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Maki PM, Panay N, Simon JA. Sleep disturbance associated with the menopause. Menopause 2024; 31:724-733. [PMID: 38916279 DOI: 10.1097/gme.0000000000002386] [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: 06/26/2024]
Abstract
IMPORTANCE AND OBJECTIVES Sleep disturbance is one of the most common and debilitating symptoms experienced by women during the menopause transition. However, there are currently no therapies specifically approved for sleep disturbance associated with the menopause. Here, we consider how to characterize sleep disturbance associated with the menopause and discuss its etiology, including the latest advances in our understanding of the neuronal circuits that regulate reproduction, body temperature, sleep, and mood; and reflect on its impact on women's health and well-being. We also examine the current treatment landscape and look to the future of treatment for this condition. METHODS We conducted a review of the literature and combined this with discussion with experts in the fields of sleep and menopause as well as experiences from our own clinical practices. DISCUSSION AND CONCLUSIONS Sleep disturbance associated with the menopause is characterized by frequent night-time awakenings and increased awake time after sleep onset. Its impacts are wide-ranging, negatively affecting health as well as personal and social relationships, productivity, and work performance. There is currently an unmet need for effective, safe, and well-tolerated treatments to address this important symptom, and wider recognition of the association between sleep disturbances and the menopause is needed. Sleep disturbances associated with the menopause can result from hormone changes as well as vasomotor and mood symptoms. Growing research has contributed to our knowledge of the role of hypothalamic estrogen-sensitive kisspeptin/neurokinin B/dynorphin neurons. These neurons are thought to integrate the gonadotropin-releasing hormone pathway and the pathways responsible for the homeostatic control of body temperature and the circadian regulation of sleep-wake cycles. Understanding these neurons offers the potential to create treatments that target a key cause of sleep disturbance associated with the menopause. Further research to understand their etiology and characterize the neuronal circuits responsible could benefit the development of these targeted treatment approaches.
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Affiliation(s)
| | - Nick Panay
- Queen Charlotte's & Chelsea Hospital, Imperial College London, United Kingdom
| | - James A Simon
- George Washington University, IntimMedicine Specialists, Washington, DC
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2
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Liu Y, Barnet JH, Hagen EW, Peppard PE, Mignot E, Reither EN. Objectively measured daytime sleepiness predicts weight change among adults: Findings from the Wisconsin Sleep Cohort Study. Sleep Health 2024; 10:327-334. [PMID: 38688810 DOI: 10.1016/j.sleh.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE Body mass index (BMI) trajectories are associated with night-time sleep, but it is not clear how they relate to daytime sleepiness in population data. This study aimed to examine longitudinal associations between levels and changes in daytime sleepiness and BMI trajectories among men and women. METHODS We estimated growth curve models among 827 participants in the Wisconsin Sleep Cohort Study (mean [sd] age = 55.2 [8.0] years at baseline). The outcome variable was BMI (kg/m2) and the key predictor was daytime sleepiness measured by Multiple Sleep Latency Test (MSLT) scores. Covariates included demographics, health behaviors, retirement status, stimulant use, and depressive symptoms. In sensitivity analyses, we evaluated the potential effects of cardiovascular disease, shift work status, and sleep apnea on the robustness of sleepiness and BMI associations. RESULTS At the between-person level, men who were sleepier had higher BMI levels. At the within-person level, age moderated the positive association between sleepiness and BMI among women. Specifically, young women who became sleepier over time gained more BMI than older women with comparable increases in sleepiness. Furthermore, while BMI tended to increase with age among women, BMI trajectories were steeper among sleepy women than among well-rested women, who experienced less increase in BMI over time. CONCLUSION The study suggested that levels and changes in daytime sleepiness as objectively measured by MSLT scores are associated with body mass among adults.
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Affiliation(s)
- Yin Liu
- Department of Human Development and Family Studies, Utah State University, Logan, Utah, USA
| | - Jodi H Barnet
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Erika W Hagen
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Paul E Peppard
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Emmanuel Mignot
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Eric N Reither
- Department of Sociology and Anthropology, Utah State University, Logan, Utah, USA.
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3
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Carmona NE, Starick E, Millett GE, Green SM, Carney CE. Sleep effects of psychological therapies for menopausal symptoms in women with hot flashes and night sweats: A systematic review. Post Reprod Health 2024:20533691241246365. [PMID: 38804110 DOI: 10.1177/20533691241246365] [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: 05/29/2024]
Abstract
Sleep disturbance is frequently reported by women during the menopausal transition due to various physiological changes and environmental factors. Insomnia is a critical treatment target for its deleterious effects on daytime functioning and quality of life and increased risk of developing a depressive disorder. Due to medication side effects and patient preferences, there is increased interest in the use of psychological treatments that address the myriad of menopausal symptoms, including cognitive-behavioural therapy, clinical hypnosis and mindfulness-based therapies. The objective of this article is to review the effects of psychological treatments for menopausal symptoms on sleep disturbance in peri-/postmenopausal women. We conducted a systematic review of the literature using PubMed and reference lists from inception until May 2023, including 12 studies that evaluated sleep as a secondary outcome. Most studies found that group and self-help (guided and unguided) cognitive-behavioural therapies and clinical hypnosis for menopausal symptoms have positive effects on sleep among women with significant vasomotor symptoms. There was preliminary support for mindfulness-based stress reduction. Future research including more diverse samples and women with sleep disorders is needed. Evaluating the implementation of psychological therapies in clinics where menopausal women seek care is an important next step.
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Affiliation(s)
- Nicole E Carmona
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Elisha Starick
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Geneva E Millett
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Sheryl M Green
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Colleen E Carney
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
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4
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Yalcinkaya Ö, Gozuyesil E. The effect of therapeutic touch on sleep quality and fatigue in menopausal women. Explore (NY) 2024; 20:222-230. [PMID: 37640590 DOI: 10.1016/j.explore.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND AND AIMS The management of well-known and common complaints such as insomnia and fatigue experienced in the menopausal period has the potential to affect many aspects of life in women during this period positively. This research was carried out to determine the effect of therapeutic touch on sleep quality and fatigue in menopausal women. METHODS This randomized controlled experimental study was conducted with 48 (24 in the intervention group and 24 in the control group) women who sought treatment in the gynecological outpatient clinic of a public hospital. According to the study procedure, while the intervention group received therapeutic touch, the control group received SHAM therapeutic touch for 10 min a day for five consecutive days. Data were collected through the Personal Information Form, the Pittsburgh Sleep Quality Index, and the Piper Fatigue Scale. RESULTS The median post-test total sleep quality score was significantly lower in the intervention group than in the control group (p=0.010). However, the mean total fatigue scores did not differ significantly between the groups (p=0.917). CONCLUSIONS The results of this study showed that therapeutic touch was effective in improving sleep quality, but it did not affect fatigue in menopausal women.
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Affiliation(s)
- Özlem Yalcinkaya
- Turkey Republic Ministry of Health Tepecik Training and Research Hospital, Gaziler Cd, No:468, Yenişehir, Konak, İzmir 35020, Turkey
| | - Ebru Gozuyesil
- Midwifery Department, Faculty of Health Sciences, Çukurova University, Adana 01330, Turkey.
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Lankila H, Kuutti MA, Kekäläinen T, Hietavala EM, Laakkonen EK. Associations of menopausal status and eating behaviour with subjective measures of sleep. J Sleep Res 2024:e14155. [PMID: 38327126 DOI: 10.1111/jsr.14155] [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: 06/07/2023] [Revised: 12/08/2023] [Accepted: 01/13/2024] [Indexed: 02/09/2024]
Abstract
Eating and sleeping behaviour are known to interact with each other, yet research is limited in the context of menopausal women. The aim of this study was to examine whether menopausal status is associated with perceived problems in sleeping. Furthermore, we studied different aspects of eating behaviour as potential risk factors for poor sleep in menopausal women. The present study is exploratory in nature, thus the results should be interpreted as hypothesis-generating. We analysed the sleeping and eating behaviour of 1098 women aged 47-55 years and represented different menopausal statuses with regression analyses. Over 20% of them reported fairly poor or poor perceived sleep quality. A higher number of postmenopausal women reported experiencing at least fairly poor sleep quality compared with the other menopausal groups. However, in regression models controlled for several confounding factors menopausal status was not associated with measures of sleep. Women who reported more snacking-type eating behaviour were more likely to report shorter sleep duration, and more daytime tiredness. Externally cued eating was associated with shorter sleep duration and emotional eating was associated with experiencing daytime tiredness. However, after adjusting for multiple testing, it appears that eating behaviour is associated only with daytime tiredness. Menopausal women with sleeping problems may benefit from nutritional interventions targeting eating behaviour.
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Affiliation(s)
- Hannamari Lankila
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Mari A Kuutti
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Tiia Kekäläinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Enni-Maria Hietavala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eija K Laakkonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
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Zolfaghari S, Keil A, Pelletier A, Postuma RB. Sleep disorders and mortality: A prospective study in the Canadian longitudinal study on aging. Sleep Med 2024; 114:128-136. [PMID: 38183803 DOI: 10.1016/j.sleep.2023.12.023] [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: 10/11/2023] [Revised: 12/11/2023] [Accepted: 12/25/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND AND OBJECTIVES Sleep disorders are commonly linked to various health conditions, although it remains unclear to what degree they are linked with overall mortality. We compared mortality in different self-reported sleep disorders in a large population-based prospective study. METHODS In this case-control study within the CLSA cohort, participants completed a questionnaire at baseline (2011-2015) measuring overall sleep satisfaction, daily sleep duration, sleep-onset and sleep-maintenance insomnia, daytime somnolence, REM sleep behavior disorder (RBD), restless leg syndrome (RLS), and obstructive sleep apnea (OSA). The vital status of participants was assessed in July 2019. Baseline sleep problems of participants who died (cases) were compared to those who survived (controls). For each case, five age/sex-matched controls were selected. Binary logistic regression was used to estimate the association between sleep symptoms and mortality, adjusting for age, sex, marital status, province, education, alcohol consumption, smoking, caffeine, and body mass index. In a complementary model, anxiety and depression were also added. RESULTS Among 30,097 participants at baseline, 974 deaths were reported in 2019 (60.7 % male, age = 72.3 ± 9.4 years). In the initial analysis, mortality cases reported more baseline sleep-maintenance insomnia (12.1 % vs. 8.0 %, Adjusted OR[95%CI] = 1.62[1.15,2.29]), daytime somnolence (2.4 % vs. 1.1 %, AOR = 2.70[1.34,5.44]), and higher possible RLS (16.4 % vs. 12.4 %, AOR = 1.50[1.09,2.05]). They were also more likely to screen positive for possible OSA (33.8 % vs. 24.2 %, AOR = 1.32[1.07,1.64]); however, this effect was not related to core apnea symptoms. Sleep durations exceeding 10 h/day were also associated with increased mortality (3.4 % vs. 1.9 %, AOR = 1.83[1.04,3.24]). Other sleep symptoms/disorders, such as sleep-onset insomnia (7.3 % vs. 4.3 %, AOR = 1.54 [1.00,2.37]), possible RBD (5.3 % vs. 5.1 %, AOR = 1.02[0.62,1.69]), and overall sleep dissatisfaction (26.5 % vs. 22.6 %, AOR = 1.14[0.93,1.41]) were not different among these groups. After adding anxiety and depression to the adjustment model, all differences attenuated to become statistically non-significant, except for daytime somnolence disorder. When stratified by sex, the association between sleep disorders and mortality was only observed in women, with men showing no association. DISCUSSION We confirm a relationship between numerous sleep disorders and mortality. This effect is most evident in women, and appears to be strongly related to co-existing anxiety and depression.
