Using Wearable Skin Temperature Data to Advance Tracking and Characterization of the Menstrual Cycle in a Real-World Setting

The menstrual cycle is a loop involving the interplay of different organs and hormones, with the capacity to impact numerous physiological processes, including body temperature and heart rate, which in turn display menstrual rhythms. The advent of wearable devices that can continuously track physiological data opens the possibility of using these prolonged time series of skin temperature data to noninvasively detect the temperature variations that occur in ovulatory menstrual cycles. Here, we show that the menstrual skin temperature variation is better represented by a model of oscillation, the cosinor, than by a biphasic square wave model. We describe how applying a cosinor model to a menstrual cycle of distal skin temperature data can be used to assess whether the data oscillate or not, and in cases of oscillation, rhythm metrics for the cycle, including mesor, amplitude, and acrophase, can be obtained. We apply the method to wearable temperature data collected at a minute resolution each day from 120 female individuals over a menstrual cycle to illustrate how the method can be used to derive and present menstrual cycle characteristics, which can be used in other analyses examining indicators of female health. The cosinor method, frequently used in circadian rhythms studies, can be employed in research to facilitate the assessment of menstrual cycle effects on physiological parameters, and in clinical settings to use the characteristics of the menstrual cycles as health markers or to facilitate menstrual chronotherapy.

Menstrual cycle phases and dosage of synthetic hormonal contraceptives influence diurnal rhythm characteristics of distal skin temperature

This study aimed to explore how natural menstrual cycle phases and dosage of oral hormonal contraceptives (OC) influence the diurnal rhythm of distal skin temperature (DST) under real-life conditions. Participants were 41 healthy females (23.9 ± 2.48 y), comprising 27 females taking monophasic hormonal oral contraceptives (OC users) and 14 females with menstrual cycles (non-OC users). Wrist DST was continuously recorded and averaged over two consecutive 24-hour days during (pseudo)follicular and (pseudo)luteal menstrual phases. Diurnal rhythm characteristics, i.e. acrophase and amplitude, describing timing and strength of the DST rhythm, respectively, were calculated using cosinor analysis. Results show that non-OC users experienced earlier diurnal DST maximum (acrophase, p = 0.019) and larger amplitude (p = 0.016) during the luteal phase than during the follicular phase. This was observed in most (71.4%) but not all individuals. The OC users showed no differences in acrophase or amplitude between pseudoluteal and pseudofollicular phases. OC users taking a higher dosage of progestin displayed a larger amplitude for DST rhythm during the pseudoluteal phase (p = 0.009), while estrogen dosage had no effect. In conclusion, monophasic OC cause changes in diurnal DST rhythm, similar to those observed in the luteal phase of females with menstrual cycles, suggesting that synthetic progestins act in a similar manner on skin thermoregulation as progesterone does.

Optimal sampling interval for characterisation of the circadian rhythm of body temperature in homeothermic animals using periodogram and cosinor analysis

Core body temperature (T c) is a critical aspect of homeostasis in birds and mammals and is increasingly used as a biomarker of the fitness of an animal to its environment. Periodogram and cosinor analysis can be used to estimate the characteristics of the circadian rhythm of T c from data obtained on loggers that have limited memory capacity and battery life. The sampling interval can be manipulated to maximise the recording period, but the impact of sampling interval on the output of periodogram or cosinor analysis is unknown. Some basic guidelines are available from signal analysis theory, but those guidelines have never been tested on T c data. We obtained data at 1-, 5- or 10-min intervals from nine avian or mammalian species, and re-sampled those data to simulate logging at up to 240-min intervals. The period of the rhythm was first analysed using the Lomb-Scargle periodogram, and the mesor, amplitude, acrophase and adjusted coefficient of determination (R 2) from the original and the re-sampled data were obtained using cosinor analysis. Sampling intervals longer than 60 min did not affect the average mesor, amplitude, acrophase or adjusted R 2, but did impact the estimation of the period of the rhythm. In most species, the period was not detectable when intervals longer than 120 min were used. In all individual profiles, a 30-min sampling interval modified the values of the mesor and amplitude by less than 0.1°C, and the adjusted R 2 by less than 0.1. At a 30-min interval, the acrophase was accurate to within 15 min for all species except mice. The adjusted R 2 increased as sampling frequency decreased. In most cases, a 30-min sampling interval provides a reliable estimate of the circadian T c rhythm using periodogram and cosinor analysis. Our findings will help biologists to select sampling intervals to fit their research goals.

