1.63; P = 0.008), functioning capacity during the day (OR, 1.72; P = 0.01), and sleepiness during the day (OR, 1.66; P = 0.03); whereas we found Symptom Checklist-90-Revised depression subscale scores to be associated with sleep induction (OR, 2.09; P < 0.001), final awakening earlier than desired (OR, 2.21; P < 0.001), total sleep duration (OR, 1.62; P = 0.01), overall quality of sleep (OR, 1.64; P = 0.009), well-being during the day (OR, 1.67; P = 0.006), functioning capacity during the day (OR, 1.68; P = 0.01), and sleepiness during the day (OR, 1.57; P = 0.04). CONCLUSIONS VMS and depression symptoms are associated with different patterns of sleep disturbance. Although both symptoms are related to sleep quality, daytime functioning, and daytime well-being, depression is uniquely associated with difficulty falling asleep and waking up earlier than desired, whereas VMS are related to frequent awakenings during sleep. The findings are limited by the cross-sectional design and relatively small sample size of the study. Recommendations for future research are discussed to guide this line of inquiry and to gain a better understanding of the complex relationship between climacteric and mood symptoms and their contribution to the development of sleep disturbances during menopause.
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Sun K, Li F, Qi Y, Lin D, Ren M, Xu M, Li F, Li Y, Yan L. Sex difference in the association between habitual daytime napping and prevalence of diabetes: a population-based study. Endocrine 2016; 52:263-70. [PMID: 26487615 DOI: 10.1007/s12020-015-0772-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 10/06/2015] [Indexed: 01/07/2023]
Abstract
Our objective was to evaluate the associations between habitual daytime napping and diabetes and whether it varies by sex, menopause, and sleep quality. We conducted a population-based cross-sectional study in 8621 eligible individuals aged 40 years or older. Information on daytime napping hours, night-time sleep duration, history of menstruation, and sleep quality was self-reported. Diabetes was diagnosed according to the 1999 World Health Organization diagnostic criteria. The prevalence of diabetes was 19.4 % in men and 15.6 % in women. Increased daytime napping hours were positively associated with parameters of glycometabolism in women, such as fasting plasma glucose, oral glucose tolerance test (OGTT) 2-h plasma glucose, and Hemoglobin A1c (HbA1c, all P for trend <0.05). In women, the prevalence of diabetes in no-habitual daytime napping group, 0-1-h daytime napping group, and more than 1-h daytime napping group were 14.5, 15.6, and 20.8 %, respectively (P for trend = 0.0004). A similar trend was detected in postmenopausal women (P for trend = 0.002). In multivariate logistic regression analysis, compared with no-habitual daytime napping postmenopausal women, those with daytime napping more than 1 h had higher prevalent diabetes (odds ratios 1.36, 95 % confidence interval, 1.04-1.77). In subgroup analysis of postmenopausal women, associations of daytime napping levels and prevalent diabetes were detected in older, overweight participants with good sleep quality who have not retired from work. In conclusion, our study suggests that habitual daytime napping is associated with prevalence of diabetes in postmenopausal women.
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Affiliation(s)
- Kan Sun
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China.