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Affiliation(s)
- Sheida Zolfaghari
- Integrated Program in Neuroscience, McGill University, Montreal, Canada; Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Allison Keil
- Integrated Program in Neuroscience, McGill University, Montreal, Canada; Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Amélie Pelletier
- Research Institute of the McGill University Health Centre, Montreal, Canada; Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Canada
| | - Ronald B Postuma
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Canada; Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
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Akhmedova AA, Gorobets LN. [Features of the clinical picture of affective disorders in women during the menopausal transition and early postmenopause]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:75-79. [PMID: 38676681 DOI: 10.17116/jnevro202412404175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
OBJECTIVE To determine the clinical and psychopathological features of affective disorders in women in the perimenopausal and early postmenopausal periods. MATERIAL AND METHODS The study included 90 female patients receiving inpatient psychiatric care for affective disorders, among them 41 patients were perimenopausal (group 1) and 49 were early postmenopausal (group 2). Clinical and psychopathological, psychometric (the Hospital Anxiety and Depression Scale - HADS, the Hamilton Depression and Anxiety Scales - HAM-D and HAM-A, the Hypomania Checklist-32 - HCL-32, the Bipolarity Index (BI), the Insomnia Severity Index - ISI, the Pittsburgh Sleep Quality Index - PSQI) and statistical methods were used. RESULTS Symptoms of atypical (63.4%) and anxious (87.8%) depression predominated among perimenopausal patients, and melancholic depression (59.2%) prevailed in early postmenopause. Patients in group 1 had higher anxiety scores on HADS and HAM-A compared to group 2 (p=0.003 and p=0.01). At the same time, early postmenopausal women had higher depression scores on the HADS and HAM-D (p=0.001). ISI and PSQI scores in postmenopause were significantly higher than in perimenopause (p=0.001 and p=0.009). CONCLUSION The clinical features of affective disorders as well as severity and nature of the accompanying sleep disturbances vary depending on the stage of menopause, which must be considered when prescribing additional methods for examination and treatment of these disorders.
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Affiliation(s)
- A A Akhmedova
- Moscow Research Institute of Psychiatry - branch of Serbsky National Medical Research Centre for Psychiatry and Narcology, Moscow, Russia
| | - L N Gorobets
- Moscow Research Institute of Psychiatry - branch of Serbsky National Medical Research Centre for Psychiatry and Narcology, Moscow, Russia
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Zuraikat FM, Laferrère B, Cheng B, Scaccia SE, Cui Z, Aggarwal B, Jelic S, St-Onge MP. Chronic Insufficient Sleep in Women Impairs Insulin Sensitivity Independent of Adiposity Changes: Results of a Randomized Trial. Diabetes Care 2024; 47:117-125. [PMID: 37955852 PMCID: PMC10733650 DOI: 10.2337/dc23-1156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE Insufficient sleep is associated with type 2 diabetes, yet the causal impact of chronic insufficient sleep on glucose metabolism in women is unknown. We investigated whether prolonged mild sleep restriction (SR), resembling real-world short sleep, impairs glucose metabolism in women. RESEARCH DESIGN AND METHODS Women (aged 20-75 years) without cardiometabolic diseases and with actigraphy-confirmed habitual total sleep time (TST) of 7-9 h/night were recruited to participate in this randomized, crossover study with two 6-week phases: maintenance of adequate sleep (AS) and 1.5 h/night SR. Outcomes included plasma glucose and insulin levels, HOMA of insulin resistance (HOMA-IR) values based on fasting blood samples, as well as total area under the curve for glucose and insulin, the Matsuda index, and the disposition index from an oral glucose tolerance test. RESULTS Our sample included 38 women (n = 11 postmenopausal women). Values are reported with ±SEM. Linear models adjusted for baseline outcome values demonstrated that TST was reduced by 1.34 ± 0.04 h/night with SR versus AS (P < 0.0001). Fasting insulin (β = 6.8 ± 2.8 pmol/L; P = 0.016) and HOMA-IR (β = 0.30 ± 0.12; P = 0.016) values were increased with SR versus AS, with effects on HOMA-IR more pronounced in postmenopausal women compared with premenopausal women (β = 0.45 ± 0.25 vs. β = 0.27 ± 0.13, respectively; P for interaction = 0.042). Change in adiposity did not mediate the effects of SR on glucose metabolism or change results in the full sample when included as a covariate. CONCLUSIONS Curtailing sleep duration to 6.2 h/night, reflecting the median sleep duration of U.S. adults with short sleep, for 6 weeks impairs insulin sensitivity, independent of adiposity. Findings highlight insufficient sleep as a modifiable risk factor for insulin resistance in women to be targeted in diabetes prevention efforts.
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Affiliation(s)
- Faris M. Zuraikat
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY
- Center of Excellence for Sleep and Circadian Research, Columbia University Irving Medical Center, New York, NY
- New York Nutrition Obesity Research Center, Columbia University Irving Medical Center, New York, NY
| | - Blandine Laferrère
- New York Nutrition Obesity Research Center, Columbia University Irving Medical Center, New York, NY
- Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Bin Cheng
- Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY
| | - Samantha E. Scaccia
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Zuoqiao Cui
- Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY
| | - Brooke Aggarwal
- Center of Excellence for Sleep and Circadian Research, Columbia University Irving Medical Center, New York, NY
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Sanja Jelic
- Center of Excellence for Sleep and Circadian Research, Columbia University Irving Medical Center, New York, NY
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Marie-Pierre St-Onge
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY
- Center of Excellence for Sleep and Circadian Research, Columbia University Irving Medical Center, New York, NY
- New York Nutrition Obesity Research Center, Columbia University Irving Medical Center, New York, NY
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Hachul H, Hachul de Campos B, Lucena L, Tufik S. Sleep During Menopause. Sleep Med Clin 2023; 18:423-433. [PMID: 38501515 DOI: 10.1016/j.jsmc.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Postmenopause is defined retrospectively after 12 consecutive months of amenorrhea. It represents the end of the reproductive period and ovarian failure. A decrease in estrogen leads to several changes in the short and long term. Among the early changes, vasomotor symptoms (hot flashes) are particularly common, occurring in about 70% of women. In addition, there are changes in mood, anxiety, depression, and insomnia. Insomnia occurs in almost 60% of postmenopausal women. Psychosocial aspects may also affect sleep. Proper diagnosis may lead to adequate treatment of sleep disturbances during menopause. Hormonal or other complementary therapies can improve sleep quality.
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Affiliation(s)
- Helena Hachul
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil; Department of Ginecology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
| | | | - Leandro Lucena
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Sergio Tufik
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
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Beura S, Patnaik L, Sahu M. Effectiveness of lifestyle related interventions to improve quality of life among postmenopausal women in selected slums of Bhubaneswar: A community based quasi experimental study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:388. [PMID: 38333177 PMCID: PMC10852166 DOI: 10.4103/jehp.jehp_599_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/19/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Postmenopausal women considered as risk population, due to estrogen deficiency, 80% of women reduce physical and mental well-being in their menopausal years. Menopausal symptoms are not always reasons for any life-intimidating situations, but it disturbs quality of life (QoL) of middle-aged women. MATERIALS AND METHODS This non-randomized control trial was conducted among slum women in the age group of 40 to 60 years who were in their postmenopausal period (within 5 years). Study group was intervened by lifestyle-related interventional module about concept of menopause, symptoms, health issues, dietary habit for reducing menopausal symptoms with a practical demonstration of yoga, exercises and pranayama, group and individual counseling to the participants. Independent t-test, paired t-test, Chi-squared test, and Fisher's exact test were analyzed by SPSS software version 28 licensed to the institute. RESULTS The mean age of the participants was 51.02 ± 2.94 years ranging from 47 to 58 years. As per anthropometric and blood pressure measurements data, significant differences were found in weight (P < 0.02), body mass index (P < 0.001), waist/Hip Ratio (P < 0.001), SBP (P < 0.001) and DBP (P < 0.001) between both the groups. Comparing the mean difference score of vasomotor, psychosocial, physical and sexual domains of the MENQOL questionnaire pre- and post-intervention found that, there was significant reduction of QoL score in study group. CONCLUSION The lifestyle related interventions as an alternative therapy are safe, free from side effects, cost-effective and government program may be implemented for the betterment of the menopausal women.