Cellular Thermal Biology Using Fluorescent Nanothermometers

It has been known that cells have mechanisms to sense and respond to environmental noxiousness and mild temperature changes, such as heat shock response and thermosensitive TRP channels. Meanwhile, new methods of measuring temperature at the cellular level has recently been developed using fluorescent nanothermometers. Among these thermometers, fluorescent polymeric thermometers and fluorescent nanodiamonds excel in the properties required for intracellular thermometry. By using these novel methods to measure the temperature of single cells in cultures and tissues, it was revealed that spontaneous spatiotemporal temperature fluctuations occur within cells. Furthermore, the temperature fluctuations were related to organelles such as mitochondria and cellular and physiological functions, revealing a close relationship between intracellular temperature and cellular functions.

Increase of body temperature immediately after ovulation in mares

To successfully inseminate mares, precise detection of ovulation time is crucial, especially when using frozen-thawed semen. Monitoring body temperature, as has been described in women, could be a non-invasive way to detect ovulation. The objective of this study was to investigate the relationship between the time of ovulation and the variation of body temperature in mares based on automatic continuous measurements during estrus. The experimental group included 21 mares for 70 analyzed estrous cycles. When the mares showed estrous behavior, they were administered intramuscular deslorelin acetate (2.25 mg) in the evening. At the same time, monitoring of body temperature using a sensor device fixed at the left lateral thorax was started and continued for over 60 h. In 2-hour intervals, transrectal ultrasonography was performed to detect ovulation. Estimated body temperature in the 6 h following ovulation detection was on average 0.06°C +/- 0.05°C (mean +/- SD) significantly higher when compared with body temperature at the same time on the preceding day (p=0.01). In addition, a significant effect of PGF_2α administration for estrus induction on the body temperature was found, being significantly higher until 6 h before ovulation compared to that of uninduced cycles (p=0.005). In conclusion, changes in body temperature during estrus in mares were related to ovulation. The increase in body temperature immediately after ovulation might be used in the future to establish automatized and non-invasive systems to detect ovulation. However, the identified temperature rise is relatively small on average and hardly identifiable in the individual mares.

Effects of exogenous melatonin on sleep and circadian rhythms in women with premenstrual dysphoric disorder

We previously found normal polysomnographic (PSG) sleep efficiency, increased slow-wave sleep (SWS), and a blunted melatonin secretion in women with premenstrual dysphoric disorder (PMDD) compared to controls. Here, we investigated the effects of exogenous melatonin in five patients previously studied. They took 2 mg of slow-release melatonin 1 h before bedtime during their luteal phase (LP) for three menstrual cycles. At baseline, patients spent every third night throughout one menstrual cycle sleeping in the laboratory. Measures included morning urinary 6-sulfatoxymelatonin (aMt6), PSG sleep, nocturnal core body temperature (CBT), visual analog scale for mood (VAS-Mood), Prospective Record of the Impact and Severity of Menstrual Symptoms (PRISM), and ovarian plasma hormones. Participants also underwent two 24-hour intensive physiological monitoring (during the follicular phase and LP) in time-isolation/constant conditions to determine 24-hour plasma melatonin and CBT rhythms. The same measures were repeated during their third menstrual cycle of melatonin administration. In the intervention condition compared to baseline, we found increased urinary aMt6 (p < 0.001), reduced objective sleep onset latency (p = 0.01), reduced SWS (p < 0.001), and increased Stage 2 sleep (p < 0.001). Increased urinary aMt6 was correlated with reduced SWS (r = -0.51, p < 0.001). Circadian parameters derived from 24-hour plasma melatonin and CBT did not differ between conditions, except for an increased melatonin mesor in the intervention condition (p = 0.01). Ovarian hormones were comparable between the conditions (p ≥ 0.28). Symptoms improved in the intervention condition, as measured by the VAS-Mood (p = 0.02) and the PRISM (p < 0.001). These findings support a role for disturbed melatonergic system in PMDD that can be partially corrected by exogenous melatonin.