| | - Feng Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Yiqin Qi
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Diaozhu Lin
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Meng Ren
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Mingtong Xu
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Fangping Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Yan Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Li Yan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
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de Zambotti M, Sugarbaker D, Trinder J, Colrain IM, Baker FC. Acute stress alters autonomic modulation during sleep in women approaching menopause. Psychoneuroendocrinology 2016; 66:1-10. [PMID: 26766119 PMCID: PMC4788552 DOI: 10.1016/j.psyneuen.2015.12.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 12/14/2015] [Accepted: 12/15/2015] [Indexed: 10/22/2022]
Abstract
Hot flashes, hormones, and psychosocial factors contribute to insomnia risk in the context of the menopausal transition. Stress is a well-recognized factor implicated in the pathophysiology of insomnia; however the impact of stress on sleep and sleep-related processes in perimenopausal women remains largely unknown. We investigated the effect of an acute experimental stress (impending Trier Social Stress Task in the morning) on pre-sleep measures of cortisol and autonomic arousal in perimenopausal women with and without insomnia that developed in the context of the menopausal transition. In addition, we assessed the macro- and micro-structure of sleep and autonomic functioning during sleep. Following adaptation to the laboratory, twenty two women with (age: 50.4 ± 3.2 years) and eighteen women without (age: 48.5 ± 2.3 years) insomnia had two randomized in-lab overnight recordings: baseline and stress nights. Anticipation of the task resulted in higher pre-sleep salivary cortisol levels and perceived tension, faster heart rate and lower vagal activity, based on heart rate variability measures, in both groups of women. The effect of the stress manipulation on the autonomic nervous system extended into the first 4 h of the night in both groups. However, vagal tone recovered 4-6 h into the stress night in controls but not in the insomnia group. Sleep macrostructure was largely unaltered by the stress, apart from a delayed latency to REM sleep in both groups. Quantitative analysis of non-rapid eye movement sleep microstructure revealed greater electroencephalographic (EEG) power in the beta1 range (15-≤23 Hz), reflecting greater EEG arousal during sleep, on the stress night compared to baseline, in the insomnia group. Hot flash frequency remained similar on both nights for both groups. These results show that pre-sleep stress impacts autonomic nervous system functioning before and during sleep in perimenopausal women with and without insomnia. Findings also indicate that women with insomnia had increased EEG arousal and lacked recovery in vagal activity across the stress night suggesting a greater sensitivity to stress in this group.
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Affiliation(s)
| | - David Sugarbaker
- Center for Health Sciences, SRI International, Menlo Park, CA-94025, USA
| | - John Trinder
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC-3010, Australia
| | - Ian M. Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA-94025, USA
,Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC-3010, Australia
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, Menlo Park, CA-94025, USA
,Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg 2000, South Africa
,Corresponding author at: Center for Health Sciences, SRI International • 333 Ravenswood Avenue, Menlo Park, CA-94025, USA. Tel.: +1 (650) 859-3062, Fax: +1 (650) 859-2743 .
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Association between personality traits and DSM-IV diagnosis of insomnia in peri- and postmenopausal women. Menopause 2015; 21:602-11. [PMID: 24448105 DOI: 10.1097/gme.0000000000000192] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The aim of this study was to determine the role of personality factors in the development of DSM-IV insomnia coincident with perimenopause. METHODS Perimenopausal women (35 women with DSM-IV insomnia and 28 women with self-reported normal sleep) underwent clinical assessments and completed menopause-related questionnaires, the NEO Five Factor Inventory and the Structured Interview for DSM-IV Personality. Logistic regressions determined whether personality factors and hot flash-related interference were associated with an insomnia diagnosis concurrent with the menopausal transition. RESULTS Women with insomnia reported higher neuroticism, lower agreeableness, and lower conscientiousness than controls on the NEO Five Factor Inventory. Moreover, women with insomnia were more likely to meet DSM-IV criteria for cluster C personality disorders, particularly obsessive-compulsive personality disorder, on the Structured Interview for DSM-IV Personality. Women with insomnia were more likely to have had a past depressive episode and a history of severe premenstrual symptoms. Findings from regressions revealed that higher neuroticism and greater interference from hot flashes were associated with insomnia classification even after controlling for history of depression, suggesting that sensitivity to hot flashes and a greater degree of neuroticism are independent contributors toward establishing which women are most likely to have sleep problems during perimenopause. CONCLUSIONS Findings show the relevance of personality factors, particularly neuroticism and obsessive-compulsive personality, to a woman's experience of insomnia as she goes through the menopausal transition.
