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Johnson CE, Duncan MJ, Murphy MP. Sex and Sleep Disruption as Contributing Factors in Alzheimer's Disease. J Alzheimers Dis 2024; 97:31-74. [PMID: 38007653 PMCID: PMC10842753 DOI: 10.3233/jad-230527] [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] [Indexed: 11/27/2023]
Abstract
Alzheimer's disease (AD) affects more women than men, with women throughout the menopausal transition potentially being the most under researched and at-risk group. Sleep disruptions, which are an established risk factor for AD, increase in prevalence with normal aging and are exacerbated in women during menopause. Sex differences showing more disrupted sleep patterns and increased AD pathology in women and female animal models have been established in literature, with much emphasis placed on loss of circulating gonadal hormones with age. Interestingly, increases in gonadotropins such as follicle stimulating hormone are emerging to be a major contributor to AD pathogenesis and may also play a role in sleep disruption, perhaps in combination with other lesser studied hormones. Several sleep influencing regions of the brain appear to be affected early in AD progression and some may exhibit sexual dimorphisms that may contribute to increased sleep disruptions in women with age. Additionally, some of the most common sleep disorders, as well as multiple health conditions that impair sleep quality, are more prevalent and more severe in women. These conditions are often comorbid with AD and have bi-directional relationships that contribute synergistically to cognitive decline and neuropathology. The association during aging of increased sleep disruption and sleep disorders, dramatic hormonal changes during and after menopause, and increased AD pathology may be interacting and contributing factors that lead to the increased number of women living with AD.
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Affiliation(s)
- Carrie E. Johnson
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
| | - Marilyn J. Duncan
- University of Kentucky, College of Medicine, Department of Neuroscience, Lexington, KY, USA
| | - M. Paul Murphy
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
- University of Kentucky, Sanders-Brown Center on Aging, Lexington, KY, USA
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Jung HN, Suh D, Jeong WC, Ryu J, Kim YM, Yoon S, Kim H. Associations of chronotype and insomnia with menstrual problems in newly employed nurses at university hospitals in the Republic of Korea. Ann Occup Environ Med 2023; 35:e30. [PMID: 37701482 PMCID: PMC10493377 DOI: 10.35371/aoem.2023.35.e30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/06/2023] [Accepted: 06/30/2023] [Indexed: 09/14/2023] Open
Abstract
Background Dysmenorrhea and menstrual cycle changes occur in women working shifts. Circadian rhythm disruption and sleep disturbances associated with shift work leads to health problems. We identified chronotypes and the occurrence of insomnia among newly employed university hospital nurses and investigated the association of these factors with menstrual problems. Methods We conducted pre-placement health examinations for shift workers using self-reported questionnaires between 2018 and 2020. A total of 463 nurses were included in the study. Sociodemographic data, shift work experience, and information on insomnia were collected from health examination data. In addition, details regarding chronotype, dysmenorrhea, irregular and abnormal menstrual cycles, amenorrhea, and contraceptive use were obtained from the questionnaire. Multiple logistic regression analysis was performed to study the association between chronotype, insomnia, and menstrual problems after controlling for age, body mass index, contraceptive use, amenorrhea, and prior shift work. Results The prevalence rates of dysmenorrhea, irregular menstrual cycles, and longer menstrual cycles were 23.8%, 14.9%, and 4.1%, respectively. The risk of dysmenorrhea increased in the evening-type (odds ratio [OR]: 3.209; 95% confidence interval [CI]: 1.685-6.113) and those with insomnia (OR: 1.871; 95% CI: 1.074-3.261). Additionally, the risk of an irregular menstrual cycle (OR: 2.698; 95% CI: 1.167-6.237) increased in the evening-type, and the risk of a longer menstrual cycle (OR: 4.008; 95% CI: 1.354-11.864) increased in individuals with insomnia. Conclusions Our findings suggest that dysmenorrhea is promoted in the evening-type and insomnia individuals. There may be an increased risk of irregular menstrual cycles among evening-type nurses and an increased risk of longer menstrual cycles among those with insomnia. Therefore, factors such as evening-type and insomnia should be considered for the prevention of menstrual problems in women performing shift work.
