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Virtanen I, Polo-Kantola P, Kalleinen N. Overnight Heart Rate Variability During Sleep Disturbance In Peri- And Postmenopausal Women. Behav Sleep Med 2024; 22:329-339. [PMID: 37671829 DOI: 10.1080/15402002.2023.2255329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
OBJECTIVES Disturbed sleep, common during the climacteric, is associated with increased sympathetic activity, a cardiovascular risk factor. We evaluated sleep disturbance effect on autonomic nervous function in climacteric women. METHODS Seventeen perimenopausal and 18 postmenopausal women underwent a sleep study protocol: an adaptation night, a reference night, and a sleep disturbance night, with a hand loosely tied to the bed to allow blood sampling. This procedure was repeated after six months of menopausal hormone therapy (MHT) or placebo. Sleep disturbance and MHT effects on overnight heart rate variability (HRV) were analyzed. RESULTS At baseline, sleep disturbance increased vagal HRV in postmenopausal women, but no changes were seen in perimenopausal women. At six months, sleep disturbance increased total HRV power in the perimenopausal placebo group, and increased nonlinear vagal HRV in the postmenopausal placebo group, but no other changes were seen. MHT did not have any effects on HRV, neither at perimenopause nor at postmenopause. CONCLUSIONS External sleep disturbance had only minor effects on HRV across menopause. MHT had no detectable HRV effects.
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Affiliation(s)
- Irina Virtanen
- Department of Clinical Neurophysiology, TYKS-SAPA, Hospital District of Southwest Finland, Turku, Finland
- Sleep Research Centre, Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland
| | - Päivi Polo-Kantola
- Sleep Research Centre, Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland
| | - Nea Kalleinen
- Sleep Research Centre, Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
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2
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Givens C, Nairon EB, Jackson M, Vashisht A, Olson DM. Use of Family Photographs Reduces Restlessness in Neurocritical Care Patients. J Neurosci Nurs 2024; 56:6-11. [PMID: 37972989 DOI: 10.1097/jnn.0000000000000725] [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: 11/19/2023]
Abstract
ABSTRACT BACKGROUND: Patients admitted to the neuroscience intensive care unit often experience varying states of confusion and restlessness. The purpose of this study was to examine restlessness in acutely confused patients through use of familiar photographs. METHODS : This randomized prospective pilot study placed family photographs (photos) on the bedrail of confused patients during the night shift (8 pm to 4 am ) in a neuroscience intensive care unit. Wrist actigraphy was used to examine restlessness when patients were turned to face the photos versus when they were not facing the photos. RESULTS: The 20 patients enrolled provided 34 nights worth of data during which 32 640 actigraph readings were obtained. On the first night of study, the odds of wrist movement were higher when the patient was facing the photos compared with not (odds ratio, 1.51; 95% confidence interval, 1.42-1.61). During subsequent nights, the odds of wrist movement were lower when the patient was facing the photos compared with not (odds ratio, 0.82; 95% confidence interval, 0.75-0.90). CONCLUSION : Use of familiar photos does not change restlessness, agitation, or delirium on the first night of observation. However, the use of familiar photos may decrease restlessness on the subsequent nights. There are important subjective observations from researchers and family that suggest all subjects had a noticeable response when initially seeing the familiar photos.
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Kalleinen N, Aittokallio J, Lampio L, Kaisti M, Polo-Kantola P, Polo O, Heinonen OJ, Saaresranta T. Sleep during menopausal transition: a 10-year follow-up. Sleep 2021; 44:6039192. [PMID: 33326582 PMCID: PMC8193555 DOI: 10.1093/sleep/zsaa283] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/11/2020] [Indexed: 11/22/2022] Open
Abstract
Study Objectives A 10-year observational follow-up study to evaluate the changes in sleep architecture during the menopausal transition. Methods Fifty-seven premenopausal women (mean age 46 years, SD 0.9) were studied at baseline and after a 10-year follow-up. At both time points, polysomnography (PSG) was performed, and the serum follicle-stimulating hormone (S-FSH) concentration was measured. Linear regression models were used to study the effects of aging and menopause (assessed as change in S-FSH) on sleep. Results After controlling for body mass index, vasomotor, and depressive symptoms, higher S-FSH level was associated with longer sleep latency (B 0.45, 95% confidence interval [CI]: 0.07 to 0.83). Aging of 10 years was associated with shorter sleep latency (B −46.8, 95% CI: −77.2 to −16.4), shorter latency to stage 2 sleep (B −50.6, 95% CI: −85.3 to −15.9), decreased stage 2 sleep (B −12.4, 95% CI: −21.4 to −3.4), and increased slow-wave sleep (B 12.8, 95% CI: 2.32 to 23.3) after controlling for confounding factors. Conclusions This study suggests that PSG measured sleep of middle-aged women does not worsen over a 10-year time span due to the menopausal transition. The observed changes seem to be rather age- than menopause-dependent.
