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Jia Y, Zhou Z, Cao X. Prevalence of poor sleep quality during menopause: a meta-analysis. Sleep Breath 2024:10.1007/s11325-024-03132-y. [PMID: 39145901 DOI: 10.1007/s11325-024-03132-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 07/28/2024] [Accepted: 08/05/2024] [Indexed: 08/16/2024]
Abstract
PURPOSE Numerous researches have demonstrated that sleep quality deteriorates during menopause, but the prevalence rates vary between studies. The purpose of this meta-analysis was to determine the pooled prevalence of poor sleep quality during menopause and to explore potential moderators of discrepancies in prevalence between studies. METHODS Web of Science, PubMed, PsycINFO and Embase databases were comprehensively searched from database creation to June 19, 2024. Studies were included if they focused on menopausal women and provided an estimate of the prevalence of poor sleep quality, which could be derived from the Pittsburgh Sleep Quality Index (PSQI). RESULTS Totally, 37 studies with 29,284 menopausal women were included in the analysis. A meta-analysis based on a random-effects model revealed that the prevalence of poor sleep quality during menopause was 50.8% (95% CI: 45.4-56.3%). The PSQI score was 6.24 (95% CI: 5.73-6.75). Subgroup analyses indicated that cut-off values of PSQI, menopausal status, age range, depressive symptoms and geographic region moderated the prevalence of poor sleep quality. Meta-regression analyses indicated that quality score was negatively correlated with the pooled prevalence. CONCLUSIONS Poor sleep quality is a prevalent phenomenon among women during menopause. In light of the numerous adverse effects of poor sleep quality on menopausal women, it is of paramount importance to assess sleep quality on a regular basis and to implement effective interventions for menopausal women.
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Affiliation(s)
- Yu Jia
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Zitong Zhou
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Xuehua Cao
- Department of Gynecology Nursing, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
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Pan Z, Wen S, Qiao X, Yang M, Shen X, Xu L. Different regimens of menopausal hormone therapy for improving sleep quality: a systematic review and meta-analysis. Menopause 2022; 29:627-635. [PMID: 35102100 PMCID: PMC9060837 DOI: 10.1097/gme.0000000000001945] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 11/26/2022]
Abstract
IMPORTANCE Long-term sleep disturbances in menopausal women are closely related to cardiovascular disorders, metabolic disorders, and cognitive impairment. At present, hormone therapy (HT) is a standard treatment for menopausal symptoms. However, it remains unclear whether HT can improve sleep quality. OBJECTIVE We did a systematic review and meta-analysis to assess the effects of different HT regimens on menopausal sleep quality. EVIDENCE REVIEW We systematically searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, PsycINFO, CINAHL, and Web of Science for randomized controlled trials of menopausal HT on sleep disturbances up to June 14,2021. Information about ongoing and unpublished trials was collected by searching WHOICTRP and ClinicalTrials.gov. Our primary outcome was sleep quality with objective measurements. We estimated the standardized mean difference (SMD) using random-effects models. FINDINGS We identified a total of 3,059 studies and finally included 15 studies in the meta-analysis. Compared with placebo, HT improved self-reported sleep outcomes (SMD = -0.13; 95% CI, -0.18 to -0.08, P < 0.00001 and I2 = 41%), but not sleep parameters measured by polysomnography. Subgroup analyses according to the regimen of HT showed that 17β-estradiol (17β-E2) (SMD = -0.34; 95% CI, -0.51 to -0.17, P < 0.0001, and I2 = 0%) and conjugated equine estrogens (SMD = -0.10; 95% CI, -0.12 to -0.07, P < 0.00001, and I2 = 0%) improved sleep quality. Moreover, transdermal administration (SMD = -0.35; 95% CI, -0.64 to -0.06, and P = 0.02) was more beneficial than oral (SMD = -0.10; 95% CI, -0.14 to -0.07, and P < 0.00001). In addition, the combination of estrogen and progesterone had a positive effect on sleep disturbance (SMD = -0.10; 95% CI, -0.13 to -0.07, P < 0.00001, and I2 = 0%), while estrogen monotherapy did not. The results showed that estrogen/micronized progesterone (SMD = -0.22; 95% CI, -0.37 to -0.06, P = 0.007, and I2 = 0%) and estrogen/medroxyprogesterone acetate (SMD = -0.10; 95% CI, -0.13 to -0.07, P < 0.00001, and I2 = 0%) could alleviate sleep disturbance. CONCLUSIONS AND RELEVANCE HT has a beneficial effect on sleep disturbance to some extent, and the formulations and routes of administration of hormonal agents influence the effect size.
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Affiliation(s)
- Zhuo Pan
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
- Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- The Joint Laboratory for Reproductive Medicine of Sichuan University, The Chinese University of Hong Kong, Hong Kong, China
| | - Shu Wen
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
- Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- The Joint Laboratory for Reproductive Medicine of Sichuan University, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiaoyong Qiao
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
- Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- The Joint Laboratory for Reproductive Medicine of Sichuan University, The Chinese University of Hong Kong, Hong Kong, China
| | - Meina Yang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
- Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- The Joint Laboratory for Reproductive Medicine of Sichuan University, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiaoyang Shen
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
- Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- The Joint Laboratory for Reproductive Medicine of Sichuan University, The Chinese University of Hong Kong, Hong Kong, China
| | - Liangzhi Xu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
- Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- The Joint Laboratory for Reproductive Medicine of Sichuan University, The Chinese University of Hong Kong, Hong Kong, China
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Sleep Conditions Associate with Anxiety and Depression Symptoms among Pregnant Women during the Epidemic of COVID-19 in Shenzhen. J Affect Disord 2021; 281:567-573. [PMID: 33261931 PMCID: PMC7688420 DOI: 10.1016/j.jad.2020.11.114] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 11/02/2020] [Accepted: 11/20/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Pregnant women often encounter psychiatric symptoms and declined sleep quality as pregnancy proceeds. The associations between sleep conditions and anxious and depressive symptoms among pregnant women remained to be investigated, particularly during the epidemic of COVID-19. METHODS An online cross-sectional survey on pregnant women was conducted at the time period of fast increasing cases of COVID-19 in Shenzhen. The Self-Rating Anxiety Scale (SAS) and the Patient Health Questionnaire (PHQ-9) were applied to detect anxious and depressive symptoms. Multivariable logistic regressions models were established to explore the associations of sleep conditions with psychological symptoms. RESULTS In total, 751 pregnant women were enrolled, with a mean age of 30.51 years (Standard deviation: 4.28). Overall, 82.7% of the respondents considered low risk of being infected by COVID-19. The prevalence of anxiety and depression symptoms during the epidemic of COVID-19 among pregnant women were 13.4% and 35.4%, respectively, but most of which were mild. Variables referred to poor sleep conditions were strongly associated with anxious and depressive symptoms, including random or late time of going to bed, difficulty in falling sleep, short sleep duration, and ordinary or poor subjective sleep quality. LIMITATIONS Non-random sample restricted generalization of our findings to the whole population of pregnant women. CONCLUSIONS Our research revealed a notable proportion of the pregnant women who exhibited mild anxiety and depression symptoms during the epidemic of COVID-19 in Shenzhen. Targeted interventions in improving sleep conditions might help alleviate gestational anxious and depressive symptoms.
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