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Affiliation(s)
- Han-Na Jung
- Department of Occupational and Environmental Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Dongwhan Suh
- Department of Occupational and Environmental Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Woo Chul Jeong
- Department of Occupational and Environmental Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Jia Ryu
- Department of Occupational and Environmental Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Korea
| | - Yu-Mi Kim
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Korea
- School of Public Health, Hanyang University, Seoul, Korea
| | - Seohyun Yoon
- Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyunjoo Kim
- Department of Occupational and Environmental Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
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Messman BA, Wiley JF, Yap Y, Tung YC, Almeida IM, Dietch JR, Taylor DJ, Slavish DC. How much does sleep vary from night-to-night? A quantitative summary of intraindividual variability in sleep by age, gender, and racial/ethnic identity across eight-pooled datasets. J Sleep Res 2022; 31:e13680. [PMID: 35811092 PMCID: PMC9649840 DOI: 10.1111/jsr.13680] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 11/26/2022]
Abstract
Habitual sleep duration and efficiency vary widely by age, gender, and racial/ethnic identity. Despite growing research on the importance of night-to-night, intraindividual variability (IIV) in sleep, few studies have examined demographic differences in sleep IIV. The present study describes typical sleep IIV overall and by demographics among healthy sleepers. Eight datasets of healthy sleepers (N = 2,404; 26,121 total days of sleep data) were synthesised to examine age, gender, and racial/ethnic identity differences in sleep IIV measured via diaries, actigraphy, and electroencephalography (EEG). Sleep IIV estimates included the intraindividual standard deviation (iSD), root mean square of successive differences (RMSSD), coefficient of variation (CV), and a validated Bayesian Variability Model (BVM). There was substantial IIV in sleep across measurement types (diary, actigraphy, EEG) for both sleep duration (iSD: 85.80 [diary], 77.41 [actigraphy], 67.04 [EEG] minutes; RMSSD: 118.91, 108.89, 91.93 minutes; CV: 19.19%, 19.11%, 18.57%; BVM: 60.60, 58.20, 48.60 minutes) and sleep efficiency (iSD: 5.18% [diary], 5.22% [actigraphy], 6.46% [EEG]; RMSSD: 7.01%, 7.08%, 8.44%; CV: 5.80%, 6.27%, 8.14%; BVM: 3.40%, 3.58%, 4.16%). Younger adults had more diary and actigraphy sleep duration IIV. Gender differences were inconsistent. White and non-Hispanic/Latinx adults had less IIV in sleep duration and efficiency compared to racial/ethnic minority groups. Even among healthy sleepers, sleep varies widely from night-to-night. Like mean sleep, there also may be disparities in IIV in sleep by demographic characteristics. Study results help characterise normative values of sleep IIV in healthy sleepers.
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Affiliation(s)
- Brett A. Messman
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Joshua F. Wiley
- Turner Institute for Brain and Mental Health, Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Yang Yap
- Turner Institute for Brain and Mental Health, Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Yan Chi Tung
- Turner Institute for Brain and Mental Health, Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Isamar M. Almeida
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Jessica R. Dietch
- Department of Psychology, University of North Texas, Denton, TX, USA
- School of Psychological Science, Oregon State University, Corvallis, OR, USA
| | - Daniel J. Taylor
- Department of Psychology, University of North Texas, Denton, TX, USA
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Danica C. Slavish
- Department of Psychology, University of North Texas, Denton, TX, USA
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4
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Enea C, Arc C, Delpech N. Les spécificités hormonales de la sportive de haut niveau : adapter la prise en charge pour optimiser la performance. Sci Sports 2022. [DOI: 10.1016/j.scispo.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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5
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Beroukhim G, Esencan E, Seifer DB. Impact of sleep patterns upon female neuroendocrinology and reproductive outcomes: a comprehensive review. Reprod Biol Endocrinol 2022; 20:16. [PMID: 35042515 PMCID: PMC8764829 DOI: 10.1186/s12958-022-00889-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/06/2022] [Indexed: 12/17/2022] Open
Abstract
Sleep is vital to human bodily function. Growing evidence indicates that sleep deprivation, disruption, dysrhythmia, and disorders are associated with impaired reproductive function and poor clinical outcomes in women. These associations are largely mediated by molecular-genetic and hormonal pathways, which are crucial for the complex and time sensitive processes of hormone synthesis/secretion, folliculogenesis, ovulation, fertilization, implantation, and menstruation. Pathologic sleep patterns are closely linked to menstrual irregularity, polycystic ovarian syndrome, premature ovarian insufficiency, sub/infertility, and early pregnancy loss. Measures of success with assisted reproductive technology are also lower among women who engage in shift work, or experience sleep disruption or short sleep duration. Extremes of sleep duration, poor sleep quality, sleep disordered breathing, and shift work are also associated with several harmful conditions in pregnancy, including gestational diabetes and hypertensive disorders. While accumulating evidence implicates pathologic sleep patterns in impaired reproductive function and poor reproductive outcomes, additional research is needed to determine causality and propose therapeutic interventions.