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Affiliation(s)
- Nea Kalleinen
- Department of Pulmonary Diseases and Clinical Allergology, Sleep Research Center, University of Turku, Turku, Finland.,Heart Center, Turku University Hospital, University of Turku, Turku, Finland
| | - Jenni Aittokallio
- Department of Pulmonary Diseases and Clinical Allergology, Sleep Research Center, University of Turku, Turku, Finland.,Department of Anesthesiology and Intensive Care, University of Turku, Turku, Finland.,Division of Perioperative Services, Intensive Care and Pain Medicine, Turku University Hospital, Turku, Finland
| | - Laura Lampio
- Department of Pulmonary Diseases and Clinical Allergology, Sleep Research Center, University of Turku, Turku, Finland.,Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland
| | - Matti Kaisti
- Department of Future Technologies, University of Turku, Turku, Finland
| | - Päivi Polo-Kantola
- Department of Pulmonary Diseases and Clinical Allergology, Sleep Research Center, University of Turku, Turku, Finland.,Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland
| | - Olli Polo
- Bragée ME/CFS Center, Stockholm, Sweden
| | - Olli J Heinonen
- Paavo Nurmi Centre and Unit for Health & Physical Activity, University of Turku, Turku, Finland
| | - Tarja Saaresranta
- Department of Pulmonary Diseases and Clinical Allergology, Sleep Research Center, University of Turku, Turku, Finland.,Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital, Turku, Finland
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Kapagiannidou D, Koutris M, Wetselaar P, Visscher CM, van der Zaag J, Lobbezoo F. Association between polysomnographic parameters of sleep bruxism and attrition-type tooth wear. J Oral Rehabil 2021; 48:687-691. [PMID: 33474786 PMCID: PMC8248153 DOI: 10.1111/joor.13149] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 12/21/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Clinically, sleep bruxism is considered to be associated with the presence of tooth wear, but strong evidence is still lacking. OBJECTIVE To examine whether an association exists between polysomnographic parameters, recorded from patients with possible sleep bruxism and tooth wear. METHODS Sixty-three possible sleep bruxers (19 males and 44 females, mean ± SD age = 38.5 ± 11.4 years) were recruited among patients attending the Clinic for orofacial pain and dysfunction of the Academic Centre for Dentistry Amsterdam (ACTA). The incisal/occlusal tooth wear was recorded for each tooth clinically, using a 5-point ordinal scale. Subsequently, all patients underwent an one-night ambulatory polysomnographic recording, during which the number of bruxism episodes per hour of sleep (Epi/h), the number of bruxism bursts per hour of sleep (Bur/h), and the bruxism time index (BTI) were recorded and analysed. Logistic regression analysis was performed using the presence of tooth wear as the dependent variable, the polysomnographic recordings as independent variables, and corrected for age and gender. The Bur/h and BTI were removed from the analyses due to collinearity with the Epi/h. Additionally, the polysomnographic recordings were also tested for possible association with self-reported grinding of the teeth during sleep. RESULTS No significant correlation was found between tooth wear and Epi/h (P = 0.381). In addition, the presence of tooth wear was not associated with self-reported parafunctions. CONCLUSION Clinically measured tooth wear and self-reported parafunction seem not be related to the polysomnographic parameters of possible sleep bruxism.