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Affiliation(s)
- Saswatika Beura
- Department of Community Medicine, IMS and SUM Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Lipilekha Patnaik
- Department of Community Medicine, IMS and SUM Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Manisha Sahu
- Department of Obstetrics and Gynaecology, IMS and SUM Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
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11
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Wu J, Yu Y, Qin K, Ou Z. Mechanisms connecting square dance to sleep quality among middle-aged and older Chinese females: serial mediation roles of social support and depressive symptoms. Front Public Health 2023; 11:1307596. [PMID: 38074751 PMCID: PMC10701395 DOI: 10.3389/fpubh.2023.1307596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Background Square dance is gaining increasing popularity among middle-aged and older Chinese women who are also at high risk of sleep disturbance. Although previous studies have shown exercise could improve sleep quality, the association between square dance and sleep quality remains to be discussed, and even less is known about the potential mechanism underlying this association. Purpose This study aims to investigate the relationship between square dance and sleep quality and test if social support and depressive symptoms together play a serial mediating role in the influence of square dance on sleep quality. Methods A cross-sectional study was conducted among 549 middle-aged and older Chinese females from September to December 2020 in Shao Yang City, Hunan Province of China, with ethics approval granted (SYU [2020]002). Square dance involvement was assessed by three questions about the time participants spent in square dance. Social support, depressive symptoms, and sleep quality were measured using the Pittsburgh Sleep Quality Index (PSQI), Social Support Self-Rating Scale (SSRS), and 9-item Patient Health Questionnaire (PHQ-9), respectively. The serial mediation model was analyzed by the bootstrapping method to assess whether social support and depressive symptoms mediate the relationship between square dance and sleep quality. Results Two-thirds of the participants had high involvement in square dance and most reported a moderate and high level of social support (98.54%). The prevalence of depressive symptoms and sleep disturbance was 19.49 and 26.78%, respectively. The serial mediation model showed a significant association between square dance and sleep quality, which was fully mediated by social support and depressive symptoms in a serial model (total effect c = -0.114, 95%CI = -0.227 to -0.001; direct effect c' = -0.036, 95% CI = -0.138 to 0.065; total indirect effect ab = -0.077, 95% CI = -0.139 to-0.016). Conclusion Our study extends the understanding of how square dance is associated with sleep quality through the serial mediating roles of social support and depressive symptoms. It provides crucial implications for developing square dance interventions to improve sleep quality among middle-aged and older Chinese females.
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Affiliation(s)
- Jun Wu
- School of Music and Dance, Shaoyang University, Shaoyang, Hunan, China
| | - Yong Yu
- School of Politics and Public Administration, Guangxi Normal University, Guilin, Guangxi, China
| | - Keke Qin
- School of Politics and Public Administration, Guangxi Normal University, Guilin, Guangxi, China
| | - Zhiwen Ou
- School of Marxism, Shaoyang University, Shaoyang, Hunan, China
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12
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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 D, Lee S, Jang M, Kim K. Effect of Household Type on the Prevalence of Climacteric Syndrome among Middle-Aged Men. Healthcare (Basel) 2023; 11:2684. [PMID: 37830721 PMCID: PMC10572107 DOI: 10.3390/healthcare11192684] [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: 09/06/2023] [Revised: 09/30/2023] [Accepted: 10/03/2023] [Indexed: 10/14/2023] Open
Abstract
Research on climacteric syndrome among middle-aged men remains scant compared to the research among women. Research is also lacking on climacteric syndrome among older adults living alone, particularly men, who are more vulnerable than females living alone. This cross-sectional study investigated whether the prevalence of climacteric syndrome is associated with the type of household middle-aged men live in and identified the determinants of climacteric syndrome based on the household type. Six hundred middle-aged men living in multi-person households and six hundred living alone were surveyed about general characteristics, diet-related factors, and climacteric syndrome. Data were analyzed using Pearson's chi-squared test, Fisher's exact test, and logistic regression. The risk of climacteric syndrome in single-person households was found to be 1.6 times higher than that among multi-person households (p = 0.006). In multi-person households, income and breakfast frequency predicted climacteric syndrome (p < 0.05), while age, breakfast frequency, dinner frequency, and weekly eating out frequency predicted climacteric syndrome in single-person households (p < 0.05). Thus, dietary factors are more closely linked to the prevalence of climacteric syndrome in single-person households than in multi-person households. This highlights the need for climacteric syndrome interventions for middle-aged men, whose health concerns may persist into older adulthood.
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Affiliation(s)
- Dohhee Kim
- Department of Research Institute, Seoul Medical Center, Seoul 02053, Republic of Korea; (D.K.); (S.L.); (M.J.)
| | - Seunghee Lee
- Department of Research Institute, Seoul Medical Center, Seoul 02053, Republic of Korea; (D.K.); (S.L.); (M.J.)
| | - Mijung Jang
- Department of Research Institute, Seoul Medical Center, Seoul 02053, Republic of Korea; (D.K.); (S.L.); (M.J.)
| | - KyooSang Kim
- Department of Research Institute, Seoul Medical Center, Seoul 02053, Republic of Korea; (D.K.); (S.L.); (M.J.)
- Department of Occupational Environmental Medicine, Seoul Medical Center, Seoul 02053, Republic of Korea
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14
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Gervais NJ, Gravelsins L, Brown A, Reuben R, Perovic M, Karkaby L, Nicoll G, Laird K, Ramana S, Bernardini MQ, Jacobson M, Velsher L, Foulkes W, Rajah MN, Olsen RK, Grady C, Einstein G. Disturbed sleep is associated with reduced verbal episodic memory and entorhinal cortex volume in younger middle-aged women with risk-reducing early ovarian removal. Front Endocrinol (Lausanne) 2023; 14:1265470. [PMID: 37859979 PMCID: PMC10584319 DOI: 10.3389/fendo.2023.1265470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 09/05/2023] [Indexed: 10/21/2023] Open
Abstract
Introduction Women with early ovarian removal (<48 years) have an elevated risk for both late-life Alzheimer's disease (AD) and insomnia, a modifiable risk factor. In early midlife, they also show reduced verbal episodic memory and hippocampal volume. Whether these reductions correlate with a sleep phenotype consistent with insomnia risk remains unexplored. Methods We recruited thirty-one younger middleaged women with risk-reducing early bilateral salpingo-oophorectomy (BSO), fifteen of whom were taking estradiol-based hormone replacement therapy (BSO+ERT) and sixteen who were not (BSO). Fourteen age-matched premenopausal (AMC) and seventeen spontaneously peri-postmenopausal (SM) women who were ~10y older and not taking ERT were also enrolled. Overnight polysomnography recordings were collected at participants' home across multiple nights (M=2.38 SEM=0.19), along with subjective sleep quality and hot flash ratings. In addition to group comparisons on sleep measures, associations with verbal episodic memory and medial temporal lobe volume were assessed. Results Increased sleep latency and decreased sleep efficiency were observed on polysomnography recordings of those not taking ERT, consistent with insomnia symptoms. This phenotype was also observed in the older women in SM, implicating ovarian hormone loss. Further, sleep latency was associated with more forgetting on the paragraph recall task, previously shown to be altered in women with early BSO. Both increased sleep latency and reduced sleep efficiency were associated with smaller anterolateral entorhinal cortex volume. Discussion Together, these findings confirm an association between ovarian hormone loss and insomnia symptoms, and importantly, identify an younger onset age in women with early ovarian removal, which may contribute to poorer cognitive and brain outcomes in these women.
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Affiliation(s)
- Nicole J. Gervais
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, Netherlands
| | - Laura Gravelsins
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Alana Brown
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Rebekah Reuben
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Mateja Perovic
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Laurice Karkaby
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Gina Nicoll
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Kazakao Laird
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Shreeyaa Ramana
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Marcus Q. Bernardini
- Cancer Clinical Research Unit, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Michelle Jacobson
- Cancer Clinical Research Unit, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Lea Velsher
- Genetics Program, North York General Hospital, Toronto, ON, Canada
| | - William Foulkes
- Department of Human Genetics, McGill University, Montreal, QC, Canada
- Lady Davis Institute, Segal Cancer Centre, Jewish General Hospital, Montreal, QC, Canada
| | - M. Natasha Rajah
- Departments of Psychiatry and Douglas Research Centre, McGill University, Montreal, QC, Canada
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Rosanna K. Olsen
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Cheryl Grady
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Gillian Einstein
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Tema Genus, Linköping University, Linköping, Sweden
- Women’s College Research Institute, Toronto, ON, Canada
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15
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Iqbal AZ, Wu SK, Zailani H, Chiu WC, Liu WC, Su KP, Lee SD. Effects of Omega-3 Polyunsaturated Fatty Acids Intake on Vasomotor Symptoms, Sleep Quality and Depression in Postmenopausal Women: A Systematic Review. Nutrients 2023; 15:4231. [PMID: 37836515 PMCID: PMC10574492 DOI: 10.3390/nu15194231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/28/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
The menopausal transition is often accompanied with distressing manifestations, such as vasomotor symptoms, sleep disruptions, and depressive syndrome. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) have emerged as a potential intervention to alleviate these symptoms. This review aimed to comprehensively assess the impact of n-3 PUFAs supplementation on vasomotor symptoms, sleep quality, and depression among postmenopausal women. We conducted a systematic literature search of randomized controlled trials across the Cochrane Library, Web of Science, PubMed, CINAHL, EMBASE, and SCOPUS databases from inception to August 2023. Among the initial pool of 163 identified studies, nine studies met the inclusion criteria and were incorporated into this systematic review. Notably, four studies detected potential benefits of n-3 PUFAs in improving hot flashes and night sweats. On the contrary, sleep quality outcomes displayed heterogeneity across the studies. Incorporating diverse scales, such as the Hamilton Depression Rating Scale-21, the Patient Health Questionnaire depression scale, and Generalized Anxiety Disorder-7 for depression outcomes, we found inconclusive evidence of n-3 PUFA's impact on depression. Overall, the combined analysis of these studies did not provide substantial evidence to support the efficacy of n-3 PUFAs in improving vasomotor symptoms, sleep quality, and depression. Further well-designed randomized clinical trials with larger participant groups are crucial to validate and generalize these results. Review Registration: PROSPERO registration no: CRD42023421922.
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Affiliation(s)
- Ayesha Zafar Iqbal
- Graduate Institute of Nutrition, China Medical University, Taichung 404, Taiwan; (A.Z.I.); (S.-K.W.); (H.Z.)
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan
| | - Suet-Kei Wu
- Graduate Institute of Nutrition, China Medical University, Taichung 404, Taiwan; (A.Z.I.); (S.-K.W.); (H.Z.)
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan
| | - Halliru Zailani
- Graduate Institute of Nutrition, China Medical University, Taichung 404, Taiwan; (A.Z.I.); (S.-K.W.); (H.Z.)