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Affiliation(s)
- Gabriela Beroukhim
- Department of Obstetrics, Gynecology, and Reproductive Sciences at Yale School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA.
| | - Ecem Esencan
- Department of Obstetrics, Gynecology, and Reproductive Sciences at Yale School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA
| | - David B Seifer
- Department of Obstetrics, Gynecology, and Reproductive Sciences at Yale School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA
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Singla B, Banerjee K, Thind A, Bhatnagar N, Agria K, Bajaj P, Jindal A, Arora S, Goyal P, Mittal B, Malhotra K, Pai H, Malhotra J, Goel P, Jindal N. Effect of reproductive and lifestyle factors on anti-mullerian hormone levels in women of Indian origin. J Hum Reprod Sci 2022; 15:259-271. [PMID: 36341011 PMCID: PMC9635372 DOI: 10.4103/jhrs.jhrs_79_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/21/2022] Open
Abstract
Background: Infertility is a world-wide problem and one third females. Over the years, anti-mullerian hormone (AMH) has emerged as a major marker of ovarian reserve. There is also increasing interest in determining the factors which can impact AMH levels. Aims: To correlate the association of reproductive and lifestyle factors on AMH levels in women of Indian origin. Settings and Design: Multicentric cross sectional study. Materials and Methods: The study was conducted using data extracted from the patient records of seven private fertility practices located in North India. Women who were attending these clinics for fertility treatment were requested to fill the questionnaire related to reproductive and lifestyle factors. Statistical Analysis used: Our outcome variable was level of AMH measured in the past 3 months, and was assessed as normal or low. All analyses were conducted using STATA 17. Results: We found a direct association of low AMH with increasing age, short cycles, amenorrhea and women with family history of premature menopause. We found a direct correlation of high AMH and women with polycystic ovary syndrome and those whose partners had Oligoasthenoteratozoospermia (OATS) or azoospermia. There was no correlation with smoking, sleep, diet, body mass index, cell phone or laptop use in our study. Conclusion: Reproductive and lifestyle factors may affect ovarian reserve and but there was a dearth of human studies in this area. To the best of our knowledge this is the first human study on the effect of AMH on Laptop and Cell phone use. We urgently need more studies to confirm or refute our findings so that we can counsel our patients well.
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Smith PC, Phillips DJ, Pocivavsek A, Byrd CA, Viechweg SS, Hampton B, Mong JA. Estradiol Influences Adenosinergic Signaling and NREM Sleep Need in Adult Female Rats. Sleep 2021; 45:6363599. [PMID: 34477210 DOI: 10.1093/sleep/zsab225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
Gonadal steroids and gender are risk factors for sleep disruptions and insomnia in women. However, the relationship between ovarian steroids and sleep is poorly understood. In rodent models, estradiol (E2) suppresses sleep in females suggesting that E2 may reduce homeostatic sleep need. The current study investigates whether E2 decreases sleep need and the potential mechanisms that govern E2 suppression of sleep. Our previous findings suggest that the median preoptic nucleus (MnPO) is a key nexus for E2 action on sleep. Using behavioral, neurochemical and pharmacological approaches, we tested whether (1) E2 influenced the sleep homeostat and (2) E2 influenced adenosine signaling in the MnPO of adult female rats. In both unrestricted baseline sleep and recovery sleep from 6-hour sleep deprivation, E2 significantly reduced non-rapid eye movement sleep (NREM)-delta power, NREM-Slow Wave Activity (NREM-SWA, 0.5-4.0Hz), and NREM-delta energy suggesting that E2 decreases homeostatic sleep need. However, coordinate with E2-induced changes in physiological markers of homeostatic sleep was a marked increase in MnPO extracellular adenosine (a molecular marker of homeostatic sleep need) during unrestricted and recovery sleep in E2-treated but not oil control animals. While these results seemed contradictory, systemically administered E2 blocked the ability of CGS-21680 (adenosine A2A receptor agonist) microinjected into the MnPO to increase NREM sleep suggesting that E2 may block adenosine signaling. Together, these findings provide evidence that E2 may attenuate the local effects of the A2A receptors in the MnPO which in turn may underlie estrogenic suppression of sleep behavior as well as changes in homeostatic sleep need.