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Affiliation(s)
- Despoina Kapagiannidou
- Department of Orofacial Pain and DysfunctionAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Michail Koutris
- Department of Orofacial Pain and DysfunctionAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Peter Wetselaar
- Department of Orofacial Pain and DysfunctionAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Corine Miriam Visscher
- Department of Orofacial Pain and DysfunctionAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Jacques van der Zaag
- Department of Orofacial Pain and DysfunctionAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and DysfunctionAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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5
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DiPietro JA, Raghunathan RS, Wu HT, Bai J, Watson H, Sgambati FP, Henderson JL, Pien GW. Fetal heart rate during maternal sleep. Dev Psychobiol 2021; 63:945-959. [PMID: 33764539 DOI: 10.1002/dev.22118] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/07/2021] [Accepted: 02/22/2021] [Indexed: 11/09/2022]
Abstract
Despite prolonged and cumulative exposure during gestation, little is known about the fetal response to maternal sleep. Eighty-four pregnant women with obesity (based on pre-pregnancy BMI) participated in laboratory-based polysomnography (PSG) with continuous fetal electrocardiogram monitoring at 36 weeks gestation. Multilevel modeling revealed both correspondence and lack of it in maternal and fetal heart rate patterns. Fetal heart rate (fHR) and variability (fHRV), and maternal heart rate (mHR) and variability (mHRV), all declined during the night, with steeper rates of decline prior to 01:00. fHR declined upon maternal sleep onset but was not otherwise associated with maternal sleep stage; fHRV differed during maternal REM and NREM. There was frequent maternal waking after sleep onset (WASO) and fHRV and mHRV were elevated during these episodes. Cross-correlation analyses revealed little temporal coupling between maternal and fetal heart rate, except during WASO, suggesting that any observed associations in maternal and fetal heart rates during sleep are the result of other physiological processes. Implications of the maternal sleep context for the developing fetus are discussed, including the potential consequences of the typical sleep fragmentation that accompanies pregnancy.
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Affiliation(s)
- Janet A DiPietro
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Radhika S Raghunathan
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Hau-Tieng Wu
- Department of Mathematics and Department of Statistical Science, Duke University, Durham, NC, USA
| | - Jiawei Bai
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Heather Watson
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Francis P Sgambati
- Center for Interdisciplinary Sleep Research and Education, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Janice L Henderson
- Division of Maternal-Fetal Medicine, Department of Gynecology & Obstetrics, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Grace W Pien
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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Kordestani-Moghadam P, Nasehi M, Vaseghi S, Khodagholi F, Zarrindast MR. The role of sleep disturbances in depressive-like behavior with emphasis on α-ketoglutarate dehydrogenase activity in rats. Physiol Behav 2020; 224:113023. [PMID: 32574661 DOI: 10.1016/j.physbeh.2020.113023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 06/01/2020] [Accepted: 06/19/2020] [Indexed: 02/06/2023]
Abstract
Sleep disorders may induce anxiety- and depressive-like behaviors. Furthermore, sleep disorders can alter the function of α-KGDH (α-ketoglutarate dehydrogenase), which is involved in the citric acid cycle. In this study, we evaluated the effect of two models of sleep deprivation (SD) including total SD (TSD) and partial SD (PSD), and two models of napping combined with each models of SD on rats' performance in Forced Swim Test (FST) and α-KGDH activity in both hemispheres of the amygdala. 64 male Wistar rats were used in this study. A modified water box was also used to induce SD. The results showed that, immobility was increased in 48-hour PSD group, indicating a possible depressive-like behavior. Swimming time was also increased following 48-hour TSD. However, climbing time was decreased in 48-hour PSD/TSD groups. Additionally, α-KGDH activity was increased in the left amygdala in 48-hour TSD and PSD groups. In conclusion, PSD may increase depressive-like behavior. TSD and PSD can decrease swimming time but increase climbing time, and these effects may be related to serotonergic and noradrenergic transmissions, respectively. Increase in α-KGDH activity in the left amygdala may be related to the brain's need for more energy during prolonged wakefulness. α-KGDH activity in the right amygdala was unaffected probably due to a decrease in alertness following SD.
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Affiliation(s)
| | - Mohammad Nasehi
- Cognitive and Neuroscience Research Center (CNRC), Amir-Almomenin Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Salar Vaseghi
- Cognitive and Neuroscience Research Center (CNRC), Amir-Almomenin Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; Institute for Cognitive Science Studies (ICSS), Tehran, Iran
| | - Fariba Khodagholi
- Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Zarrindast
- Institute for Cognitive Science Studies (ICSS), Tehran, Iran; Department of Pharmacology School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Neuroendocrinology Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Metin M, Avcu M. An evaluation of the effects of video modelling on the first-night effect in polysomonography examination of patients with obstructive sleep apnea. Sleep Biol Rhythms 2020. [DOI: 10.1007/s41105-020-00272-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Virtanen I, Kalleinen N, Urrila AS, Polo-Kantola P. First-night effect on cardiac autonomic function in different female reproductive states. J Sleep Res 2018; 27:150-158. [PMID: 28548300 DOI: 10.1111/jsr.12560] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 04/10/2017] [Indexed: 11/27/2022]
Abstract
Decreases in heart rate variability, a marker of autonomic nervous system function, are associated with increased cardiovascular mortality. Heart rate variability increases in non-rapid eye movement sleep, peaking in slow-wave sleep. Therefore, decreasing the amount of deep sleep, for example, by introducing patients to a sleep laboratory environment, could decrease heart rate variability, increasing cardiovascular risk. We studied four groups of women with no previous sleep laboratory experience: young [n = 11, 23.1 (0.5) years]; perimenopausal [n = 15, 48.0 (0.4) years]; postmenopausal without hormone therapy [n = 22, 63.4 (0.8) years]; and postmenopausal on hormone therapy [n = 16, 63.1 (0.9) years], using a cross-sectional design. Polysomnography including electrocardiogram was performed over two consecutive nights. Heart rate variability was assessed overnight, and the first-night effect on heart rate variability was analysed. Furthermore, correlations between heart rate variability and sleep variables were analysed. Using combined groups, only minor changes were observed in non-linear heart rate variability, indicating increased parasympathetic tone from the first to the second night. No group differences in first-night effect were seen. Heart rate variability and sleep variables were not significantly correlated. Heart rate variability decreased with increasing age, and it was lowest in the postmenopausal women on hormone therapy. We conclude that a first night in a sleep laboratory elicits only minimal changes in overnight vagally mediated non-linear heart rate variability in women irrespective of reproductive state. This finding warrants further analyses in different sleep stages, but suggests that changes in sleep architecture per se do not predict the autonomic strain of a poor night.