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Melatonin in perimenopausal and postmenopausal women: associations with mood, sleep, climacteric symptoms, and quality of life. Menopause 2015; 21:493-500. [PMID: 24065140 DOI: 10.1097/gme.0b013e3182a6c8f3] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Melatonin synthesis and secretion are partly modulated by estrogen and progesterone. Changes in melatonin concentrations, possibly related to the menopausal transition, may be associated with climacteric mood, sleep, and vasomotor symptoms. The aims of this study were to compare the serum concentrations of melatonin in perimenopausal and postmenopausal women and to evaluate melatonin's influence on mood, sleep, vasomotor symptoms, and quality of life. METHODS We analyzed the data of 17 healthy perimenopausal women (aged 43-51 y) and 18 healthy postmenopausal women (aged 58-71 y) who participated in a prospective study. On study night (9:00 pm-9:00 am), serum melatonin was sampled at 20-minute (9:00 pm-12:00 midnight; 6:00-9:00 am) and 1-hour (12:00 midnight-6:00 am) intervals. Questionnaires were used to assess depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory), insomnia and sleepiness (Basic Nordic Sleep Questionnaire [BNSQ]), subjective sleep quality, vasomotor symptoms, and quality of life (EuroQoL). RESULTS Postmenopausal women had lower nighttime serum melatonin concentrations than perimenopausal women. The duration of melatonin secretion tended to be shorter in postmenopause, whereas melatonin peak time did not differ. Mean melatonin concentrations and exposure levels did not correlate with follicle-stimulating hormone level, estradiol level, body mass index, Beck Depression Inventory score, State-Trait Anxiety Inventory score, BNSQ insomnia score, BNSQ sleepiness score, subjective sleep score, climacteric vasomotor score, or quality of life. In perimenopause, the later is the melatonin peak, the higher is the level of anxiety (P = 0.022), and the longer is the melatonin secretion, the better is the quality of life (P < 0.001). CONCLUSIONS Longitudinal research is needed to better understand the possible contributory role of menopause in lower melatonin levels.
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van Dijk GM, Kavousi M, Troup J, Franco OH. Health issues for menopausal women: the top 11 conditions have common solutions. Maturitas 2014; 80:24-30. [PMID: 25449663 DOI: 10.1016/j.maturitas.2014.09.013] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 09/25/2014] [Accepted: 09/26/2014] [Indexed: 12/27/2022]
Abstract
Multiple health issues affect women throughout the life course differently from men, or do not affect men at all. Although attention to women's health is important in all stages in life, health among middle-aged and elderly women has not received sufficient attention by scientists and policy-makers. Related to the menopausal transition and the experiences accumulated until that age, many diseases occur or further develop in middle-aged and elderly women. To improve women's quality of life and guarantee a long-lasting and active role for middle-aged and elderly women in society, prevention of chronic diseases and disability is a key aspect. In this manuscript we give an overview of the major health issues for peri- and post-menopausal women, we summarize risk factors and interventions to improve menopausal health. Based on the available scientific literature and the global burden of disease endeavor, we have selected and herein describe the following top 11 key health issues, selected in terms of burden exerted in women's mortality, morbidity, disability and quality of life: cardiovascular disease, musculoskeletal disorders, cancer, cognitive decline and dementia, chronic obstructive pulmonary disease, diabetes mellitus, metabolic syndrome, depression, vasomotor symptoms, sleep disturbances and migraine.