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Affiliation(s)
- Philip C Smith
- Department of Pharmacology, University of Maryland Baltimore, Baltimore, Md
| | - Derrick J Phillips
- Department of Pharmacology, University of Maryland Baltimore, Baltimore, Md
| | - Ana Pocivavsek
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, S. C
| | - Carissa A Byrd
- Department of Pharmacology, University of Maryland Baltimore, Baltimore, Md
| | - Shaun S Viechweg
- Department of Pharmacology, University of Maryland Baltimore, Baltimore, Md
| | - Brian Hampton
- Protein Analysis Laboratory, Center for Innovative Biomedical Resources, University of Maryland Baltimore, Baltimore, Md
| | - Jessica A Mong
- Department of Pharmacology, University of Maryland Baltimore, Baltimore, Md
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Triebner K, Bifulco E, Barrera-Gómez J, Basagaña X, Benediktsdóttir B, Forsberg B, Franklin KA, Garcia-Larsen V, Leynaert B, Lindberg E, Martínez-Moratalla J, Muniozguren-Agirre N, Pin I, Raherison C, Pereira-Vega A, Schlünssen V, Valentin A, Hustad S, Real FG, Dadvand P. Ultraviolet radiation as a predictor of sex hormone levels in postmenopausal women: A European multi-center study (ECRHS). Maturitas 2021; 145:49-55. [PMID: 33541562 DOI: 10.1016/j.maturitas.2020.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 11/02/2020] [Accepted: 12/26/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Solar ultraviolet radiation (UVR) affects the body through pathways that exhibit positive as well as negative health effects such as immunoregulation and vitamin D production. Different vitamin D metabolites are associated with higher or lower concentrations of estrogens and may thus alter the female sex hormone balance. OBJECTIVE To study whether exposure to UVR, as a modifiable lifestyle factor, is associated with levels of sex hormones (17β-estradiol, estrone, estrone 3-sulfate, testosterone, dehydroepiandrosterone sulfate), gonadotropins (follicle stimulating hormone, luteinizing hormone) as well as sex hormone binding globulin in postmenopausal women, and thus investigate whether managing UVR exposure can influence the hormone balance, with potential benefits for the biological aging process. METHODS The study included 580 postmenopausal women from six European countries, participating in the European Community Respiratory Health Survey (2010-2014). Average UVR exposure during the month before blood sampling was estimated based on personal sun behavior and ambient levels. Hormone concentrations were measured in serum using state-of-the-art methods. Subsequently we applied linear mixed-effects models, including center as random intercept, hormone concentrations (one at a time) as outcome and UVR, age, skin type, body mass index, vitamin D from dietary sources, smoking, age at completed full-time education and season of blood sampling as fixed-effect predictors. RESULTS One interquartile range increase in UVR exposure was associated with decreased levels of 17β-estradiol (-15.6 pmol/L, 95 % Confidence Interval (CI): -27.69, -3.51) and estrone (-13.36 pmol/L, 95 % CI: -26.04, -0.68) and increased levels of follicle stimulating hormone (9.34IU/L, 95 % CI: 2.91, 15.77) and luteinizing hormone (13.86 IU/daL, 95 % CI: 2.48, 25.25). CONCLUSIONS Exposure to UVR is associated with decreased estrogens and increased gonadotropins in postmenopausal women, a status associated with osteoporosis, lung function decline and other adverse health effects. This study indicates that managing UVR exposure has potential to influence the hormone balance and counteract adverse health conditions after menopause.
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Affiliation(s)
- Kai Triebner
- Department of Clinical Science, University of Bergen, Bergen, Norway; Core Facility for Metabolomics, University of Bergen, Bergen, Norway.