Intracellular thermometry uncovers spontaneous thermogenesis and associated thermal signaling

Conventional thermal biology has elucidated the physiological function of temperature homeostasis through spontaneous thermogenesis and responses to variations in environmental temperature in organisms. In addition to research on individual physiological phenomena, the molecular mechanisms of fever and physiological events such as temperature-dependent sex determination have been intensively addressed. Thermosensitive biomacromolecules such as heat shock proteins (HSPs) and transient receptor potential (TRP) channels were systematically identified, and their sophisticated functions were clarified. Complementarily, recent progress in intracellular thermometry has opened new research fields in thermal biology. High-resolution intracellular temperature mapping has uncovered thermogenic organelles, and the thermogenic functions of brown adipocytes were ascertained by the combination of intracellular thermometry and classic molecular biology. In addition, intracellular thermometry has introduced a new concept, "thermal signaling", in which temperature variation within biological cells acts as a signal in a cascade of intriguing biological events.

Menstrual phase-dependent differences in neurobehavioral performance: the role of temperature and the progesterone/estradiol ratio

STUDY OBJECTIVES

Women in the luteal phase of the menstrual cycle exhibit better cognitive performance overnight than women in the follicular phase, although the mechanism is unknown. Given the link between core body temperature (CBT) and performance, one potential mechanism is the thermoregulatory role of progesterone (P4), estradiol (E2), and their ratio (P4/E2), which change across the menstrual cycle. We examined the role of P4/E2 in modulating performance during extended wake in premenopausal women. Additionally, we compared the acute effects of nighttime light exposure on performance, CBT, and hormones between the menstrual phases.

METHODS

Participants were studied during a 50 h constant routine and a 6.5 h monochromatic nighttime light exposure. Participants were 16 healthy, naturally cycling women (eight follicular; eight luteal). Outcome measures included reaction time, attentional failures, self-reported sleepiness, CBT, melatonin, P4, and E2.

RESULTS

As compared to women in the luteal phase, women in the follicular phase exhibited worse performance overnight. CBT was significantly associated with performance, P4, and P4/E2 but not with other sex hormones. Sex hormones were not directly related to performance. Light exposure that suppressed melatonin improved performance in the follicular phase (n = 4 per group) to levels observed during the luteal phase and increased CBT but without concomitant changes in P4/E2.

CONCLUSIONS

Our results underscore the importance of considering menstrual phase when assessing cognitive performance during sleep loss in women and indicate that these changes are driven predominantly by CBT. Furthermore, this study shows that vulnerability to sleep loss during the follicular phase may be resolved by exposure to light.

Circadian rhythmicity of body temperature and metabolism

This article reviews the literature on the circadian rhythms of body temperature and whole-organism metabolism. The two rhythms are first described separately, each description preceded by a review of research methods. Both rhythms are generated endogenously but can be affected by exogenous factors. The relationship between the two rhythms is discussed next. In endothermic animals, modulation of metabolic activity can affect body temperature, but the rhythm of body temperature is not a mere side effect of the rhythm of metabolic thermogenesis associated with general activity. The circadian system modulates metabolic heat production to generate the body temperature rhythm, which challenges homeothermy but does not abolish it. Individual cells do not regulate their own temperature, but the relationship between circadian rhythms and metabolism at the cellular level is also discussed. Metabolism is both an output of and an input to the circadian clock, meaning that circadian rhythmicity and metabolism are intertwined in the cell.

Temperature regulation in women: Effects of the menstrual cycle

Core body temperature changes across the ovulatory menstrual cycle, such that it is 0.3°C to 0.7°C higher in the post-ovulatory luteal phase when progesterone is high compared with the pre-ovulatory follicular phase. This temperature difference, which is most evident during sleep or immediately upon waking before any activity, is used by women as a retrospective indicator of an ovulatory cycle. Here, we review both historical and current literature aimed at characterizing changes in core body temperature across the menstrual cycle, considering the assessment of the circadian rhythm of core body temperature and thermoregulatory responses to challenges, including heat and cold exposure, exercise, and fever. We discuss potential mechanisms for the thermogenic effect of progesterone and the temperature-lowering effect of estrogen, and discuss effects on body temperature of exogenous formulations of these hormones as contained in oral contraceptives. We review new wearable temperature sensors aimed at tracking daily temperature changes of women across multiple menstrual cycles and highlight the need for future research on the validity and reliability of these devices. Despite the change in core body temperature across the menstrual cycle being so well identified, there remain gaps in our current understanding, particularly about the underlying mechanisms and microcircuitry involved in the temperature changes.

