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El-Monshed AH, Khonji LM, Altheeb M, Saad MTEM, Elsheikh MA, Loutfy A, Ali AS, El-Gazar HE, Fayed SM, Zoromba MA. Does a program-based cognitive behavioral therapy affect insomnia and depression in menopausal women? A randomized controlled trial. Worldviews Evid Based Nurs 2024; 21:202-215. [PMID: 38329153 DOI: 10.1111/wvn.12707] [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: 07/19/2023] [Revised: 12/07/2023] [Accepted: 12/19/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Menopausal women often complain of a range of physical and psychological symptoms known as menopausal syndrome. These symptoms are associated with fluctuating hormone levels, sleep disturbances, and mood swings. AIM This study aimed to examine the efficacy of a program-based cognitive behavioral group therapy (CBT) for insomnia and depression among women experiencing menopause. METHODS A randomized controlled trial of 88 women experiencing menopause was conducted in Egypt from June to September 2022 in outpatient clinics at Mansoura University Hospitals in Egypt. Participants were randomly assigned to a control group (45 women) and an intervention group (43 women). The intervention group received 7 weeks of CBT sessions. Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Inventory 2nd Edition (BDI-II) were administered before and after the intervention. RESULTS In the intervention group, there was a significant difference in scores of the subdomains of PSQI, including sleep efficiency, daytime dysfunction, subjective sleep quality, and sleep disturbance (t = 8.911, 11.77, 7.638, and 11.054, respectively), while no significant difference in domains of using sleep medication, sleep duration, and sleep latency. Significant improvements were observed between pre-and-post-intervention in the intervention group for the total scores of PSQI, ISI, and BDII-II (t = 12.711, 16.272, and 12.384, respectively), indicating a large effect size for the three studied variables (r = .81, .87, .8, respectively). LINKING EVIDENCE TO ACTION This study demonstrated the efficacy of group CBT for lowering insomnia and depression in women experiencing menopause. Thus, results indicated the need of considering prompt and appropriate interventions such as CBT as a safe treatment option to prevent the aggravation of sleep and emotional problems for menopausal women. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05920460.
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Affiliation(s)
- Ahmed Hashem El-Monshed
- Department of Nursing, College of Health and Sport Sciences, University of Bahrain, Manama, Bahrain
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Leena Mohamed Khonji
- Midwifery Specialty, Nursing Department, College of Health and Sport Sciences, University of Bahrain, Manama, Bahrain
| | - Marwan Altheeb
- Department of Nursing, College of Health and Sport Sciences, University of Bahrain, Manama, Bahrain
| | | | | | - Ahmed Loutfy
- Department of Nursing, College of Health Sciences, University of Fujairah, Fujairah, United Arab Emirates
- Department of Pediatric Nursing, Faculty of Nursing, Beni-Suef University, Beni Suef, Egypt
| | - Ahmed Salah Ali
- Department of Pediatric Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Heba E El-Gazar
- Department of Nursing Administration, Faculty of Nursing, Port Said University, Port Said, Egypt
| | - Sara Mohamed Fayed
- Department of Pediatric Nursing, Faculty of Nursing, Port Said University, Port Said, Egypt
| | - Mohamed A Zoromba
- College of Nursing, Prince Sattam Bin Abdulaziz University, AlKharj, Saudi Arabia
- Faculty of Nursing, Mansoura University, Mansoura, Egypt
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Zhao J, Ji Y, Zuo Y, Zhang L, Ku C, Wang W, Wang P, Yang Y, Kang Y, Wang F. Association of Oxidative Stress and Proinflammation with Insomnia in Perimenopause. J Womens Health (Larchmt) 2024; 33:379-387. [PMID: 38394165 DOI: 10.1089/jwh.2023.0316] [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: 02/25/2024] Open
Abstract