| | - Ersilia Bifulco
- Department of Clinical Science, University of Bergen, Bergen, Norway; Core Facility for Metabolomics, University of Bergen, Bergen, Norway
| | - Jose Barrera-Gómez
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Karl A Franklin
- Department of Surgical and Perioperative Sciences, Surgery, Umea University, Umea, Sweden
| | - Vanessa Garcia-Larsen
- Program in Human Nutrition, Department of International Health, The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, USA
| | - Bénédicte Leynaert
- Team of Epidemiology, French National Institute of Health and Medical Research UMR1152, Paris, France
| | - Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Akademiska sjukhuset, Uppsala, Sweden
| | - Jesús Martínez-Moratalla
- Pulmonology Service, Albacete University Hospital Complex, Health Service of Castilla - La Mancha. Albacete, Spain; Faculty of Medicine of Albacete, Castilla-La Mancha University, Albacete, Spain
| | | | - Isabelle Pin
- Department of Paediatrics, University Hospital Grenoble Alpes, Grenoble, France; French National Institute of Health and Medical Research, France; Institute for Advanced Biosciences, Grenoble, France; University Grenoble Alpes, CS 10217, 38043, Grenoble Cedex 9, France
| | - Chantal Raherison
- U1219, Bordeaux Population Health Research, Bordeaux University, 146 Rue Leo Saignat, 33076, Bordeaux, France
| | - Antonio Pereira-Vega
- Service of Pneumology and Allergy, University Hospital Juan Ramón Jiménez, Huelva, Spain
| | - Vivi Schlünssen
- Department of Public Health, Aarhus University, Aarhus, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark
| | - Antonia Valentin
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Steinar Hustad
- Department of Clinical Science, University of Bergen, Bergen, Norway; Core Facility for Metabolomics, University of Bergen, Bergen, Norway
| | - Francisco Gómez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Gynaecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
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Abstract
The reproductive function of humans is regulated by several sex hormones which are secreted in synergy with the circadian timing of the body. Sleep patterns produce generic signatures that physiologically drive the synthesis, secretion, and metabolism of hormones necessary for reproduction. Sleep deprivation among men and women is increasingly reported as one of the causes of infertility. In animal models, sleep disturbances impair the secretion of sexual hormones thereby leading to a decrease in testosterone level, reduced sperm motility and apoptosis of the Leydig cells in male rats. Sleep deprivation generates stressful stimuli intrinsically, due to circadian desynchrony and thereby increases the activation of the Hypothalamus-Pituitary Adrenal (HPA) axis, which, consequently, increases the production of corticosterone. The elevated level of corticosteroids results in a reduction in testosterone production. Sleep deprivation produces a commensurate effect on women by reducing the chances of fertility. Sleeplessness among female shift workers suppresses melatonin production as well as excessive HPA activation which results in early pregnancy loss, failed embryo implantation, anovulation and amenorrhea. Sleep deprivation in women has also be found to be associated with altered gonadotropin and sex steroid secretion which all together lead to female infertility. Poor quality of sleep is observed in middle-aged and older men and this also contributes to reduced testosterone concentrations. The influence of sleep disturbances post-menopausal is associated with irregular synthesis and secretion of female sex steroid hormones.
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Kang W, Jang KH, Lim HM, Ahn JS, Park WJ. The menstrual cycle associated with insomnia in newly employed nurses performing shift work: a 12-month follow-up study. Int Arch Occup Environ Health 2018; 92:227-235. [PMID: 30386870 DOI: 10.1007/s00420-018-1371-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 10/28/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE This study aimed to investigate whether insomnia among newly-employed shift-working nurses is associated with menstrual cycle irregularity. METHODS We followed 287 nurses employed between 2015 and 2016 for 12 months. An Insomnia Severity Index (ISI) was completed to determine levels of insomnia 6 months after beginning work. At baseline and at 12-month follow-up, menstrual cycle information was obtained using clinical interviews. We analyzed baseline data separately by prevalence (participants with menstrual irregularity, n = 287) and incidence (participants with no reported menstrual irregularity, n = 238). RESULTS In a multivariate logistic regression analysis, including age, body mass index, and physical activity, insomnia was associated with a 2.05-fold increase in the odds of newly developing menstrual cycle irregularity compared with not having insomnia [odds ratio (OR) 2.05, 95% confidence interval (CI) 1.12-3.77]. Insomnia was associated with a 3.05-fold increase in the prevalence of menstrual cycle irregularity compared with not having insomnia (OR 3.05, 95% CI 1.81-5.13). As the ISI score increased, both the incidence and prevalence odds of menstrual cycle irregularity tended to increase. CONCLUSIONS Insomnia can induce menstrual cycle irregularity among nurses working shifts, and insomnia may have an important role in the pathway from shift work to menstrual dysfunction, aside from the possible effects of circadian rhythm disruption.
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Affiliation(s)
- WonYang Kang
- Department of Occupational and Environmental Medicine, Chonnam National University Hwasun Hospital, 322, Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeollanam-do, 58128, Republic of Korea
| | - Keun-Ho Jang
- Department of Occupational and Environmental Medicine, Mokpo Christian Hospital, Mokpo, Jeollanam-do, Republic of Korea
| | - Hyeong-Min Lim
- Department of Occupational and Environmental Medicine, Chonnam National University Hwasun Hospital, 322, Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeollanam-do, 58128, Republic of Korea
| | - Ji-Sung Ahn
- Department of Occupational and Environmental Medicine, Chonnam National University Hwasun Hospital, 322, Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeollanam-do, 58128, Republic of Korea
| | - Won-Ju Park
- Department of Occupational and Environmental Medicine, Chonnam National University Hwasun Hospital, 322, Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeollanam-do, 58128, Republic of Korea.