The Dynamic and Correlation of Skin Temperature and Cardiorespiratory Fitness in Male Endurance Runners

During endurance exercise, skin temperature (Tsk) plays a fundamental role in thermoregulatory processes. Environmental temperature is the biggest determinant of the Tsk. During exercise, the response of the skin temperature might be influenced by aerobic fitness (VO_2peak). The aim of this study was to analyze and compare the dynamic of Tsk in high (HF) and moderately (MF) fit endurance runners during a progressive maximal stress test. Seventy-nine male endurance runners were classified into HF (n = 35; VO_2peak = 56.62 ± 4.31 mL/kg/min) and MF (n = 44; VO_2peak = 47.86 ± 5.29 mL/kg/min) groups. Tsk and cardiovascular data were continuously monitored during an incremental exercise, followed by a recovery period of five minutes. Results revealed that the MF group exhibited lower VO_2peak, Speed_peak, ventilation (VE), muscle mass %, and higher BMI and fat mass % than the HF group (all p < 0.001). HF had significantly higher Tsk at baseline, and at 60% and 70% of peak workload (all p < 0.05). Tsk_peak correlated with age, fat mass %, muscle mass %, VO_2peak, Speed_peak, HR and VE (all p < 0.05). These findings indicate that VO_2peak was positively associated with increased Tsk during incremental exercise in male endurance runners.

Gender and the circadian pattern of body temperature in normoxia and hypoxia

Circadian patterns are at the core of many physiological processes, and their disruption can have short- and long-term consequences. This essay focuses on one of the best known patterns, the daily oscillation of body temperature (Tb), and the possibility of its difference between genders. From human and animal studies globally considered, the tentative conclusion is reached that differences in Tb circadian pattern between genders are very small and probably limited to the timing of the rhythm, not to its amplitude. Such similarity between genders, despite the differences in hormonal systems, presumably testifies to the importance that the Tb circadian pattern plays in the economy of the organism and its survival against environmental challenges. The second part of the article presents some previously unpublished experimental data from behaving male and female rats during hypoxia in synchronized conditions. In adult rats hypoxia (10.5% O₂ for three days) caused a profound drop of the Tb daily oscillations; by day 3 they were 55% (♀) and 22% (♂) of the normoxic amplitudes, with a statistically significant gender difference. In pre-puberty rats (26-day old) hypoxia caused a major disruption of the circadian pattern qualitatively similar to the adults but not different between genders. Hence, on the basis of this preliminary set of data, it seems that sex-hormones may be a factor in how the Tb daily pattern responds to hypoxia. The implications of the effects of hypoxia on the circadian patterns, and the possibility that such effects may differ between genders, are matters that could have biological and clinical implications and deserve further investigations.

Core body temperature is not a reliable parameter to follow the reproductive cycle in female marmoset monkey (<i>Callithrix jacchus</i>)

Abstract. Marmosets represent an attractive and widely used animal species in biomedical research, and the routine monitoring of female reproductive cycles is often mandatory in the fields of reproductive biology and stem cell research. Today, the established method for the reliable detection of ovulation is the determination of progesterone concentrations from blood samples. This method is based on relatively frequent handling and blood collections; therefore, less invasive alternatives would help to reduce stress on the animals. Here, we investigated whether the core body temperature of marmosets would show a correlation with cycle-dependent hormonal fluctuations, as has been described for humans and other primate species. In particular, the objective was to investigate whether the telemetric recording of core body temperature could replace progesterone measurements as a reliable, less invasive method for the detection of ovulation in these animals. Here we show that the core body temperature parameters in female marmosets were characterized by frequent variations, but they were not related to particular days or phases during the reproductive cycle. Therefore, the recording of core body temperature in our controlled standard experimental setting is not an appropriate method to monitor the reproductive cycle in female marmosets, and cannot replace serum progesterone measurement as a state-of-the-art method.