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan
| | - Wei-Che Chiu
- Department of Psychiatry, Cathay General Hospital, Taipei 106, Taiwan;
- School of Medicine, Fu Jen Catholic University, Taipei 242, Taiwan
| | - Wen-Chun Liu
- An-Nan Hospital, China Medical University, Tainan 709, Taiwan;
| | - Kuan-Pin Su
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan
- An-Nan Hospital, China Medical University, Tainan 709, Taiwan;
- College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Shin-Da Lee
- Ph.D. Program in Healthcare Science, Department of Physical Therapy, China Medical University, Taichung 404, Taiwan
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Kyle Martin W, Schladweiler MC, Oshiro W, Smoot J, Fisher A, Williams W, Valdez M, Miller CN, Jackson TW, Freeborn D, Kim YH, Davies D, Ian Gilmour M, Kodavanti U, Kodavanti P, Hazari MS, Farraj AK. Wildfire-related smoke inhalation worsens cardiovascular risk in sleep disrupted rats. FRONTIERS IN ENVIRONMENTAL HEALTH 2023; 2:1166918. [PMID: 38116203 PMCID: PMC10726696 DOI: 10.3389/fenvh.2023.1166918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Introduction As a lifestyle factor, poor sleep status is associated with increased cardiovascular morbidity and mortality and may be influenced by environmental stressors, including air pollution. Methods To determine whether exposure to air pollution modified cardiovascular effects of sleep disruption, we evaluated the effects of single or repeated (twice/wk for 4 wks) inhalation exposure to eucalyptus wood smoke (ES; 964 μg/m3 for 1 h), a key wildland fire air pollution source, on mild sleep loss in the form of gentle handling in rats. Blood pressure (BP) radiotelemetry and echocardiography were evaluated along with assessments of lung and systemic inflammation, cardiac and hypothalamic gene expression, and heart rate variability (HRV), a measure of cardiac autonomic tone. Results and Discussion GH alone disrupted sleep, as evidenced by active period-like locomotor activity, and increases in BP, heart rate (HR), and hypothalamic expression of the circadian gene Per2. A single bout of sleep disruption and ES, but neither alone, increased HR and BP as rats transitioned into their active period, a period aligned with a critical early morning window for stroke risk in humans. These responses were immediately preceded by reduced HRV, indicating increased cardiac sympathetic tone. In addition, only sleep disrupted rats exposed to ES had increased HR and BP during the final sleep disruption period. These rats also had increased cardiac output and cardiac expression of genes related to adrenergic function, and regulation of vasoconstriction and systemic blood pressure one day after final ES exposure. There was little evidence of lung or systemic inflammation, except for increases in serum LDL cholesterol and alanine aminotransferase. These results suggest that inhaled air pollution increases sleep perturbation-related cardiovascular risk, potentially in part by increased sympathetic activity.
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Affiliation(s)
- W. Kyle Martin
- Curriculum in Toxicology and Environmental Medicine, UNC, Chapel Hill, NC, United States
| | - M. C. Schladweiler
- Public Health & Integrated Toxicology Division, US EPA, Research Triangle Park, NC, United States
| | - W. Oshiro
- Public Health & Integrated Toxicology Division, US EPA, Research Triangle Park, NC, United States
| | - J. Smoot
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States
| | - A. Fisher
- Public Health & Integrated Toxicology Division, US EPA, Research Triangle Park, NC, United States
| | - W. Williams
- Public Health & Integrated Toxicology Division, US EPA, Research Triangle Park, NC, United States
| | - M. Valdez
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States
| | - C. N. Miller
- Public Health & Integrated Toxicology Division, US EPA, Research Triangle Park, NC, United States
| | - T. W. Jackson
- Public Health & Integrated Toxicology Division, US EPA, Research Triangle Park, NC, United States
| | - D. Freeborn
- Public Health & Integrated Toxicology Division, US EPA, Research Triangle Park, NC, United States
| | - Y. H. Kim
- Public Health & Integrated Toxicology Division, US EPA, Research Triangle Park, NC, United States
| | - D. Davies
- Public Health & Integrated Toxicology Division, US EPA, Research Triangle Park, NC, United States
| | - M. Ian Gilmour
- Public Health & Integrated Toxicology Division, US EPA, Research Triangle Park, NC, United States
| | - U. Kodavanti
- Public Health & Integrated Toxicology Division, US EPA, Research Triangle Park, NC, United States
| | - P. Kodavanti
- Public Health & Integrated Toxicology Division, US EPA, Research Triangle Park, NC, United States
| | - M. S. Hazari
- Public Health & Integrated Toxicology Division, US EPA, Research Triangle Park, NC, United States
| | - A. K. Farraj
- Public Health & Integrated Toxicology Division, US EPA, Research Triangle Park, NC, United States
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Krüger M, Obst A, Ittermann T, Bernhardt O, Ivanovska T, Zygmunt M, Ewert R, Fietze I, Penzel T, Biffar R, Daboul A. Menopause Is Associated with Obstructive Sleep Apnea in a Population-Based Sample from Mecklenburg–Western Pomerania, Germany. J Clin Med 2023; 12:jcm12062101. [PMID: 36983104 PMCID: PMC10052671 DOI: 10.3390/jcm12062101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/10/2023] [Accepted: 02/28/2023] [Indexed: 03/10/2023] Open
Abstract
Objective: Menopause is associated with multiple health risks. In several studies, a higher incidence or a higher risk for obstructive sleep apnea (OSA) in post-menopausal than pre-menopausal women is reported. This study was designed to verify such a connection between menopause and OSA in a population-based sample. Methods: For a subsample (N = 1209) of the Study of Health in Pomerania (N = 4420), complete polysomnography data was available. Of these, 559 females completed a structured interview about their menstrual cycle. Splines and ordinal regression analysis were used to analyze the resulting data. Results: In the ordinal regression analysis, a significant association between the apnea–hypopnea index (AHI) and menopause indicated that post-menopausal women had a substantially higher risk of OSA. In accordance with previous studies, risk indicators such as body mass index (BMI), age, and the influence of hysterectomies or total oophorectomies were included in the model. Conclusions: Our results clearly confirmed the assumed connection between menopause and OSA. This is important because OSA is most often associated with male patients, and it warrants further research into the underlying mechanisms.
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Affiliation(s)
- Markus Krüger
- Poliklinik für Zahnärztliche Prothetik, Alterszahnmedizin und Medizinische Werkstoffkunde, Universitätsmedizin Greifswald, 17475 Greifswald, Germany
- Correspondence:
| | - Anne Obst
- Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, 17475 Greifswald, Germany
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Olaf Bernhardt
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pediatric Dentistry, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Tatyana Ivanovska
- Fakultät für Elektrotechnik, Medien und Informatik, Ostbayerische Technische Hochschule Amberg-Weiden, 92224 Amberg, Germany
| | - Marek Zygmunt
- Department of Obstetrics and Gynecology, University of Greifswald, 17489 Greifswald, Germany
| | - Ralf Ewert
- Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, 17475 Greifswald, Germany
| | - Ingo Fietze
- Interdisziplinäres Schlafmedizinisches Zentrum, Charité–Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Thomas Penzel
- Interdisziplinäres Schlafmedizinisches Zentrum, Charité–Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Reiner Biffar
- Poliklinik für Zahnärztliche Prothetik, Alterszahnmedizin und Medizinische Werkstoffkunde, Universitätsmedizin Greifswald, 17475 Greifswald, Germany
| | - Amro Daboul
- Poliklinik für Zahnärztliche Prothetik, Alterszahnmedizin und Medizinische Werkstoffkunde, Universitätsmedizin Greifswald, 17475 Greifswald, Germany
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18
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Pérez-Medina-Carballo R, Kosmadopoulos A, Boudreau P, Robert M, Walker CD, Boivin DB. The circadian variation of sleep and alertness of postmenopausal women. Sleep 2023; 46:zsac272. [PMID: 36420995 PMCID: PMC9905778 DOI: 10.1093/sleep/zsac272] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 10/06/2022] [Indexed: 11/27/2022] Open
Abstract
STUDY OBJECTIVES Several factors may contribute to the high prevalence of sleep disturbances occurring in postmenopausal women. However, the contribution of the circadian timing system to their sleep disturbances remains unclear. In the present study, we aim to understand the impact of circadian factors on changes of sleep and alertness occurring after menopause. METHODS Eight healthy postmenopausal women and 12 healthy young women in their mid-follicular phase participated in an ultradian sleep-wake cycle procedure (USW). This protocol consisted of alternating 60-min wake periods and nap opportunities for ≥ 48 h in controlled laboratory conditions. Core body temperature (CBT), salivary melatonin, self-reported alertness, and polysomnographically recorded sleep were measured across this procedure. RESULTS In both groups, all measures displayed a circadian variation throughout the USW procedure. Compared to young women, postmenopausal women presented lower CBT values, more stage N1 and N2 sleep, and number of arousals. They also showed a reduced amplitude of the circadian variation of melatonin, total sleep time (TST), sleep onset latency (SOL), stage N3 sleep, and alertness levels. Postmenopausal women fell asleep faster and slept more during the biological day and presented higher alertness levels during the biological night than young women. CONCLUSION These results support the hypothesis of a weakened circadian signal promoting sleep and wakefulness in older women. Aging processes including hormonal changes may be main contributors to the increased sleep-wake disturbances after menopause.
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Affiliation(s)
- Rafael Pérez-Medina-Carballo
- Integrated program in Neuroscience, McGill University, Montreal, Quebec H3A 1A1, Canada
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada
| | - Anastasi Kosmadopoulos
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada
- Appleton Institute for Behavioural Sciences, Central Queensland University, Adelaide, South Australia 5034, Australia
| | - Philippe Boudreau
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada
| | - Manon Robert
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Université de Montréal, Montreal, Quebec H2X 0A9, Canada
| | - Claire-Dominique Walker
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada
| | - Diane B Boivin
- Integrated program in Neuroscience, McGill University, Montreal, Quebec H3A 1A1, Canada
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec H4H 1R3, Canada
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Broström A, Alimoradi Z, Lind J, Ulander M, Lundin F, Pakpour A. Worldwide estimation of restless legs syndrome: a systematic review and meta-analysis of prevalence in the general adult population. J Sleep Res 2023; 32:e13783. [PMID: 36600470 DOI: 10.1111/jsr.13783] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/24/2022] [Accepted: 10/24/2022] [Indexed: 01/06/2023]
Abstract
This systematic review, meta-analysis and meta-regression assessed the prevalence of restless legs syndrome (RLS) in the general adult population. Studies identified in Scopus, PubMed, Web of Science, and PsycInfo between January 2000 and February 2022 were included if they used a case-control or cross-sectional design and reported data regarding the prevalence of RLS. The protocol was pre-registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022300709). A total of 97 studies including 483,079 participants from 33 different countries met the eligibility criteria. The Newcastle Ottawa Scale was used to evaluate the methodological quality, and the fill-and-trim method was used to correct probable publication bias, while the jack-knife method was performed to assess small study effect. The corrected overall pooled prevalence of RLS was 3% (95% confidence interval [CI] 1.4%-3.8%). The pooled prevalence of RLS syndrome was affected by methodological quality (no data from non-respondents in the included studies), gender (higher among women), study design (lower prevalence in case-control versus cohort and cross-sectional studies). The figures for corrected pooled prevalence among men, women, alcohol consumers and smokers were 2.8% (95% CI 2%-3.7%); 4.7% (95% CI 3.2%-6.3%); 1.4% (95% CI 0%-4.2%); and 2.7% (95% CI 0%-5.3%), respectively. The prevalence among male and female participants was lower in community-based versus non-community-based studies. Moreover, the prevalence was higher in developed versus developing countries and among elders versus adults. In conclusion, RLS is a common disorder in the general adult population, with a higher prevalence in women; however, prevalence data are affected by study design and quality.