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The Relationships between Life Satisfaction and Sleep Quality, Sleep Duration and Variability of Sleep in University Students. JOURNAL OF EUROPEAN PSYCHOLOGY STUDENTS 2018. [DOI: 10.5334/jeps.434] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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12
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Merklinger-Gruchala A, Jasienska G, Kapiszewska M. Effect of Air Pollution on Menstrual Cycle Length-A Prognostic Factor of Women's Reproductive Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E816. [PMID: 28726748 PMCID: PMC5551254 DOI: 10.3390/ijerph14070816] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 07/02/2017] [Accepted: 07/13/2017] [Indexed: 12/22/2022]
Abstract
Air pollution can influence women's reproductive health, specifically menstrual cycle characteristics, oocyte quality, and risk of miscarriage. The aim of the study was to assess whether air pollution can affect the length of the overall menstrual cycle and the length of its phases (follicular and luteal). Municipal ecological monitoring data was used to assess the air pollution exposure during the monitored menstrual cycle of each of 133 woman of reproductive age. Principal component analyses were used to group pollutants (PM10, SO₂, CO, and NOx) to represent a source-related mixture. PM10 and SO₂ assessed separately negatively affected the length of the luteal phase after standardization (b = -0.02; p = 0.03; b = -0.06; p = 0.02, respectively). Representing a fossil fuel combustion emission, they were also associated with luteal phase shortening (b = -0.32; p = 0.02). These pollutants did not affect the follicular phase length and overall cycle length, neither in single- nor in multi-pollutant models. CO and NOx assessed either separately or together as a traffic emission were not associated with overall cycle length or the length of cycle phases. Luteal phase shortening, a possible manifestation of luteal phase deficiency, can result from fossil fuel combustion. This suggests that air pollution may contribute to fertility problems in women.
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Affiliation(s)
- Anna Merklinger-Gruchala
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland.
| | - Grazyna Jasienska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-531 Krakow, Poland.
| | - Maria Kapiszewska
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland.
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Merklinger-Gruchala A, Jasienska G, Kapiszewska M. Parity Conditions the Risk for Low Birth Weight after Maternal Exposure to Air Pollution. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2017; 63:71-86. [PMID: 28287305 DOI: 10.1080/19485565.2016.1264872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Multiparous mothers have greater umbilical blood flow and thus more efficient transport of pollutants than primiparous mothers. We tested a hypothesis that multiparous mothers are more prone to have an infant with low birth weight (LBW) after prenatal exposure to air pollution. A study was conducted on a representative group of more than 74,000 singleton, live, full-term infants. Birth data were obtained from the birth registry, while pollution data were from an environmental monitoring system (Poland). Multiple comparisons were controlled by the false discovery rate procedure (FDR). After standardization, the harmful effect of carbon monoxide (CO) on the odds ratio (OR) for LBW was seen among the multiparous mothers (OR = 1.28; 95% CI 1.06-1.54), while in primiparous mothers it was nonsignificant. The effect of CO on the OR for LBW differed according to parity, which was confirmed by the test for interaction (FDR-adjusted p = 0.03). The interaction between parity and sulfur dioxide (SO2) was statistically nonsignificant (FDR-adjusted p = 0.08). Multiparous mothers may be more vulnerable to CO than primiparous mothers. Parity may be the modifier of the association between pollutants and the risk of LBW.
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Affiliation(s)
- Anna Merklinger-Gruchala
- a Department of Pediatrics, Faculty of Medicine , Andrzej Frycz Modrzewski Krakow University , Krakow , Poland
| | - Grazyna Jasienska
- b Department of Environmental Health, Faculty of Health Sciences , Jagiellonian University Medical College , Krakow , Poland
| | - Maria Kapiszewska
- c Department of Health and Medical Sciences , Andrzej Frycz Modrzewski Krakow University , Krakow , Poland
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Li DX, Romans S, De Souza MJ, Murray B, Einstein G. Actigraphic and self-reported sleep quality in women: associations with ovarian hormones and mood. Sleep Med 2015; 16:1217-24. [DOI: 10.1016/j.sleep.2015.06.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 06/23/2015] [Indexed: 01/18/2023]
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Kloss JD, Perlis ML, Zamzow JA, Culnan EJ, Gracia CR. Sleep, sleep disturbance, and fertility in women. Sleep Med Rev 2015; 22:78-87. [PMID: 25458772 PMCID: PMC4402098 DOI: 10.1016/j.smrv.2014.10.005] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 10/07/2014] [Accepted: 10/07/2014] [Indexed: 01/27/2023]
Abstract
Sleep and sleep disturbances are increasingly recognized as determinants of women's health and well-being, particularly in the context of the menstrual cycle, pregnancy, and menopause. At present, however, little is known about whether fertility is affected by sleep quantity and quality. That is, to what degree, and by what mechanisms, do sleep and/or its disturbances affect fertility? The purpose of this review is to synthesize what is known about sleep disturbances in relation to reproductive capacity. A model is provided, whereby stress, sleep dysregulation, and circadian misalignment are delineated for their potential relevance to infertility. Ultimately, if it is the case that sleep disturbance is associated with infertility, new avenues for clinical intervention may be possible.