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Affiliation(s)
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Jenna Troup
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
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22
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Chen G, Chen L, Wen J, Yao J, Li L, Lin L, Tang K, Huang H, Liang J, Lin W, Chen H, Li M, Gong X, Peng S, Lu J, Bi Y, Ning G. Associations between sleep duration, daytime nap duration, and osteoporosis vary by sex, menopause, and sleep quality. J Clin Endocrinol Metab 2014; 99:2869-77. [PMID: 24848706 DOI: 10.1210/jc.2013-3629] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Associations between sleep, daytime nap duration, and osteoporosis remain uncertain, and far less is even known about the influence of sex, menopause, and sleep quality on them. OBJECTIVE The objective of the study was to test the associations between sleep, daytime nap duration, and osteoporosis and whether they vary by sex, menopause, and sleep quality. DESIGN, SETTING, AND PATIENTS This cross-sectional study was based on two communities in China. A total of 8688 participants (3950 males and 4738 females) aged 40 years or older were enrolled in the study. MAIN OUTCOMES MEASURES Self-reported sleep duration, daytime nap duration, sleep quality, and calcaneus bone mineral density were recorded. RESULTS Sleep duration of 8-9 h/d and nap duration of 0 min/d were regarded as reference values. In postmenopausal women, risks (odds ratio and 95% confidence interval) of osteoporosis for sleep durations of 7-8 h/d, 9-10 h/d, and 10 h/d or longer were 1.531 (1.106, 2.121), 1.360 (1.035, 1.787), and 1.569 (1.146, 2.149), respectively (P < .05), and risks of osteoporosis for daytime nap durations of 30-60 min/d and longer than 60 min/d were 1.553 (1.212-1.989) and 1.645 (1.250-2.165), respectively (P < .05). However, a significant difference was not consistently observed in men or premenopausal women, regardless of sleep or daytime nap duration. As for sleep quality, positive results were seen most remarkably in postmenopausal females with good sleep. CONCLUSIONS Sleep durations of 7-8 h/d, 9-10 h/d, and 10 h/d or longer, as well as longer daytime napping times, tend to present higher risks of having osteoporosis, and this tendency is most obvious in postmenopausal women reporting good-quality sleep.
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Affiliation(s)
- Gang Chen
- Department of Endocrinology (G.C., L.C., J.W., J.Y., L.Li, L.Lin, K.T., H.H., J.Li., W.L., H.C., M.L., X.G., S.P.), Fujian Provincial Hospital, Key Laboratory of Endocrinology, Fujian Medical University, Fuzhou 350001, China; and Department of Endocrinology (J.Lu, Y.B., G.N.), Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
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Toffol E, Kalleinen N, Urrila AS, Himanen SL, Porkka-Heiskanen T, Partonen T, Polo-Kantola P. The relationship between mood and sleep in different female reproductive states. BMC Psychiatry 2014; 14:177. [PMID: 24935559 PMCID: PMC4071019 DOI: 10.1186/1471-244x-14-177] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 06/10/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Sleep is disrupted in depressed subjects, but it also deteriorates with age and possibly with the transition to menopause. The nature of interaction between mood, sleep, age and reproductive state is not well-defined. The aim of this study was to evaluate the relationship between mood and sleep among healthy women in different reproductive states. METHODS We analyzed data from 11 younger (20-26 years), 21 perimenopausal (43-51 years) and 29 postmenopausal (58-71 years) healthy women who participated in a study on menopause, sleep and cognition. The 21-item Beck Depression Inventory (BDI) was administered to assess mood. Subjective sleep quality was assessed with the Basic Nordic Sleep Questionnaire (BNSQ). Objective sleep was measured with all-night polysomnography (PSG) recordings. Perimenopausal and younger women were examined during the first days of their menstrual cycle at the follicular phase. RESULTS Among younger women, less arousals associated with higher BDI total scores (p = 0.026), and higher SWS percentages with more dissatisfaction (p = 0.001) and depressive-somatic symptoms (p = 0.025), but with less depressive-emotional symptoms (p = 0.001). In specific, less awakenings either from REM sleep or SWS, respectively, associated with more punishment (p = 0.005; p = 0.036), more dissatisfaction (p < 0.001; p = 0.001) and more depressive-somatic symptoms (p = 0.001; p = 0.009), but with less depressive-emotional symptoms (p = 0.002; p = 0.003). In perimenopausal women, higher BNSQ insomnia scores (p = 0.005), lower sleep efficiencies (p = 0.022) and shorter total sleep times (p = 0.024) associated with higher BDI scores, longer sleep latencies with more depressive-somatic symptoms (p = 0.032) and longer REM latencies with more dissatisfaction (p = 0.017). In postmenopausal women, higher REM percentages associated with higher BDI total scores (p = 0.019) and more depressive-somatic symptoms (p = 0.005), and longer SWS latencies with more depressive-somatic symptoms (p = 0.030). CONCLUSIONS Depressive symptoms measured with the total BDI scores associated with sleep impairment in both perimenopausal and postmenopausal women. In younger women, specific BDI factors revealed minor associations, suggesting that the type of sleep impairment can vary in relation to different depressive features. Our data indicate that associations between sleep and depressed mood may change in conjunction with hormonal milestones.