Integration of biological clocks and rhythms

Animals, plants, and microorganisms exhibit numerous biological rhythms that are generated by numerous biological clocks. This article summarizes experimental data pertinent to the often-ignored issue of integration of multiple rhythms. Five contexts of integration are discussed: (i) integration of circadian rhythms of multiple processes within an individual organism, (ii) integration of biological rhythms operating in different time scales (such as tidal, daily, and seasonal), (iii) integration of rhythms across multiple species, (iv) integration of rhythms of different members of a species, and (v) integration of rhythmicity and physiological homeostasis. Understanding of these multiple rhythmic interactions is an important first step in the eventual thorough understanding of how organisms arrange their vital functions temporally within and without their bodies.

Diurnal and menstrual cycles in body temperature are regulated differently: a 28-day ambulatory study in healthy women with thermal discomfort of cold extremities and controls

Diurnal cycle variations in body-heat loss and heat production, and their resulting core body temperature (CBT), are relatively well investigated; however, little is known about their variations across the menstrual cycle under ambulatory conditions. The main purpose of this study was to determine whether menstrual cycle variations in distal and proximal skin temperatures exhibit similar patterns to those of diurnal variations, with lower internal heat conductance when CBT is high, i.e. during the luteal phase. Furthermore, we tested these relationships in two groups of women, with and without thermal discomfort of cold extremities (TDCE). In total, 19 healthy eumenorrheic women with regular menstrual cycles (28-32 days), 9 with habitual TDCE (ages 29 ± 1.5 year; BMI 20.1 ± 0.4) and 10 controls without these symptoms (CON: aged 27 ± 0.8 year; BMI 22.7 ± 0.6; p < 0.004 different to TDCE) took part in the study. Twenty-eight days continuous ambulatory skin temperature measurements of distal (mean of hands and feet) and proximal (mean of sternum and infraclavicular regions) skin regions, thighs, and calves were carried out under real-life, ambulatory conditions (i-Buttons® skin probes, sampling rate: 2.5 min). The distal minus proximal skin temperature gradient (DPG) provided a valuable measure for heat redistribution from the core to the shell, and, hence, for internal heat conduction. Additionally, basal body temperature was measured sublingually directly after waking up in bed. Mean diurnal amplitudes in skin temperatures increased from proximal to distal skin regions and the 24-h mean values were inversely related. TDCE compared to CON showed significantly lower hand skin temperatures and DPG during daytime. However, menstrual cycle phase did not modify these diurnal patterns, indicating that menstrual and diurnal cycle variations in skin temperatures reveal additive effects. Most striking was the finding that all measured skin temperatures, together with basal body temperature, revealed a similar menstrual cycle variation (independent of BMI), with highest and lowest values during the luteal and follicular phases, respectively. These findings lead to the conclusion that in contrast to diurnal cycle, variations in CBT variation across the menstrual cycle cannot be explained by changes in internal heat conduction under ambulatory conditions. Although no measurements of metabolic heat production were carried out increased metabolic heat generation during the luteal phase seems to be the most plausible explanation for similar body temperature increases.

Women and the DSM-5: a clinician's response to the question of invisibility

Diagnosis of psychiatric conditions is a topic that is currently receiving significant attention in light of the release of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders in 2013. The process of the revisions is complex and involves political, social, and economic influences, all of which are amplified in an evolving corporate health care system in the United States. Of particular concern in the development of the revised nosology is the representation of gender-specific diagnoses and course specifiers to reflect the distinct manifestations of the psychiatric symptoms of women. Based on a growing body of psychobiological evidence related to gender differences in symptom manifestation, gender specific diagnoses remain palpably absent from the taxonomy. This article explores the issue of invisibility of women-specific diagnosis from the perspective of a women's health advanced practice nurse.