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Affiliation(s)
- Anders Broström
- School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
| | - Zainab Alimoradi
- Social Determinants of Health Research Centre, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Jonas Lind
- Department of Biomedical and Clinical Sciences, Division of Neurobiology, Linköping University, Linköping, Sweden.,Section of Neurology, Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
| | - Martin Ulander
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Division of Neurobiology, Linköping University, Linköping, Sweden
| | - Fredrik Lundin
- Department of Neurology and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Amir Pakpour
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
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20
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Shabani F, Montazeri M, Abdolalipour S, Mirghafourvand M. The effect of mindfulness training on stress and sleep quality of postmenopausal women: A systematic review and meta-analysis. Post Reprod Health 2022; 28:223-236. [PMID: 36346199 DOI: 10.1177/20533691221140191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Mindfulness is an effective method for empowering women to cope with menopausal changes. This study aimed to determine the effect of mindfulness training on stress and sleep quality in postmenopausal women. MATERIALS AND METHODS English (PubMed, Cochrane Library, Google Scholar, Scopus, Web of Science, and CINHAL) and Persian (SID, Magiran) databases were searched until 25 June 2022, using the free and MeSH keywords included Mindfulness and Menopause. The quality of the published papers was evaluated using Cochrane Handbook for Systematic Reviews of Interventions version 5.2.0. The meta-analysis was conducted in RevMan 5.3 and the results were reported with mean difference (95% confidence interval). The quality of evidence was assessed using the GRADE approach. RESULTS A total of 1206 records were obtained. After removing duplicate and non-eligible records, finally five articles were included in the systematic review and meta-analysis. The results indicated that sleep quality score (SMD = -1.44; 95% CI = -2.44 to -0.46; p = 0.004) and perceived stress score (MD = -4.21; 95% CI = -6.41 to -2.00; p = 0.0002) were significantly reduced in the mindfulness training group compared to control group. CONCLUSION Mindfulness training is associated with improving sleep quality and perceived stress (with a low quality of evidence) in postmenopausal women. Mental health and quality of life in postmenopausal women impressively affect the community health. Given the low quality of evidence of the studies in this field, randomized controlled trials with better methodologies are suggested.
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Affiliation(s)
- Fatemeh Shabani
- Department of Midwifery, Student Research Committee, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Montazeri
- Midwifery Department, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Somayeh Abdolalipour
- Department of Midwifery, Student Research Committee, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Family Health, Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
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Behavioral interventions for improving sleep outcomes in menopausal women: a systematic review and meta-analysis. Menopause 2022; 29:1210-1221. [PMID: 36067398 DOI: 10.1097/gme.0000000000002051] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
IMPORTANCE Perimenopausal and postmenopausal women commonly report sleep disruption and insomnia. Behavioral interventions may be safe alternatives for patients who are unwilling to begin pharmacological treatments because of adverse effects, contraindications, or personal preference. OBJECTIVE The primary objective is to assess the efficacy of behavioral interventions on sleep outcomes among perimenopausal and postmenopausal women, as measured using standardized scales and objective methods (polysomnography, actigraphy). The secondary objective is to evaluate the safety of these methods through occurrence of adverse events. EVIDENCE REVIEW Searches were performed within MEDLINE (OVID interface, 1946 onward), Embase (OVID interface, 1974 onward), Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Web of Science (Core collection) using a search strategy developed in consultation with a health sciences librarian. Title/abstract and full-text screenings were performed in duplicate, and relevant studies were selected based on inclusion and exclusion criteria set to identify randomized controlled trials evaluating the effects of behavioral interventions on sleep quality. Risk of bias assessments were done using the Cochrane Risk of Bias 2 tool, and the Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the certainty of the body of evidence. Data were pooled in a meta-analysis using a random-effects model. FINDINGS Nineteen articles reporting results from 16 randomized controlled trials were included, representing a total of 2,108 perimenopausal and postmenopausal women. Overall, behavioral interventions showed a statistically significant effect on sleep outcomes (standardized mean difference [SMD], -0.62; 95% confidence interval [CI], -0.88 to -0.35; I2 = 93.4%). Subgroup analyses revealed that cognitive behavioral therapy (SMD, -0.40; 95% CI, -0.70 to -0.11; I2 = 72.7%), physical exercise (SMD, -0.57; 95% CI, -0.94 to -0.21; I2 = 94.0%), and mindfulness/relaxation (SMD, -1.28; 95% CI, -2.20 to -0.37; I2 = 96.0%) improved sleep, as measured using both subjective (eg, Pittsburg Sleep Quality Index) and objective measures. Low-intensity (SMD, -0.91; 95% CI, -1.59 to -0.24; I2 = 96.8) and moderate-intensity exercise (SMD, -0.21; 95% CI, -0.34 to -0.08; I2 = 0.0%) also improved sleep outcomes. No serious adverse events were reported. Overall risk of bias ranged from some concern to serious, and the certainty of the body of evidence was assessed to be of very low quality. CONCLUSIONS AND RELEVANCE This meta-analysis provides evidence that behavioral interventions, specifically, cognitive behavioral therapy, physical exercise, and mindfulness/relaxation, are effective treatments for improving sleep outcomes among perimenopausal and postmenopausal women.
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Liu X, Zhang J, Peng S, Pei M, Dai C, Wang T, Zhang P. Mediating effects of sleep duration on the association between natural menopause and stroke risk among Chinese women. Front Neurosci 2022; 16:960497. [PMID: 36033607 PMCID: PMC9403275 DOI: 10.3389/fnins.2022.960497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/27/2022] [Indexed: 11/24/2022] Open
Abstract
Background Sleep disturbance is commonly reported by menopausal women. Stroke risk and poor stroke outcomes in women have usually been attributed to menopause. This study aimed to investigate the mediating effect of sleep duration on relationship between menopause and risk of stroke in natural menopause women. Materials and methods A cross-sectional study was performed, and participants were recruited through a multistage, stratified, probability proportional to size sampling method in this research. The stroke risk was measured using the risk assessment form for high-risk stroke population. The average sleep duration was calculated by adding up night sleep and afternoon nap duration. Multivariate regression analysis was conducted to identify the association between menopause, sleep duration, and stroke risk. The direct and indirect effects of menopause on stroke risk were analyzed by using the sleep duration in a mediation framework. Results Perimenopause, menopause, average sleep duration, and night sleep duration were significantly associated with stroke risk (P < 0.001), after adjusting for covariates. Perimenopause and menopause were significantly related to average sleep duration (P < 0.001) and night sleep duration (P < 0.001). The average sleep duration (ab = 0.016, 95% CI: 0.003, 0.030; ab = −0.048, 95% CI: −0.070, −0.027) partially mediated the relationship between menopause and stroke risk. And night sleep duration (ab = 0.024, 95% CI: 0.009, 0.040; ab = −0.054, 95% CI: −0.077, −0.033) played a major mediating role, in which night sleep duration of ≤5 h mediated the link between both perimenopause (ab = 0.707, 95% CI: 0.392, 1.021) and menopause (ab = −0.787, 95% CI: −1.096, −0.478) and stroke risk; both night sleep duration of >8–9 h (ab = 0.079, 95% CI: 0.010, 0.193) and >9 h (ab = 0.379, 95% CI: 0.086, 0.712) had mediating effects on perimenopause and stroke risk. Conclusion A significant relationship between menopause and stroke risk factors among natural menopausal status was found in this study. The average sleep duration, especially night sleep duration, partially mediated the association between menopause and stroke risk, which is a novel insight to the progression of stroke risk in Women. Suitable prevention methods and interventions for sleep in menopausal women may reduce the risk of stroke.
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Affiliation(s)
- Xingyue Liu
- Graduate School, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Juhua Zhang
- Department of Integrated Traditional Chinese and Western Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Shuzhi Peng
- Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mengyun Pei
- Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chunying Dai
- Department of Medicine, Kashgar Vocational and Technical College, Kashgar, China
| | - Tingting Wang
- School of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China
- *Correspondence: Tingting Wang,
| | - Peng Zhang
- Department of Medicine, Kashgar Vocational and Technical College, Kashgar, China
- School of Clinical Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Peng Zhang,
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Examining negative affect, sleep duration, and using food to cope as predictors of weight in midlife women. J Behav Med 2022; 45:894-903. [PMID: 35933573 DOI: 10.1007/s10865-022-00338-x] [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: 01/06/2021] [Accepted: 06/20/2022] [Indexed: 10/15/2022]
Abstract
Midlife women are vulnerable to developing obesity. Behavioral and psychosocial factors including sleep duration, stress eating, and negative emotionality are risk factors. However, little is known about the complex daily interplay between sleep, eating, emotion, and weight among midlife women. The current study examined how daily sleep, using food to cope, and negative emotionality are associated with weight using a daily process research design. An archival analysis was performed using the Midlife in the United States-II study (MIDUS II). The sample consisted of 489 midlife women (40-64 years of age). Variables included ecological momentary assessments of daily sleep duration, using food to cope, and negative affect (means and intraindividual variability) and a standardized measurement of BMI. Sleep duration variability was a significant predictor of BMI, albeit the model only accounted for .8% of the variance in BMI (b = .019, p < .05). In the final adjusted model, sleep duration variability, using food to cope, age, and physical activity were all significant predictors of BMI F(5, 559) = 21.503, p < .001, R2 = .161, ⨂R2 = .024, p = .001. Variability in negative affect, mean sleep duration or negative affect and the interactions between sleep duration (mean, variability) and negative affect (mean, variability) were not significant. Greater variability in sleep duration and greater use of food to cope predicted higher BMI in this sample across age and physical activity levels. Results highlight that daily health and psychosocial factors play an important role in weight.