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Affiliation(s)
- Elena Toffol
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare (THL), Mannerheimintie 170, P.O. Box 30, Helsinki FI-00271, Finland
| | - Nea Kalleinen
- Department of Physiology, Sleep Research Unit, University of Turku, Turku, Finland
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Anna Sofia Urrila
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare (THL), Mannerheimintie 170, P.O. Box 30, Helsinki FI-00271, Finland
- Department of Physiology, University of Helsinki, Helsinki, Finland
- Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Sari-Leena Himanen
- Department of Clinical Neurophysiology, Pirkanmaa Hospital District, Tampere, Finland
- Faculty of Medicine, University of Tampere, Tampere, Finland
| | | | - Timo Partonen
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare (THL), Mannerheimintie 170, P.O. Box 30, Helsinki FI-00271, Finland
| | - Päivi Polo-Kantola
- Department of Physiology, Sleep Research Unit, University of Turku, Turku, Finland
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland
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Carpenter JS, Igega CM, Otte JL, Burns DS, Yu M, Wu J. Somatosensory amplification and menopausal symptoms in breast cancer survivors and midlife women. Maturitas 2014; 78:51-5. [PMID: 24631194 DOI: 10.1016/j.maturitas.2014.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 02/06/2014] [Accepted: 02/11/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Somatosensory amplification is the experience of sensing everyday bodily sensations as intense, agitating, and unpleasant. Using data from menopausal breast cancer survivors and midlife women without cancer, the study purposes were to (1) explore the psychometric properties of the Somatosensory Amplification Scale and (2) to describe somatosensory amplification and its relationship to menopausal symptoms of hot flashes, mood and sleep disturbance. STUDY DESIGN This was a cross-sectional, descriptive, correlational study using demographic, e-diary, and questionnaire data from 99 breast cancer survivors and 138 midlife women. MAIN OUTCOME MEASURES Somatosensory amplification, hot flashes (frequency, severity, bother, interference, perceived control), mood, and sleep. RESULTS Cronbach's alphas for the scale were low. When an 8-item version of the scale was evaluated, alphas improved and item-total correlations remained strong or improved. Midlife women and breast cancer survivors did not have significantly different somatosensory amplification total or item scores after adjusting for group differences in demographics. Somatosensory amplification was significantly correlated with hot flash interference, perceived control over hot flashes, and mood and sleep disturbance in both groups but the patterns of correlations differed slightly between groups and depending on whether the 10-item or 8-item scale was used. CONCLUSION Somatosensory amplification may be a relevant concept to assess in relation to the menopausal symptom experience of midlife women with and without breast cancer as it may represent a potential intervention target to improve the menopausal symptom experience.
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Affiliation(s)
- Janet S Carpenter
- School of Nursing, Indiana University, Indianapolis, IN 46202, United States.