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Affiliation(s)
| | - Michael L Perlis
- Department of Psychiatry, Behavioral Sleep Medicine Program, University of Pennsylvania, USA
| | | | | | - Clarisa R Gracia
- Department of Obstetrics and Gynecology at the Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, USA
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16
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Bei B, Wiley JF, Trinder J, Manber R. Beyond the mean: A systematic review on the correlates of daily intraindividual variability of sleep/wake patterns. Sleep Med Rev 2015; 28:108-24. [PMID: 26588182 DOI: 10.1016/j.smrv.2015.06.003] [Citation(s) in RCA: 246] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 06/23/2015] [Accepted: 06/23/2015] [Indexed: 11/20/2022]
Abstract
Features of an individual's sleep/wake patterns across multiple days are governed by two dimensions, the mean and the intraindividual variability (IIV). The existing literature focuses on the means, while the nature and correlates of sleep/wake IIV are not well understood. A systematic search of records in five major databases from inception to November 2014 identified 53 peer-reviewed empirical publications that examined correlates of sleep/wake IIV in adults. Overall, this literature appeared unsystematic and post hoc, with under-developed theoretical frameworks and inconsistent methodologies. Correlates most consistently associated with greater IIV in one or more aspects of sleep/wake patterns were: younger age, non-White race/ethnicity, living alone, physical health conditions, higher body mass index, weight gain, bipolar and unipolar depression symptomatology, stress, and evening chronotype; symptoms of insomnia and poor sleep were associated with higher sleep/wake IIV, which was reduced following sleep interventions. The effects of experimentally reduced sleep/wake IIV on daytime functioning were inconclusive. In extending current understanding of sleep/wake patterns beyond the mean values, IIV should be incorporated as an additional dimension when sleep is examined across multiple days. Theoretical and methodological shortcomings in the existing literature, and opportunities for future research are discussed.
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Affiliation(s)
- Bei Bei
- Monash Institute of Cognitive and Clinical Neurosciences, Monash School of Psychological Sciences, Faculty of Biomedical and Psychological Sciences, Monash University, Australia; Centre for Women's Mental Health, Royal Women's Hospital, Australia.
| | - Joshua F Wiley
- Centre for Primary Care and Prevention, Mary MacKillop Institute for Health Research, Australian Catholic University, Australia
| | - John Trinder
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - Rachel Manber
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Science, USA
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Barrett ES, Parlett LE, Windham GC, Swan SH. Differences in ovarian hormones in relation to parity and time since last birth. Fertil Steril 2014; 101:1773-80.e1. [PMID: 24684956 DOI: 10.1016/j.fertnstert.2014.02.047] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 02/25/2014] [Accepted: 02/25/2014] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine ovarian function in relation to parity and time since last birth. DESIGN Cross-sectional study. SETTING Health-care program in California. PATIENT(S) 346 naturally cycling women, aged 18 to 39 years. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Mean follicular urinary estradiol metabolite concentration (E1C) (cycle days -8 to -1), mean luteal progesterone metabolite concentration (PdG) (days 0 to +10), and cycle phase lengths in ovulatory cycles. RESULT(S) After the women had collected daily urine samples for up to eight menstrual cycles, we measured the E1C and PdG using enzyme-linked immunoassay. The cycle phase lengths were calculated from the hormone profiles and daily diaries. Women who had given birth within the previous 3 years had lower E1C than the nulliparous women and women who last given birth >3 years earlier. Among the parous women, E1C was positively associated with the time since last birth. Women who last gave birth >3 years earlier had longer follicular phases than the nulliparous women. There were no associations between parity and PdG or luteal phase length. CONCLUSION(S) Our cross-sectional data suggest that ovarian function differs in nulliparous and parous women and is positively associated with the time since last birth. Longitudinal research is needed to explore within-woman changes in ovarian function prepartum and postpartum.