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Effects of a palaeolithic diet on obstructive sleep apnoea occurring in females who are overweight after menopause—a randomised controlled trial. Int J Obes (Lond) 2022; 46:1833-1839. [PMID: 35879528 PMCID: PMC9492533 DOI: 10.1038/s41366-022-01182-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/20/2022] [Accepted: 06/29/2022] [Indexed: 11/08/2022]
Abstract
Abstract
Background/Objectives
Obesity is the main risk factor for obstructive sleep apnoea, commonly occurring in females who are overweight after menopause. We aimed to study the effect of a palaeolithic diet on sleep apnoea in females with overweight after menopause from the population.
Methods
Seventy healthy, non-smoking females with a mean age of 60 years and a mean BMI of 33 kg/m2 were randomised to a palaeolithic diet or to a control low-fat diet according to Nordic Nutritional Recommendations, for 2 years. The apnoea-hypopnoea index was measured and daytime sleepiness was estimated during the intervention.
Results
The mean apnoea-hypopnoea index at baseline was 11.6 (95% CI 8.6–14.5). The mean weight loss was 7.2 kg (95% CI 5.3–9.2 kg) in the palaeolithic diet group and 3.9 kg in the control group (95% CI 1.9–5.9 kg); p < 0.021 for the group difference. The reduction in weight corresponded to a reduction in the apnoea-hypopnoea index in the palaeolithic diet group (r = 0.38, p = 0.034) but not in the control group (r = 0.08, p = 0.69). The apnoea-hypopnoea index was reduced in the palaeolithic diet group when the weight was reduced by more than 8 kg. Daytime sleepiness according to the Epworth Sleepiness Scale score and the Karolinska Sleepiness Scale score was unaffected by dietary group allocation.
Conclusions
A substantial decrease in body weight of 8 kg was needed to achieve a reduction in sleep apnoea in this small trial of women who are overweight after menopause. The palaeolithic diet was more effective for weight reduction than a control low-fat diet and the reduction in sleep apnoea was related to the degree of weight decrement within this diet group.
Trial registration
Clinicaltrials.gov: NCT00692536.
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25
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Abdelaziz EM, Elsharkawy NB, Mohamed SM. Health Promoting Lifestyle Behaviors and Sleep Quality Among Saudi Postmenopausal Women. Front Public Health 2022; 10:859819. [PMID: 35784250 PMCID: PMC9240311 DOI: 10.3389/fpubh.2022.859819] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundOne of the most effective measures regarding improving women's health is to promote healthy lifestyle behaviors. This study aimed to investigate the relationship between health-promoting behaviors and sleep quality among a sample of Saudi menopausal women.MethodsA descriptive cross-sectional study was used to collect data from 410 Saudi postmenopausal women visiting primary healthcare care centers located in Sakaka, Jouf, Saudi Arabia, using the Menopause Rating Scale (MRS), Health-Promoting Lifestyle Profile II (HPLPII) and Pittsburgh Sleep Quality Index (PSQI).ResultsThe mean age of the study participants was 52.60 ± 4.65 years, the study findings highlighted that among all the HPLP domains, the highest mean score was observed for spiritual growth (24.00 ± 6.60) whereas the lowest score was observed for physical activity (16.18 ± 1.8). Statistically significant negative relations between the total score of HPLP and sleep quality score and menopausal symptoms (p < 0.001, p < 0.005), respectively. Total scores of lifestyle, health responsibility, and stress management were significant differences between participants with good and poor sleep quality. Being overweight/obese, physically inactive, having a chronic illness and poor sleep quality were predictors influencing health-promoting behavior.ConclusionHealth-Promoting Lifestyle Profile II was more obvious in the good sleeper in form of health responsibility and stress management. Being overweight and or obese, having a chronic illness, and having poor sleep quality were the significant factors influencing health-promoting behaviors. Designing and performing educational interventional plans are crucial to create motivation toward a healthy lifestyle and improve the quality of their sleep.
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Affiliation(s)
- Enas Mahrous Abdelaziz
- Department of Nursing, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia
- Department of Psychiatric Mental Health Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt
- *Correspondence: Enas Mahrous Abdelaziz
| | - Nadia Bassuoni Elsharkawy
- Department of Nursing, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia
- Department of Maternal and Newborn Health Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt
| | - Sayeda Mohamed Mohamed
- Department of Psychiatric Mental Health Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt
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26
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Chopra S, Ranjan P, Verma A, Kumari A, Malhotra A, Upadhyay AD, Baitha U, Vikram NK. A cross sectional survey of 504 women regarding perceived risk factors and barriers to follow healthy lifestyle and association with sociodemographic factors and menopausal symptoms. Diabetes Metab Syndr 2022; 16:102529. [PMID: 35696899 DOI: 10.1016/j.dsx.2022.102529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Midlife women undergoing menopausal transition are predisposed to weight gain. Weight gain in midlife is driven by two modifiable risk factors: menopausal symptom's severity and lifestyle practices. The independent and interactive nature of menopausal symptoms and lifestyle practices as risk factors of weight gain has not been investigated yet. This study was undertaken to study menopausal symptoms and lifestyle practices as risk factors for weight gain in midlife women and identify midlife -related barriers in managing corrective lifestyle practices. METHODS In this cross-sectional study, menopausal symptom severity and lifestyle practices such as diet, exercise, and sleep were assessed using a pre-validated and reliable questionnaire on a convenience sample of midlife women (43-55 years) via an interview schedule. The association of lifestyle practices and its barriers with socio-demographics and menopausal symptoms were analysed. RESULT A total of 504 women (mean age: 47.3 ± 4.1 years) were recruited. More than half of them followed corrective dietary practices, but only one-fourth engaged in moderate-intensity exercises. Total menopausal symptom severity was associated with increased food intake (P < 0.001), joint pain with limited physical activity and hot flashes and emotional volatility with sleep disturbances (P < 0.01). Demographic variables such as education, economic and employment status were associated with unhealthy lifestyle practices. CONCLUSION Assessment of menopausal symptoms and lifestyle practices as risk factors and associated barriers must be the pivotal component to devise comprehensive women-centric weight management modules. Similar studies should be carried out in future when there is no clear effect of COVID19 on lifestyle factors.
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Affiliation(s)
- Sakshi Chopra
- University of Delhi, Department of Home Science, New Delhi, India
| | - Piyush Ranjan
- All India Institute of Medical Sciences, Department of Medicine, New Delhi, India.
| | - Aditi Verma
- University of Delhi, Department of Home Science, New Delhi, India
| | - Archana Kumari
- All India Institute of Medical Sciences, Department of Gynaecology and Obstetric, New Delhi, India
| | - Anita Malhotra
- Lakshmibai College University of Delhi, Department of Home Science, New Delhi, India
| | - Ashish Datt Upadhyay
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Upendra Baitha
- All India Institute of Medical Sciences, Department of Medicine, New Delhi, India
| | - Naval K Vikram
- All India Institute of Medical Sciences, Department of Medicine, New Delhi, India
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Yao CW, Pelletier A, Fereshtehnejad SM, Cross N, Dang-Vu T, Postuma RB. Insomnia symptom subtypes and manifestations of prodromal neurodegeneration: a population-based study in the Canadian Longitudinal Study on Aging. J Clin Sleep Med 2022; 18:345-359. [PMID: 34314348 PMCID: PMC8804990 DOI: 10.5664/jcsm.9562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVES To identify the association between insomnia symptoms and signs of prodromal neurodegeneration, including an analysis of potential differences between sleep-onset and sleep-maintenance insomnia. METHODS We included those aged 45-85 years, living in 1 of 10 Canadian provinces between 2012 and 2015 (at the baseline), recruited via 3 population-based sampling methods. Insomnia symptoms were assessed using questions adapted/modified from the Pittsburgh Sleep Quality Index. A panel of potential prodromal neurodegenerative markers including self-reported symptoms and objective gait motor, cognitive, and autonomic variables were assessed cross sectionally. We compared those who endorsed insomnia symptoms ≥ 3 times per week to controls, adjusting for age, sex, and education via logistic regression. RESULTS Overall, 2,051/30,097 people screened positive for sleep-onset insomnia alone and 4,333 for sleep-maintenance insomnia alone, while 2,371 endorsed both subtypes. On objective gait tests, participants with sleep-onset insomnia, but not sleep-maintenance insomnia, had worse balance (odds ratio [OR] = 1.33, 95% confidence interval = [1.16, 1.52]) and slower gait speed (OR = 1.52 [1.34, 1.73]). Although participants with any insomnia subtype endorsed more motor symptoms, these were more severe in those with sleep-onset insomnia (OR onset vs maintenance = 1.13 [1.07, 1.18]). On objective cognitive tests, those with sleep-maintenance insomnia scored normally. However, participants with sleep-onset insomnia performed worse on tests of verbal fluency (OR = 1.24 [1.06, 1.43]), immediate memory (OR = 1.23 [1.08, 1.41]), and prospective memory task (OR = 1.29 [1.11, 1.50]). The sleep-onset insomnia group also had lower heart rate variability (OR = 1.23 [1.07, 1.43]). Secondary analyses found generally similar results in young vs older age of insomnia development. CONCLUSIONS Compared to maintenance insomnia, those with sleep-onset insomnia have more motor, cognitive, and autonomic signs/symptoms. When evaluating neurodegenerative risk, differentiating insomnia subtypes may increase precision. CITATION Yao CW, Pelletier A, Fereshtehnejad S-M, Cross N, Dang-Vu T, Postuma RB. Insomnia symptom subtypes and manifestations of prodromal neurodegeneration: a population-based study in the Canadian Longitudinal Study on Aging. J Clin Sleep Med. 2022;18(2):345-359.