| | - Christele M Igega
- School of Nursing, Indiana University, Indianapolis, IN 46202, United States
| | - Julie L Otte
- School of Nursing, Indiana University, Indianapolis, IN 46202, United States
| | - Debra S Burns
- School of Engineering and Technology, Indiana University-Purdue University, Indianapolis, IN 46202, United States
| | - Menggang Yu
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, United States
| | - Jingwei Wu
- School of Nursing, Indiana University, Indianapolis, IN 46202, United States
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Robillard R, Naismith SL, Smith KL, Rogers NL, White D, Terpening Z, Ip TKC, Hermens DF, Whitwell B, Scott EM, Hickie IB. Sleep-wake cycle in young and older persons with a lifetime history of mood disorders. PLoS One 2014; 9:e87763. [PMID: 24586290 PMCID: PMC3934865 DOI: 10.1371/journal.pone.0087763] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 12/30/2013] [Indexed: 11/19/2022] Open
Abstract
Considering the marked changes in sleep and circadian rhythms across the lifespan, age may contribute to the heterogeneity in sleep-wake profiles linked to mood disorders. This study aimed to investigate the contributions of age and depression severity to sleep-wake disturbances. The Hamilton Depression Rating Scale (HDRS) was administered to assess current symptoms severity in 238 persons with a history of a mood disorder between 12 and 90 years of age (y.o.). Actigraphy was recorded over five to 22 days. Regression analyses and analyses of variance [age (12–19 y.o., 20–39 y.o., 40–59 y.o., and ≥60 y.o.) by depression severity (HDRS< and ≥8)] were conducted. The 12–19 y.o. and 20–39 y.o. groups had a delayed sleep schedule and acrophase compared to all other groups. The ≥60 y.o. group had a lower rhythmicity and amplitude (p≤.006) than the 12–19 y.o. group (p≤.046). Participants with a HDRS≥8 spent longer time in bed, had later sleep offset times and had lower circadian rhythmicity than those with a HDRS<8 (p≤.036). Younger age and higher HDRS score correlated with later sleep onset and offset times, longer time in bed, higher WASO, lower sleep efficiency and later acrophase (p≤.023). Age was a significant predictor of delayed sleep and activity schedules (p≤.001). The profile of sleep-wake cycle disturbances associated with mood disorders changes with age, with prominent sleep phase delay during youth and reduced circadian strength in older persons. Conversely, disruptions in sleep consolidation seem more stable across age.
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Affiliation(s)
- Rébecca Robillard
- Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia
| | - Sharon L. Naismith
- Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia
- Healthy Brain Ageing Clinic, Brain & Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia
| | - Kristie Leigh Smith
- Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia
| | - Naomi L. Rogers
- Concord Clinical School, The University of Sydney, Concord, New South Wales, Australia
| | - Django White
- Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia
| | - Zoe Terpening
- Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia
- Healthy Brain Ageing Clinic, Brain & Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia
| | - Tony K. C. Ip
- Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia
| | - Daniel F. Hermens
- Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia
| | - Bradley Whitwell
- Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia
| | - Elizabeth M. Scott
- Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ian B. Hickie
- Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia
- * E-mail:
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Frame KO, Alexander IM. Mind–Body Therapies for Sleep Disturbances in Women at Midlife. J Holist Nurs 2013; 31:276-84. [DOI: 10.1177/0898010113493504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Multiple factors contribute to sleep disturbances in women at midlife. Poor sleep is a common occurrence in women transitioning through midlife and is associated with significant morbidity. Factors that are known to disturb sleep in women at midlife include vasomotor symptoms, nocturia, sleep apnea, and stress. Stress in particular has a significant impact on sleep. Various treatments, pharmacologic and nonpharmacologic, are available to treat sleep disturbances. One nonpharmacologic option includes mind-body medicine, which encompasses several therapies. Practices within this realm have been shown to moderate the experience of stress and help restore sleep quality. Each woman’s experience of disturbed sleep and transition through midlife is unique. By having a broad awareness of all evidence-based therapeutics, the clinician is able to present a diverse set of options for women at midlife who are affected by poor sleep.
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Abstract
Sex differences in sleep begin at a very early age and women report poorer sleep quality and have higher risk for insomnia than do men. Sleep may be affected by variation in reproductive hormones, stress, depression, aging, life/role transitions, and other factors. The menstrual cycle is associated with changes in circadian rhythms and sleep architecture. Menstruating women (even without significant menstrual-related complaints) often report poorer sleep quality and greater sleep disturbance during the premenstrual week compared to other times of her menstrual cycle. In addition to these sleep disturbances, women with severe premenstrual syndrome often report more disturbing dreams, sleepiness, fatigue, decreased alertness and concentration during the premenstrual phase. Sleep disturbances are also commonly reported during pregnancy and increase in frequency and duration as the pregnancy progresses. The precipitous decline in hormones and unpredictable sleep patterns of the newborn contribute to and/or exacerbate poor sleep and daytime sleepiness during the early postpartum period. Insomnia is also among the most common health complaints that are reported by perimenopausal women. Women are particularly vulnerable to developing insomnia disorder during these times of reproductive hormonal change. In this review, we present a discussion on the most relevant and recent publications on sleep across the woman's lifespan, including changes in sleep related to menstruation, pregnancy, postpartum, and the menopausal transition. Treatment for sleep disturbances and insomnia disorder and special considerations for treating women will also be discussed.