Sex differences in phase angle of entrainment and melatonin amplitude in humans

Studies of sex differences in the timing of human circadian rhythms have reported conflicting results. This may be because the studies conducted to date have not controlled for the masking effects of the rest activity cycle on the circadian rhythms being assessed. In the present analysis of data collected under controlled conditions, we examined sex differences in the timing of circadian rhythms while minimizing masking from behavioral and environmental factors using a constant routine (CR) protocol. All participants (28 women and 28 men paired by habitual wake time; age range, 18 30 years) maintained a regular self selected sleep wake schedule at home prior to the study. After 3 baseline days in the laboratory, participants began a CR. Women were found to have a significantly higher melatonin amplitude and lower temperature amplitude than men. While sleep timing was the same between the 2 groups, the timing of the circadian rhythms of core body temperature and pineal melatonin secretion was earlier relative to sleep time in women as compared to men. Sleep therefore occurred at a later biological time for women than men, despite being at the same clock time. Given that sleep propensity and structure vary with circadian phase and are impacted by circulating melatonin, these findings may have important implications for understanding sex differences in sleep timing and duration, diurnal preference, and the prevalence of sleep disorders such as insomnia.

Gender differences in the circadian rhythms of rhesus monkeys

Studies investigating gender differences in human circadian rhythms report equivocal results. In addition, many of these studies have been limited to examination of one circadian variable. This study examined gender differences in circadian rhythms of multiple physiological variables of rhesus monkeys under highly controlled conditions. Under general anesthesia, eight female and seven male rhesus were implanted with a biotelemetry transmitter to measure body temperature (T(b)) and heart rate. An external accelerometer was used to measure physical activity. The Psychomotor Task System (PTS) provided environmental enrichment and delivered a pelletized diet and water was available ad libitum. Data were collected continuously under LD 16:8 for a minimum of 31days. Mean, phase and amplitude of each rhythm were calculated and compared between genders. Although there were no significant differences between genders in mean or amplitude, circadian rhythms in females were significantly delayed compared to males in all variables (p range 0.001 to 0.030). The consistent pattern of delay suggests that a fundamental gender difference may be present in the circadian timing system. Mechanisms underlying this difference require further exploration.

Circadian variation of sleep during the follicular and luteal phases of the menstrual cycle

STUDY OBJECTIVES

Women experience insomnia more frequently than men. Menstrual cycle changes in reproductive hormones and circadian rhythms may contribute to sleep disruptions. Our aim, therefore, was to clarify the interaction between menstrual and circadian processes as it affects sleep.

DESIGN

Participants entered the laboratory during the mid-follicular (MF) and mid-luteal (ML) phases of their menstrual cycle for an ultra-rapid sleep-wake cycle (URSW) procedure, consisting of 36 cycles of 60-min wake episodes alternating with 60-min nap opportunities. This procedure concluded with an ad libitum nap episode.

SETTING

Time-isolation suite.

PARTICIPANTS

Eight unmedicated, physically and mentally healthy females with regular ovulatory menstrual cycles.

INTERVENTIONS

N/A.

MEASUREMENTS

Polysomnographic sleep from nocturnal sleep episodes and 60-min naps; subjective alertness; core body temperature (CBT); salivary melatonin; urinary estradiol; and urinary progesterone.

RESULTS

Increased CBT values at night and decreased CBT amplitude were observed during ML compared to MF. Circadian phase of CBT and the circadian melatonin profile were unaffected by menstrual phase. All analyzed sleep parameters showed a circadian variation throughout the URSW procedure, with no menstrual phase differences observed for most, including slow wave sleep (SWS). The circadian variation of REM sleep duration, however, was sensitive to menstrual phase, with reduced REM sleep during ML at circadian phase 0 degrees and 30 degrees.

CONCLUSIONS

Moderate but significant changes in REM sleep across the menstrual and circadian cycles were observed. These results support an interaction between circadian and menstrual processes in the regulation of REM sleep.

Sleep, Hormones, and Circadian Rhythms throughout the Menstrual Cycle in Healthy Women and Women with Premenstrual Dysphoric Disorder

A relationship exists between the sleep-wake cycle and hormone secretion, which, in women, is further modulated by the menstrual cycle. This interaction can influence sleep across the menstrual cycle in healthy women and in women with premenstrual dysphoric disorder (PMDD), who experience specific alterations of circadian rhythms during their symptomatic luteal phase along with sleep disturbances during this time. This review will address the variation of sleep at different menstrual phases in healthy and PMDD women, as well as changes in circadian rhythms, with an emphasis on their relationship with female sex hormones. It will conclude with a brief discussion on nonpharmacological treatments of PMDD which use chronotherapeutic methods to realign circadian rhythms as a means of improving sleep and mood in these women.