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Affiliation(s)
- Chun W Yao
- Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Amélie Pelletier
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Research Center of the Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | | | - Nathan Cross
- Institut Universitaire de Gériatrie de Montréal and CRIUGM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- PERFORM Centre, Center for Studies in Behavioral Neurobiology, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
| | - Thanh Dang-Vu
- Institut Universitaire de Gériatrie de Montréal and CRIUGM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- PERFORM Centre, Center for Studies in Behavioral Neurobiology, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
| | - Ronald B Postuma
- Research Center of the Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
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Tandon V, Sharma S, Mahajan A, Mahajan A, Tandon A. Menopause and sleep disorders. J Midlife Health 2022; 13:26-33. [PMID: 35707298 PMCID: PMC9190958 DOI: 10.4103/jmh.jmh_18_22] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/02/2022] [Accepted: 02/02/2022] [Indexed: 11/04/2022] Open
Abstract
Women are likely to suffer from sleep disorders more in comparison to men during menopause and with advancing age. The incidence of sleep disorders ranges from 16% to 47% at peri-menopause and 35%–60% at postmenopause. Insomnia with or without associated anxiety or low lying depression and Mood disorder is most common associated manifestations. Sleep disorders and insomnia largely remain a clinical diagnosis based on the subjective complaints of patients. Benzodiazepines remain the mainstay of the treatment in majority of the sleep disorders including chronic or acute insomnia. Treatment of associated anxiety, depression, or psychosis is most important. Tricyclic antidepressant, Selective Serotonin Reuptake Inhibitors (SSRI), Melatonin, Duloxetine, Fluoxetine, Imipramine, Nortriptyline or Amitriptyline and other drugs such as Eszopiclone, Escitalopram, Gabapentin, Quiteiapine, Citalopram, Mirtazapine followed by long-acting Melatonin and Ramelteon, also are very useful for the management of various sleep disorders. Hormone replacement therapy presently lacks concrete evidence to be used in menopausal women for sleep disorder. Sleep hygiene practices, self-hypnosis, meditation, and exercise play a very important role.
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Zhang J, Shao S, Ye C, Jiang B. A Clinical Study of the Effect of Estradiol Valerate on Sleep Disorders, Negative Emotions, and Quality of Life in Perimenopausal Women. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:8037459. [PMID: 34697549 PMCID: PMC8541855 DOI: 10.1155/2021/8037459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022]
Abstract
In this prospective study, we randomly divided 100 patients with perimenopausal syndrome equally into the control group (n = 50) receiving conventional treatment and the study group (n = 50) receiving estradiol valerate. The indicators observed were endometrial thickness, uterine volume, and the levels of LH (luteinizing hormone), FSH (follicle-stimulating hormone), and E2 (estradiol) of the patients before and after treatment. The Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety/Depression Scale (HAMA/HAMD), Kupperman symptom score, and menopause-specific quality of life (MENQOL) were also applied to assess the sleep quality, negative emotions, severity of the condition, and quality of life of all patients, respectively. Our findings were that estradiol valerate is beneficial in improving serum sex hormone levels, sleep disturbances, negative mood, and quality of life in patients with perimenopausal syndrome and that its safety profile is high enough to warrant clinical promotion.
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Affiliation(s)
- Jianfu Zhang
- Department of Pharmacy, Ningbo Women and Children's Hospital, Ningbo 315012, China
| | - Shurong Shao
- Department of Pharmacy, Ningbo Women and Children's Hospital, Ningbo 315012, China
| | - Chaohui Ye
- 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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Rani R, Arokiasamy P, Selvamani Y, Sikarwar A. Gender differences in self-reported sleep problems among older adults in six middle-income countries: a cross-sectional study. J Women Aging 2021; 34:605-620. [PMID: 34436971 DOI: 10.1080/08952841.2021.1965425] [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] [Indexed: 10/20/2022]
Abstract
This study examines gender differences in sleep problems among older adults in India, China, Ghana, Mexico, Russia, and South Africa. We used data on 33,929 individuals (50+ years) from the WHO-SAGE. Results showed significant gender differences in the prevalence of sleep problems with the largest difference in Russia followed by India. Regression results showed higher odds of sleep problems among women in India, China, Russia, and South Africa. Age, low back pain, depression, and poor self-rated health were significantly associated with sleep problems. This research confirms significant gender differences in sleep problems among the older population in middle-income countries.
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Affiliation(s)
- Ritu Rani
- Department of Development Studies, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Perianayagam Arokiasamy
- Department of Development Studies, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Y Selvamani
- Longitudinal Aging Study in India (LASI) Project, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Ankit Sikarwar
- Department of Development Studies, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Huang WC, Chang CS, Lin CY, Lai TF, Hsueh MC, Liao Y, Park JH. Is Sleep Timing Related to Objectively Measured Physical Activity and Sedentary Behavior in Older Women? Nat Sci Sleep 2021; 13:1377-1381. [PMID: 34354382 PMCID: PMC8331085 DOI: 10.2147/nss.s308270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/10/2021] [Indexed: 12/03/2022] Open
Abstract
PURPOSE Sleep, sedentary behavior, and physical activity are the components of the 24-hour model, while the timing of sleep may play a critical role to impact waking behaviors. Therefore, the present study aimed to examine the relationship of sleep timing with sedentary behavior, light-intensity, moderate-to-vigorous-intensity physical activity, and daily steps in older women. PATIENTS AND METHODS A total of 90 community-dwelling older women (70.5 ± 5.4 years) were included in our sample. Multiple linear regression models were used to estimate the associations of accelerometer-measured sedentary behavior and physical activity metrics with the three sleep timing indicators (bedtime and wake time, and mid-sleep time). Bedtime and wake time were recorded by the participants, and mid-sleep time was estimated based on the two sleep indicators. RESULTS Most indicators of sleep timing were negatively associated with moderate-to-vigorous-intensity physical activity (unstandardized coefficient [B]-0.07 for bedtime and mid-sleep time, p<0.05) and daily steps (B ranged from -15.51 for bedtime to -13.73 for wake time, p<0.05). No associations of sleep timing were found in sedentary behavior and light-intensity physical activity. CONCLUSION The findings suggest that sleep timing should be considered when designing promising strategies or interventions for older women to be physically active.
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Affiliation(s)
- Wan-Chi Huang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, 106, Taiwan
| | - Chia-Shuan Chang
- Institute of Health Behaviors and Community Sciences, National Taiwan University, Taipei, 100, Taiwan
| | - Chien-Yu Lin
- Graduate School of Sport Sciences, Waseda University, Tokorozawa City, Saitama Prefecture, 359-1192, Japan
| | - Ting-Fu Lai
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, 106, Taiwan
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, Taipei City, 11153, Taiwan
| | - Yung Liao
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, 106, Taiwan
- Faculty of Sport Sciences, Waseda University, Tokorozawa City, Saitama, 359-1192, Japan
| | - Jong-Hwan Park
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan, 49241, Korea
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Seixas BV. Prevalence and factors associated with use of sleeping pills among older adults in Brazil. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:235-244. [PMID: 33793814 DOI: 10.1093/ijpp/riab003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 01/19/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVES Little is known about sleeping pills consumption among older adults in low- and middle-income countries. This study investigated the prevalence and factors associated with sleeping pills use among Brazilians aged 50 and over. METHODS A cross-sectional study was conducted using baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), a nationally representative study of persons aged 50 years and older (n = 9412). Univariate and bivariate analyses were used to describe the sample. Robust Poisson regression was employed to estimate prevalence ratios and predict probabilities. KEY FINDINGS Prevalence of sleeping pills use among older Brazilians was estimated at 16.8%, with considerable disparities related to gender (22.3% among women and 10.3% among men), race/skin colour (19.7% among whites and 11.9% among blacks) and geographic region (ranging from 5.9% in the North to 20.5% in the South). The multivariate analysis showed associations between sleeping pills consumption and sociodemographic factors (age, gender, race/skin colour, geographic region and income), health status/behaviour characteristics (poor self-rated health status, number of chronic conditions and alcohol consumption) and variables related to healthcare utilisation (number of visits, usual source of care, care coordination, doctor's awareness of all medication, difficulty in managing own medication and number of medicines). CONCLUSIONS Our work found that sleeping pills consumption is disproportionately prevalent among women, is associated with worse health status and increases with more medical office visits and use of additional medicines. Moreover, the large inexplicable variations in care deserve special attention from policy-makers and clinicians.
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Affiliation(s)
- Brayan V Seixas
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
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Nocturia and hormone therapy: impact on sleep? ACTA ACUST UNITED AC 2021; 28:482-483. [PMID: 33596029 DOI: 10.1097/gme.0000000000001749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Li Y, Zhao D, Lv G, Mao C, Zhang Y, Xie Z, Li P. Individual and additive-effect relationships of sleep problems and severe menopausal symptoms among women in menopausal transition. Menopause 2021; 28:517-528. [PMID: 33438893 DOI: 10.1097/gme.0000000000001726] [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: 11/26/2022]
Abstract
OBJECTIVE Sleep problems and menopausal symptoms are both common complaints among midlife women. However, the associations of the quality and quantity of sleep problems with the severity of menopausal symptoms have not been well studied. Thus, this study aims to examine the relationships between individual sleep problems and the additive number of sleep problems with severe menopausal symptoms among women during the menopausal transition. METHODS Using the convenience sampling, a total of 848 middle-aged women in China were investigated from December 2017 to August 2018. All participants completed a questionnaire on sleep problems, Menopause Rating Scale, and the general information questionnaire. Based on the cutoff of the Menopause Rating Scale, participants were divided into the nonsevere menopausal symptom group and severe menopausal symptoms group. Propensity score matching was used to balance covariates between the two groups. Stepwise binary logistic regression and restricted cubic spline were applied to analyze the associations of individual and additive sleep problems with severe menopausal symptoms. RESULTS After propensity score matching, no significant difference was observed between the nonsevere menopausal symptoms group and severe menopausal symptoms group (Ps > 0.05). Logistic regression analysis showed that five sleep problems ("feeling too hot," "having pain," "restless legs syndrome," "taking medicine to help sleep," and "having trouble staying awake") were closely associated with severe menopausal symptoms. The restricted cubic spline curve showed an upward trend in odds ratios between the number of these five sleep problems and severe menopausal symptoms, and women were more than twice as likely to suffer severe menopausal symptoms when they experienced more than three of these individual sleep problems. CONCLUSION Both the individual and additive number of sleep problems exerted significant effects on severe menopausal symptoms. It might be useful for healthcare providers to set guidelines to support a healthy menopausal transition for midlife women.