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Affiliation(s)
- Sara Nowakowski
- University of Texas Medical Branch, Department of Obstetrics and Gynecology, Galveston, TX, USA
| | - Jessica Meers
- University of Texas Medical Branch, Department of Obstetrics and Gynecology, Galveston, TX, USA
| | - Erin Heimbach
- University of Texas Medical Branch, School of Medicine, Galveston, TX, USA
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Abstract
Sleep disorders in the menopause are common. Although these disorders may be due to the menopause itself and/or the associated vasomotor symptoms, the etiology is multifactorial and includes a number of other associated conditions. They may simply arise as part of the aging process and not be specifically related to the decrease in estrogen levels or, alternatively, because of breathing or limb movement syndromes, depression, anxiety, co-morbid medical diseases, medication, pain and/or psychosocial factors. The most commonly encountered sleep disorders in menopausal women include insomnia, nocturnal breathing disturbances and the associated sleep disorders that accompany the restless leg syndrome, periodic leg movement syndrome, depression and anxiety. This review article addresses sleep and the sleep disorders associated with menopause and briefly the role that hormone therapy may play in alleviating these disorders.
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Affiliation(s)
- F Guidozzi
- Department of Obstetrics and Gynaecology, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
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29
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Kline CE, Sui X, Hall MH, Youngstedt SD, Blair SN, Earnest CP, Church TS. Dose-response effects of exercise training on the subjective sleep quality of postmenopausal women: exploratory analyses of a randomised controlled trial. BMJ Open 2012; 2:bmjopen-2012-001044. [PMID: 22798253 PMCID: PMC3400065 DOI: 10.1136/bmjopen-2012-001044] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To investigate whether a dose-response relationship existed between exercise and subjective sleep quality in postmenopausal women. This objective represents a post hoc assessment that was not previously considered. DESIGN Parallel-group randomised controlled trial. SETTING Clinical exercise physiology laboratory in Dallas, Texas. PARTICIPANTS 437 sedentary overweight/obese postmenopausal women. INTERVENTION Participants were randomised to one of four treatments, each of 6 months of duration: a non-exercise control treatment (n=92) or one of three dosages of moderate-intensity exercise (50% of VO(2peak)), designed to meet 50% (n=151), 100% (n=99) or 150% (n=95) of the National Institutes of Health Consensus Development Panel physical activity recommendations. Exercise dosages were structured to elicit energy expenditures of 4, 8 or 12 kilocalories per kilogram of body weight per week (KKW), respectively. Analyses were intent to treat. PRIMARY OUTCOME MEASURES Continuous scores and odds of having significant sleep disturbance, as assessed by the Sleep Problems Index from the 6-item Medical Outcomes Study Sleep Scale. Outcome assessors were blinded to participant randomisation assignment. RESULTS Change in the Medical Outcomes Study Sleep Problems Index score at 6 months significantly differed by treatment group (control: -2.09 (95% CI -4.58 to 0.40), 4 KKW: -3.93 (-5.87 to -1.99), 8 KKW: -4.06 (-6.45 to -1.67), 12 KKW: -6.22 (-8.68 to -3.77); p=0.04), with a significant dose-response trend observed (p=0.02). Exercise training participants had lower odds of having significant sleep disturbance at postintervention compared with control (4 KKW: OR 0.37 (95% CI 0.19 to 0.73), 8 KKW: 0.36 (0.17 to 0.77), 12 KKW: 0.34 (0.16 to 0.72)). The magnitude of weight loss did not differ between treatment conditions. Improvements in sleep quality were not related to changes in body weight, resting parasympathetic control or cardiorespiratory fitness. CONCLUSION Exercise training induced significant improvement in subjective sleep quality in postmenopausal women, with even a low dose of exercise resulting in greatly reduced odds of having significant sleep disturbance. TRIAL REGISTRATION NUMBER clinicaltrials.gov identifier: NCT00011193.