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Affiliation(s)
- Emily S Barrett
- Department of Obstetrics and Gynecology, School of Medicine and Dentistry, University of Rochester, Rochester, New York.
| | - Lauren E Parlett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Gayle C Windham
- Division of Environmental and Occupational Disease Control, California Department of Public Health, Richmond, California
| | - Shanna H Swan
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
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Schwartz MD, Mong JA. Estradiol modulates recovery of REM sleep in a time-of-day-dependent manner. Am J Physiol Regul Integr Comp Physiol 2013; 305:R271-80. [PMID: 23678032 PMCID: PMC3743004 DOI: 10.1152/ajpregu.00474.2012] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 05/06/2013] [Indexed: 11/22/2022]
Abstract
Ovarian hormones are thought to modulate sleep and fluctuations in the hormonal milieu are coincident with sleep complaints in women. In female rats, estradiol increases waking and suppresses sleep. In this study, we asked whether this effect is mediated via circadian or homeostatic regulatory mechanisms. Ovariectomized female rats received daily injections of estradiol benzoate (EB) or sesame oil that mimicked the rapid increase and subsequent decline of circulating estradiol at proestrus. In one experiment, animals were sleep deprived for 6 h starting at lights-on, so that recovery began in the mid-light phase; in the second experiment, animals were sleep deprived starting in the mid-light phase, so that recovery began at lights-off. EB suppressed baseline rapid eye movement (REM) and non-REM (NREM) sleep and increased waking in the dark phase. In both experiments, EB enhanced REM recovery in the light phase while suppressing it in the dark compared with oil; this effect was most pronounced in the first 6 h of recovery. By contrast, NREM recovery was largely unaffected by EB. In summary, EB enhanced waking and suppressed sleep, particularly REM sleep, in the dark under baseline and recovery conditions. These strong temporally dependent effects suggest that EB consolidates circadian sleep-wake rhythms in female rats.
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Affiliation(s)
- Michael D Schwartz
- Center for Neuroscience, Biosciences Division, SRI international, 333 Ravenswood Ave., Menlo Park, CA 94025, USA.
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Xu X, Veenstra TD. Concentration of endogenous estrogens and estrogen metabolites in the NCI-60 human tumor cell lines. Genome Med 2012; 4:31. [PMID: 22546321 PMCID: PMC3446259 DOI: 10.1186/gm330] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 04/04/2012] [Accepted: 04/30/2012] [Indexed: 12/21/2022] Open
Abstract
Background Endogenous estrogens and estrogen metabolites play an important role in the pathogenesis and development of human breast, endometrial, and ovarian cancers. Increasing evidence also supports their involvement in the development of certain lung, colon and prostate cancers. Methods In this study we systemically surveyed endogenous estrogen and estrogen metabolite levels in each of the NCI-60 human tumor cell lines, which include human breast, central nerve system, colon, ovarian, prostate, kidney and non-small cell lung cancers, as well as melanomas and leukemia. The absolute abundances of these metabolites were measured using a liquid chromatography-tandem mass spectrometry method that has been previously utilized for biological fluids such as serum and urine. Results Endogenous estrogens and estrogen metabolites were found in all NCI-60 human tumor cell lines and some were substantially elevated and exceeded the levels found in well known estrogen-dependent and estrogen receptor-positive tumor cells such as MCF-7 and T-47D. While estrogens were expected to be present at high levels in cell lines representing the female reproductive system (that is, breast and ovarian), other cell lines, such as leukemia and colon, also contained very high levels of these steroid hormones. The leukemia cell line RMPI-8226 contained the highest levels of estrone (182.06 pg/106 cells) and 17β-estradiol (753.45 pg/106 cells). In comparison, the ovarian cancer cell line with the highest levels of these estrogens contained only 19.79 and 139.32 pg/106 cells of estrone and 17β-estradiol, respectively. The highest levels of estrone and 17β-estradiol in breast cancer cell lines were only 8.45 and 87.37 pg/106 cells in BT-549 and T-47D cells, respectively. Conclusions The data provided evidence for the presence of significant amounts of endogenous estrogens and estrogen metabolites in cell lines not commonly associated with these steroid hormones. This broad discovery of endogenous estrogens and estrogen metabolites in these cell lines suggest that several human tumors may be beneficially treated using endocrine therapy aimed at estrogen biosynthesis and estrogen-related signaling pathways.
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Affiliation(s)
- Xia Xu
- Laboratory of Proteomics and Analytical Technologies, SAIC-Frederick, Inc,, National Cancer Institute at Frederick, Frederick, MD 21702, USA.
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