Background: The levels of oxidative stress and proinflammatory factors in perimenopausal females increased, and they were also deeply troubled by insomnia. The occurrence of insomnia is related to the changes of oxidative stress and inflammation levels in the body. Perimenopausal insomnia may be related to mild systemic inflammation, and oxidative stress can promote chronic inflammation. However, the underlying mechanism behind the phenomenon is still unclear. Objective: The aim was to investigate whether the occurrence of perimenopausal insomnia disorder is related to higher levels of oxidative stress and inflammation in the body, and to explore the role of inducible nitric oxide synthase (iNOS) in perimenopausal insomnia. Methods: A total of 127 perimenopausal participants were recruited in this study. Participants with global scores of the Pittsburgh sleep quality index (PSQI) >7 were diagnosed with insomnia (n = 54). The patient health questionnaire-9 (PHQ-9) and generalized anxiety disorder-7 (GAD-7) were evaluated, and sociodemographic data were obtained. The serum concentrations of iNOS, interleukin 6 (IL6), and tumor necrosis factor α (TNFα) were measured using commercial assays. Results: In the insomnia group, IL6 levels were positively correlated with scores of component 5 and component 7 of PSQI, respectively. PHQ-9 and GAD-7 were positively correlated with the global score of PSQI component 7 and PSQI, respectively; PHQ-9 was positively correlated with the global score of PSQI component 1. Finally, PHQ-9, iNOS, and IL6 were found to be independent predictors of perimenopausal insomnia using logistic regression. Conclusions: Moderate oxidative stress caused by a certain concentration of iNOS plays a protective role in perimenopausal insomnia, while proinflammation and depression are potential risk factors.
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Affiliation(s)
- Jing Zhao
- Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, China
- Department of Basic Medical Teaching and Research, Ordos Institute of Technology, Ordos, China
| | - Yubo Ji
- Department of Medical Psychology, Inner Mongolia Medical University, Huhhot, China
| | - Yanni Zuo
- Physical Examination Center, Beijing Changping Hospital of Chinese Medicine, Beijing, China
| | - Long Zhang
- Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China
| | - Congwen Ku
- Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Wenyan Wang
- School of Pharmacy, Yantai University, Yantai, China
| | - Pengxiang Wang
- Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, China
| | - Yan Yang
- Urumqi Fourth People's Hospital, Urumqi, China
| | - Yimin Kang
- Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, China
| | - Fan Wang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
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张 倩, 张 梅, 刘 颖, 王 妍, 吕 菲, 王 毓. [Exploring the therapeutic mechanism of Liuwei Suanzao decoction for perimenopausal insomnia based on network pharmacology and animal experiments]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2023; 43:1536-1547. [PMID: 37814868 PMCID: PMC10563099 DOI: 10.12122/j.issn.1673-4254.2023.09.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Indexed: 10/11/2023]
Abstract
OBJECTIVE To explore the therapeutic mechanism of Liuwei Suanzao decoction (LWSZD) for perimenopausal insomnia (PI) based on network pharmacology. METHODS TCMSP and Batman-TCM databases were searched for the active ingredients and targets of LWSZD and a herb-active ingredient-target network was constructed, and the disease targets were obtained from the OMIM, Genecards and Gene databases.The common targets were imported into STRING database and Cytoscape software to screen the core therapeutic targets, and GO enrichment and KEGG pathway analyses were performed using DAVID database.Molecular docking of the main active ingredients of LWSZD and the core targets was conducted using AutoDock, and the results were verified by observing the therapeutic effects of LWSZD and zolpidem in a rat model of PI induced by bilateral ovariectomy and intraperitoneal p-chlorophenylalanine injection. RESULTS A total of 99 active ingredients, 389 drug targets, 187 PI-related targets, and 15 drug-PI common targets were screened.The core active ingredients were armepavine, sanjoinenine and mairin, and the core targets included ESR1, SIRT1, SERPINE1, COMT and CCL2, which were involved in the positive regulation of transcription from RNA polymerase II promoter, signal transduction, response to drug and positive regulation of transcription and in the pathways of dopaminergic synapses, tyrosine metabolism and tryptophan metabolism.Molecular docking results showed that LWSZD had a strong binding with ESR1, SIRT1 and SERPINE1 and was comparable to zolpidem.In the rat models of PI, treatment with LWSZD effectively alleviated the symptoms of insomnia (P<0.01), improved the levels of estrogen and other HPO axis-related hormones (P<0.05), and promoted the mRNA and protein expressions of ESR1 and SIRT1 in the hypothalamus tissues (P<0.01). CONCLUSION The active ingredients armepavine, sanjoinenine and mairin in LWSZD may synergistically regulate the expressions of ESR1, SIRT1 and SERPINE1 to improve PI in rats.