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Affiliation(s)
- Christopher E Kline
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Xuemei Sui
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Martica H Hall
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Shawn D Youngstedt
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
- WJB Dorn VA Medical Center, Columbia, South Carolina, USA
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Steven N Blair
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA
| | | | - Timothy S Church
- Department of Preventive Medicine, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
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Dacks PA, Krajewski SJ, Rance NE. Ambient temperature and 17β-estradiol modify Fos immunoreactivity in the median preoptic nucleus, a putative regulator of skin vasomotion. Endocrinology 2011; 152:2750-9. [PMID: 21521752 PMCID: PMC3115603 DOI: 10.1210/en.2010-1230] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Accepted: 03/31/2011] [Indexed: 11/19/2022]
Abstract
Estrogen has pronounced effects on thermoregulation, but the anatomic sites of integration between the reproductive and thermoregulatory axes are unknown. In this study, we tested whether estradiol-17β (E(2)) treatment would alter the activity of thermoregulatory brain regions responding to mild changes in ambient temperature (T(AMBIENT)). Core and tail skin temperatures were recorded at the ambient temperatures of 20, 24, or 31 C in ovariectomized (OVX) rats with and without E(2). Neuronal activity was evaluated by counting the number of Fos-immunoreactive cells in the brains of rats killed 90 min after exposure to one of the three ambient temperatures. Of 14 brain areas examined, the median preoptic nucleus (MnPO) was the only site that exhibited increased Fos immunoreactivity at the high T(AMBIENT) of 31 C. At 24 C, OVX rats exhibited increased numbers of MnPO Fos-immunoreactive cells, compared with OVX + E(2) rats. Interestingly, tail skin vasomotion and MnPO Fos expression were affected in a similar manner by T(AMBIENT) and E(2) treatment. In the arcuate nucleus and anteroventral periventricular nucleus (AVPV), Fos immunoreactivity was highest at the low T(AMBIENT) of 20 C, with inhibitory (arcuate nucleus) and stimulatory (AVPV) effects of E(2). No other areas responded to both T(AMBIENT) and E(2) treatment. These results implicate the MnPO, the arcuate nucleus, and the AVPV as sites of integration between the reproductive and thermoregulatory axes. Combined with studies showing the importance of MnPO neurons in heat-defense pathways, the MnPO emerges as a likely site for E(2) modulation of thermoregulatory vasomotion.
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Affiliation(s)
- Penny A Dacks
- Department of Pathology, University of Arizona College of Medicine, 1501 North Campbell Avenue, Tucson, Arizona 85724, USA
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Dhumeaux MP, Snead ECR, Hung GC, Taylor SM. Progesterone intoxication inducing marked sedation in a cat. J Feline Med Surg 2010; 12:811-3. [PMID: 20817586 PMCID: PMC11135529 DOI: 10.1016/j.jfms.2010.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2010] [Indexed: 10/19/2022]
Abstract
A 3-year-old, male castrated domestic shorthair cat presented for sudden onset of severe lethargy and loss of balance a few hours after potentially ingesting capsules containing progesterone. Elevated serum progesterone was confirmed. Supportive care and time resulted in complete resolution of the clinical signs with no long-term complications or recurrence of clinical signs noticed after 1-month follow-up. This is the first description of progesterone intoxication inducing neurological signs in a cat.
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Affiliation(s)
- Marc P Dhumeaux
- Western College of Veterinary Medicine, University of Saskatchewan, Department of Small Animal Clinical Sciences, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4, Canada.
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