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Affiliation(s)
- Irina Virtanen
- Department of Clinical Neurophysiology, TYKS-SAPA, Hospital District of Southwest Finland, Turku, Finland
- Department of Clinical Neurophysiology, University of Turku, Turku, Finland
| | - Nea Kalleinen
- Sleep Research Unit, University of Turku, Turku, Finland
- Department of Cardiology, Satakunta Central Hospital, Pori, Finland
| | - Anna S Urrila
- Department of Health, Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland
- Department of Adolescent Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Päivi Polo-Kantola
- 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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9
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Veauthier C, Piper SK, Gaede G, Penzel T, Paul F. The first night effect in multiple sclerosis patients undergoing home-based polysomnography. Nat Sci Sleep 2018; 10:337-344. [PMID: 30498381 PMCID: PMC6207396 DOI: 10.2147/nss.s176201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The first night effect (FNE) is a polysomnography (PSG) habituation effect in the first of several consecutive in-laboratory PSGs (I-PSGs). The FNE is caused by the discomfort provoked by electrodes and cables and the exposure to an unfamiliar environment. A reverse FNE (RFNE) with an improved sleep in the first night is characteristic of insomnia, presumably because the video PSG in the sleep laboratory leads to a decrease in the negatively toned cognitive activity. Therefore, two or more I-PSGs are required for an accurate diagnosis. Although the FNE is well documented in I-PSG, little is known about the FNE and the RFNE in home-based PSGs (H-PSGs). METHODS This is a retrospective analysis of a recently published cross-sectional study using H-PSG. Sixty-three consecutive patients suffering from multiple sclerosis (MS) were investigated by two consecutive H-PSGs without video. The differences between the first and second H-PSGs were analyzed. The patients were classified into four subgroups: no sleep disorder, insomnia, sleep-related breathing disorders (SRBDs), and periodic limb movement disorder or restless legs syndrome (PLMD/RLS). RESULTS MS patients suffering from insomnia showed no RFNE. MS patients with SRBD or PLMD/RLS showed no reduced sleep efficiency but significantly less slow wave sleep. Furthermore, SRBD patients showed significantly less non-rapid eye movement (NREM) sleep, and PLMD/RLS patients were significantly awake longer in the first night after sleep onset (increased wake-after-sleep-onset time) and showed a higher rapid eye movement (REM) latency. CONCLUSION SRBD and PLMD/RLS patients showed a significant FNE. Two consecutive H-PSGs are required in these patients to obtain a precise hypnogram even in the ambulatory field. In MS patients suffering from insomnia, no RFNE was found, and in insomnia patients one H-PSG seems to be sufficient.
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Affiliation(s)
- Christian Veauthier
- Interdisciplinary Center of Sleep Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany,
| | - Sophie K Piper
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Gunnar Gaede
- Department of Neurology, St. Joseph Krankenhaus Berlin-Weissensee, Berlin, Germany
| | - Thomas Penzel
- Interdisciplinary Center of Sleep Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany, .,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Friedemann Paul
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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10
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Lampio L, Polo-Kantola P, Himanen SL, Kurki S, Huupponen E, Engblom J, Heinonen OJ, Polo O, Saaresranta T. Sleep During Menopausal Transition: A 6-Year Follow-Up. Sleep 2017; 40:3836367. [DOI: 10.1093/sleep/zsx090] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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