Circadian Components in Energy and Tension and Their Relation to Physiological Activation and Performance

The purpose of the study was to examine validity of R. Thayer's activation model regarding 24h variations of two subjective dimensions of activation (Energy and Tension), and their 24 h relations with indices of physiological activation and performance efficiency. The participants of the study (n = 28 females) spent 26 h under controlled laboratory conditions. Self-ratings of subjective activation and measurements of oral temperature, electrodermal activity, and performance on a visual vigilance task were done every 4 h. Twenty-four-hour variations were examined by means of repeated measures analyses of variance and by group mean cosinor analyses before and after controlling for the data trends. Self-ratings on both dimensions of subjective activation showed significant 24 h variation. Energy showed both nonrhythmic and endogenously determined circadian variation, while 24h variation of tension was dominantly nonrhythmic and most probably determined by exogenous factors. Significant 24 h covariation was found between energy and body temperature. A negative correlation between 24 h variation of energy and tension was also found. Considering low and intermediate levels of subjective activation established over the 24 h in this study, the association of the two dimensions of subjective activation did not prove to be consistent with the assumptions of Thayer's model.

HMM-based estimation of menstrual cycle from skin temperature during sleep

An HMM-based method is proposed to estimate biphasic property in female menstrual cycle. A tiny device is developed to measure skin temperature change during sleep. Data are collected from 30 female participants for 6 months. Raw data are preprocessed to remove obvious outliers and clamped between 34 and 42 degree Celsius. A two hidden states HMM-based algorithm was applied to estimate the biphasic property in menstrual cycle. The results showed that the number of correctly detected menstrual cycle is 159 among 173 in 30 participants during 6 months. Overall sensitivity reaches 92.0%.

Organizational influence of the postnatal testosterone surge on the circadian rhythm of core body temperature of adult male rats

The suprachiasmatic nucleus (SCN) of the hypothalamus coordinates physiological and behavioral circadian rhythms such as activity, body temperature, and hormone secretion. Circadian rhythms coordinated by the SCN often show sex differences arising from both organizational and activational effects of gonadal hormones. In males, little is known about the organizational role of testosterone on the circadian regulation of core body temperature (CBT) in adulthood. To explore this, we castrated or sham-operated male rats on the day of birth, and at 4 months of age, implanted them with transmitters that measured CBT rhythms under a 12:12 light/dark cycle. This study revealed a significantly earlier rise in CBT during the light phase in neonatally castrated males. Subsequently, we found that treating neonatally castrated males with testosterone propionate (TP) in adulthood did not reverse the effect of neonatal castration, thus indicating an organizational role for testosterone. In contrast, a single injection of TP at the time of neonatal surgery, to mimic the postnatal surge of testosterone, coupled with TP treatment in adulthood, normalized the circadian rise in CBT. In a final study we examined CBT circadian rhythms in intact adult male and female rats and detected no differences in the rise of CBT during the light phase, although there was a greater overall elevation in female CBT. Together, results of these studies reveal an early organizational role of testosterone in males on the timing of the circadian rise of CBT, a difference that does not appear to reflect "defeminization".

Cosinor analysis for temperature time series data of long duration

The application of cosinor models to long time series requires special attention. With increasing length of the time series, the presence of noise and drifts in rhythm parameters from cycle to cycle lead to rapid deterioration of cosinor models. The sensitivity of amplitude and model-fit to the data length is demonstrated for body temperature data from ambulatory menstrual cycling and menopausal women and from ambulatory male swine. It follows that amplitude comparisons between studies cannot be made independent of consideration of the data length. Cosinor analysis may be carried out on serial-sections of the series for improved model-fit and for tracking changes in rhythm parameters. Noise and drift reduction can also be achieved by folding the series onto a single cycle, which leads to substantial gains in the model-fit but lowers the amplitude. Central values of model parameters are negligibly changed by consideration of the autoregressive nature of residuals.