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Affiliation(s)
- Yuanyuan Li
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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Associations between sleep duration, midday napping, depression, and falls among postmenopausal women in China: a population-based nationwide study. ACTA ACUST UNITED AC 2021; 28:554-563. [PMID: 33438896 DOI: 10.1097/gme.0000000000001732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To explore the independent and joint associations of sleep duration, midday napping, and depression with fall accidents in Chinese postmenopausal women. METHODS A total of 2,378 postmenopausal women aged ≥ 45 years from the baseline survey of the China Health and Retirement Longitudinal Study were enrolled in the study. Each participant provided data on falls, sleep duration, midday napping by a self-reporting approach. We employed the Chinese version of the Center for Epidemiologic Studies Depression Scale to assess depression. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated to estimate the associations of predictor variables with falls using multivariate logistic regression. RESULTS Of the 2,378 postmenopausal women, 478 (20.10%) reported falls in the preceding 2 years. Compared with sleep duration of 7 to 8 h/night, sleep duration of 5 to 6 h/night (OR, 1.49; 95% CI, 1.03-2.15) and of ≤ 5 h/night (OR, 1.63; 95% CI, 1.18-2.25) were associated with a higher fall prevalence. However, no significant correlation was found between sleep duration of > 8 h/night and falls. Furthermore, participants with depression were more likely to report falls (OR, 1.78; 95% CI, 1.41-2.25) than their depression-free counterparts. The duration of midday napping was not independently associated with falls, but significant joint associations of sleeping ≤ 6 h/night and no napping (OR, 1.72; 95% CI, 1.07-2.76) or napping > 60 minutes (OR, 2.14; 95% CI, 1.18-3.89) with more falls were found. Similarly, a combined status of sleeping ≤ 6 h/night and depression was related to more falls (OR, 2.97; 95% CI, 1.86-4.74). CONCLUSION The present study demonstrates that short sleep duration and depression are independently associated with more falls among postmenopausal women in China. Moreover, short sleep duration combined with no or long napping, short sleep duration combined with depression are jointly correlated with more falls. Future longitudinal studies are warranted to confirm these findings.
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Polesel DN, Nozoe KT, Bittencourt L, Tufik S, Andersen ML, Fernandes MTB, Hachul H. Waist-to-height ratio and waist circumference as the main measures to evaluate obstructive sleep apnea in the woman's reproductive life stages. Women Health 2021; 61:277-288. [PMID: 33390097 DOI: 10.1080/03630242.2020.1862386] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder. In women, the frequency of OSA increases substantially during and after the menopause, as does the prevalence of obesity in this reproductive life stage. This cross-sectional study uses data from the Sao Paulo Epidemiologic Sleep Study (EPISONO, 2007), and comprises a sample of 500 women aged 20-80 years. Multiple logistic regression analysis was used to assess the factors associated with OSA in premenopausal and postmenopausal women. All participants underwent polysomnography, and obesity was assessed using the waist-to-height ratio (WHtR), body mass index, neck and waist circumference, measured using standard methods. WHtR was the factor most associated with a significant increase in risk of OSA in premenopausal women. Waist circumference was the factor most associated with OSA in postmenopausal women, for all severities of the disease. Anthropometric factors presented a high rate of accuracy in the classification of women with OSA. The study found that different obesity-related anthropometric measures should be considered in the diagnosis of OSA, according to the woman's reproductive stage.
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Affiliation(s)
| | - Karen Tieme Nozoe
- Departmento de Psicobiologia, Universidade Federal De São Paulo, São Paulo, SP, Brazil
| | - Lia Bittencourt
- Departmento de Psicobiologia, Universidade Federal De São Paulo, São Paulo, SP, Brazil
| | - Sergio Tufik
- Departmento de Psicobiologia, Universidade Federal De São Paulo, São Paulo, SP, Brazil
| | - Monica Levy Andersen
- Departmento de Psicobiologia, Universidade Federal De São Paulo, São Paulo, SP, Brazil
| | | | - Helena Hachul
- Departmento de Psicobiologia, Universidade Federal De São Paulo, São Paulo, SP, Brazil
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Castro AM, Beltrán-Barrios T, Mercado-Lara M. Assessment of the frequency of sleep complaints and menopausal symptoms in climacteric women using the Jenkins Sleep Scale. Sleep Sci 2021; 14:92-100. [PMID: 34381572 PMCID: PMC8340889 DOI: 10.5935/1984-0063.20200041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 08/03/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To identify the frequency of sleep complaints (SC) and associated menopausal symptoms in climacteric women, apparently healthy, residing in three different capital cities of the Colombian Caribbean. MATERIAL AND METHODS Cross-sectional study which is part of the investigation project CAVIMEC [Calidad de Vida en la Menopausia y Etnias Colombianas]. Data were collected by interviewers, on a door-to-door visit. Healthy women residing in the Colombian Caribbean, 40-59 years old, were studied. Sociodemographic characteristics form and scales were applied: Menopause Rating Scale, Jenkins Sleep Scale, Perceived Psychological Stress (perceived stress), Goldberg Anxiety and Depression Scale, SCOFF scale (eating disorders), and Loneliness Scale by Hughes. The women were divided into two groups: with SC and without SC, according to the Jenkins scale result. Crude and adjusted logistic regressions were performed: SC (dependent variable) with sociodemographic characteristics and the results of the scales used (independent variables). RESULTS Five hundred eighty-five women were studied. 16.5% with SC. No differences were observed in age, BMI, and high blood pressure. Proportionally more women with SC had depression, anxiety, perception of loneliness, severe menopausal symptoms, somatic, psychological, urogenital, and quality of life severe impairment (p<0.05). There were no differences in eating disorders and perceived stress. In the adjusted model, only depression was associated with SC, OR: 9.81 [95% CI: 1.29-74.3], p<0.05. CONCLUSION SC were identified in 16.5% of the climacteric women of the Colombian Caribbean. In an adjusted model, probable depression was the only factor associated with SC.
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Affiliation(s)
- Alvaro Monterrosa Castro
- Grupo de Investigación Salud de la Mujer. Universidad de
Cartagena, Facultad de Medicina - Cartagena - Bolivar - Colombia. ,Corresponding author: Alvaro
Monterrosa Castro. E-mail:
| | - Teresa Beltrán-Barrios
- Grupo de Investigación Salud de la Mujer. Universidad de
Cartagena, Facultad de Medicina - Cartagena - Bolivar - Colombia
| | - María Mercado-Lara
- Grupo de Investigación Salud de la Mujer. Universidad de
Cartagena, Facultad de Medicina - Cartagena - Bolivar - Colombia
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Santoro N, Roeca C, Peters BA, Neal-Perry G. The Menopause Transition: Signs, Symptoms, and Management Options. J Clin Endocrinol Metab 2021; 106:1-15. [PMID: 33095879 DOI: 10.1210/clinem/dgaa764] [Citation(s) in RCA: 132] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Indexed: 02/03/2023]
Abstract
CONTEXT Menopause, the permanent cessation of menses, reflects oocyte depletion and loss of gonadal steroids. It is preceded by a transition state, the perimenopause, which is characterized by the gradual loss of oocytes, altered responsiveness to gonadal steroid feedback, wide hormonal fluctuations, and irregular menstrual patterns. The goal of this mini-review is to discuss the basic pathophysiology of the menopausal transition and the hormonal and nonhormonal management of clinicopathology attributed to it. EVIDENCE ACQUISITION A Medline search of epidemiologic, population-based studies, and studies of reproductive physiology was conducted. A total of 758 publications were screened. EVIDENCE SYNTHESIS The reproductive hormonal milieu of the menopausal transition precipitates bothersome vasomotor symptoms, mood disruption, temporary cognitive dysfunction, genitourinary symptoms, and other disease processes that reduce the quality of life of affected women. The endocrine tumult of the menopause transition also exposes racial and socioeconomic disparities in the onset, severity, and frequency of symptoms. Hormone therapy (HT) treatment can be effective for perimenopausal symptoms but its use has been stymied by concerns about health risks observed in postmenopausal HT users who are older than 60 and/or women who have been postmenopausal for greater than 10 years. CONCLUSIONS The menopause transition is a disruptive process that can last for over a decade and causes symptoms in a majority of women. It is important for clinicians to recognize early signs and symptoms of the transition and be prepared to offer treatment to mitigate these symptoms. Many safe and effective options, including HT, are available.
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Affiliation(s)
- Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado
| | - Cassandra Roeca
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado
| | - Brandilyn A Peters
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Genevieve Neal-Perry
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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Brown AMC, Gervais NJ. Role of Ovarian Hormones in the Modulation of Sleep in Females Across the Adult Lifespan. Endocrinology 2020; 161:5879359. [PMID: 32735650 PMCID: PMC7450669 DOI: 10.1210/endocr/bqaa128] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 07/22/2020] [Indexed: 12/13/2022]
Abstract
Ovarian hormones, including 17β-estradiol, are implicated in numerous physiological processes, including sleep. Beginning at puberty, girls report more sleep complaints than boys, which is maintained throughout the reproductive life stage. Sleep problems are exacerbated during the menopausal transition, evidenced by greater risk for sleep disorders. There is emerging evidence that menopause-associated hormone loss contributes to this elevated risk, but age is also an important factor. The extent to which menopause-associated sleep disturbance persists into postmenopause above and beyond the effects of age remains unknown. Untreated sleep disturbances have important implications for cognitive health, as they are emerging as risk factors for dementia. Given that sleep loss impairs memory, an important knowledge gap concerns the role played by menopause-associated hormone loss in exacerbating sleep disturbance and, ultimately, cognitive function in aging women. In this review, we take a translational approach to illustrate the contribution of ovarian hormones in maintaining the sleep-wake cycle in younger and middle-aged females, with evidence implicating 17β-estradiol in supporting the memory-promoting effects of sleep. Sleep physiology is briefly reviewed before turning to behavioral and neural evidence from young females linking 17β-estradiol to sleep-wake cycle maintenance. Implications of menopause-associated 17β-estradiol loss is also reviewed before discussing how ovarian hormones may support the memory-promoting effects of sleep, and why menopause may exacerbate pathological aging via effects on sleep. While still in its infancy, this research area offers a new sex-based perspective on aging research, with a focus on a modifiable risk factor for pathological aging.
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Affiliation(s)
- Alana M C Brown
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Nicole J Gervais
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
- Correspondence: Nicole J. Gervais, University of Toronto, Department of Psychology, 100 St. George Street, Toronto, ON, Canada M5S 3G3. E-mail:
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Abstract
Obstructive sleep apnea (OSA) telehealth management may improve initial and chronic care access, time to diagnosis and treatment, between-visit care, e-communications and e-education, workflows, costs, and therapy outcomes. OSA telehealth options may be used to replace or supplement none, some, or all steps in the evaluation, testing, treatments, and management of OSA. All telehealth steps must adhere to OSA guidelines. OSA telehealth may be adapted for continuous positive airway pressure (CPAP) and non-CPAP treatments. E-data collection enhances uses for individual and group analytics, phenotyping, testing and treatment selections, high-risk identification and targeted support, and comparative and multispecialty therapy studies.
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In Reply:. Menopause 2020; 27:607-609. [DOI: 10.1097/gme.0000000000001550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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