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Affiliation(s)
- 倩 张
- 解放军总医院第六医学中心中医学部,北京 100048Department of Traditional Chinese Medicine, Sixth Medical Center, General Hospital of the Chinese People's Liberation Army, Beijing 100048, China
| | - 梅奎 张
- 解放军总医院医疗保障中心远程医学科,北京 1008531Telemedicine Unit, Medical Security Centre, General Hospital of the Chinese People's Liberation Army, Beijing 100853, China
| | - 颖璐 刘
- 解放军总医院第一医学中心神经内科学部,北京 1008531Department of Neurology, First Medical Center, General Hospital of the Chinese People's Liberation Army, Beijing 100853, China
| | - 妍 王
- 解放军总医院第六医学中心中医学部,北京 100048Department of Traditional Chinese Medicine, Sixth Medical Center, General Hospital of the Chinese People's Liberation Army, Beijing 100048, China
| | - 菲菲 吕
- 解放军总医院第六医学中心中医学部,北京 100048Department of Traditional Chinese Medicine, Sixth Medical Center, General Hospital of the Chinese People's Liberation Army, Beijing 100048, China
| | - 毓国 王
- 解放军总医院第六医学中心中医学部,北京 100048Department of Traditional Chinese Medicine, Sixth Medical Center, General Hospital of the Chinese People's Liberation Army, Beijing 100048, China
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Liu Y, Bai X, Zhang H, Zhi X, Jiao J, Wang Q, Ji Y, Zheng X, Zhang X, Tong X, Liu J, Sun Y, Liu P. Efficacy and safety of tuina for senile insomnia: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28900. [PMID: 35212294 PMCID: PMC8878604 DOI: 10.1097/md.0000000000028900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/04/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Insomnia is a common diseases of the elderly, tuina is a widely used treatment. At present, there is a lack of supportive evidence on efficacy and safety of tuina for senile insomnia. The purpose of this systematic review is to assess the effectiveness and safety of tuina therapy in the treatment of senile insomnia. METHODS Literature on tuina for senile insomnia in the PubMed, EMBASE, Web of Science, Cochrane, China National Knowledge Infrastructure Database, Wanfang, Chinese Scientific and Journal Database, Japanese medical database, Korean Robotics Institute Summer Scholars, and Thai-Journal Citation Index Center will be conducted to search from the creation of these databases. We will search the databases from the beginning to January 2022. The primary outcome was the Pittsburgh Sleep Quality Index score, and the secondary outcomes included clinical efficacy and safety. RevMan 5.4.1 will be used for the meta-analysis. RESULTS This study aimed to will prove the effectiveness and safety of tuina therapy for the treatment of insomnia in the elderly. CONCLUSION This study provides up-to-date evidence of the effectiveness and safety of tuina for the treatment of senile insomnia. INPLASY REGISTRATION NUMBER INPLASY2021110063. ETHICS AND COMMUNICATION This systematic review will evaluate the effectiveness and safety of massage therapy for insomnia in the elderly population. As all the included data have been published, systematic reviews do not require ethical approval.
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Affiliation(s)
- Yangshengjie Liu
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Xuejiao Bai
- Acupuncture and Massage center, The Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Hongshi Zhang
- Nursing College of Changchun University of Chinese Medicine, Changchun, China
| | - Xiaoyu Zhi
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Jundong Jiao
- Department of Acupuncture and Tuina, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Quanwu Wang
- Department of Acupuncture and Tuina, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Yuanyuan Ji
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Xu Zheng
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Xinlu Zhang
- Department of Acupuncture and Tuina, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Xue Tong
- Department of Tuina, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, China
| | - Jiayi Liu
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, China
| | - Yahui Sun
- Department of Acupuncture and Tuina, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Peng Liu
- Department of Acupuncture and Tuina, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
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