Circadian rhythms and sleep patterns in urban Greek couples

A convenience sample of 14 adults (seven couples) who intentionally nap regularly was recruited to describe circadian rhythms and sleep patterns in a culture in which afternoon naps are routine. Participants wore a wrist actigraph for 48 hr during May to obtain two peaks and troughs of activity data. Peak activity, estimated by cosinor analysis (acrophase), occurred at 1542 hours for men and at 1600 hours for women. Compared to their male partners, women had a later acrophase and a significantly stronger 24-hr rhythm, despite similar nap and nighttime sleep schedules. Men had more awakenings during the night and slightly shorter naps than did women. For the 24-hr period, men averaged 6.8 +/- 1.0 hr of sleep and women averaged 7.4 +/- 1.1 hr. Results indicate that Greek adults delay sleep onset at night and awaken early in the morning. Among this small group, naps are an accepted cultural behavior.

Circadian rhythms, sleep, and the menstrual cycle

Women with ovulatory menstrual cycles have a circadian rhythm superimposed on the menstrual-associated rhythm; in turn, menstrual events affect the circadian rhythm. In this paper, we review circadian rhythms in temperature, selected hormone profiles, and sleep-wake behavior in healthy women at different phases of the menstrual cycle. The effects on menstrual cycle rhythmicity of disrupted circadian rhythms, for example, with shiftwork and altered circadian rhythms in women with menstrual-related mood disturbances, are discussed. Compared to the follicular phase, in the post-ovulation luteal phase, body temperature is elevated, but the amplitude of the temperature rhythm is reduced. Evidence indicates that the amplitude of other rhythms, such as melatonin and cortisol, may also be blunted in the luteal phase. Subjective sleep quality is lowest around menses, but the timing and composition of sleep remains relatively stable across the menstrual cycle in healthy women, apart from an increase in spindle frequency activity and a minor decrease in rapid eye movement (REM) sleep during the luteal phase. Disruption of circadian rhythms is associated with disturbances in menstrual function. Female shiftworkers compared to non-shiftworkers are more likely to report menstrual irregularity and longer menstrual cycles. There also is accumulating evidence that circadian disruption increases the risk of breast cancer in women, possibly due to altered light exposure and reduced melatonin secretion. Further investigations into the biological consequences of circadian disruption in women will offer insight into some menstrual-associated disorders, including mood changes, as well as reproductive function and possible links with breast cancer.

Assessment of circadian rhythms throughout the menstrual cycle of female rhesus monkeys

Reproductive cyclicity has a significant influence on the regulation of circadian rhythms in rodents. Studies have suggested that there are changes in body temperature rhythms between the follicular and luteal phases in human females. This study examined the effects of menstrual cyclicity on physiological and behavioral circadian rhythms in female rhesus monkeys (Macaca mulatta), an acknowledged biomedical model. Seven unrestrained subjects were implanted with a biotelemetry transmitter to measure body temperature and heart rate and an accelerometer was used to measure physical activity. Water was available ad libitum and drinking was measured via an electronic circuit attached to a water lixit. A video-based task system, the Psychomotor Test System, provided environmental enrichment and delivered a pelletized diet. Mean, phase, and amplitude of each rhythm were calculated. Estrogen and progesterone conjugates were assayed and quantified from daily urine samples to identify follicular and luteal phases of the menstrual cycle. Average circadian variables were then compared between these phases. Heart rate was significantly (P< or =0.05) delayed in the luteal phase. Albeit non-significant, analysis showed a trend toward decreased circadian amplitude of body temperature in the luteal phase.

Sleep, rhythms and women's mood. Part I. Menstrual cycle, pregnancy and postpartum

This review summarizes studies of sleep and other biological rhythms during the menstrual cycle, pregnancy and the postpartum period, focusing, where feasible, on studies in women who met DSM-IV (Diagnostic and Statistical Manual for Mental Disorders, 4th edition) criteria for a depressive disorder compared with healthy controls. The aim was to review supporting evidence for the hypothesis that disruption of the normal temporal relationship between sleep and other biological rhythms such as melatonin, core body temperature, cortisol, thyroid stimulating hormone (TSH) or prolactin occurring during times of reproductive hormonal change precipitates depressive disorders in predisposed women. Treatment strategies, designed to correct these altered phase (timing) or amplitude abnormalities, thereby improve mood. Although there may be some common features to premenstrual, pregnancy and postpartum depressive disorders (e.g. elevated prolactin levels), a specific profile of sleep and biological rhythms distinguishes healthy from depressed women during each reproductive epoch. Further work is needed to characterize more fully the particular abnormalities associated with each reproductive state to identify common versus distinctive features for each diagnostic group. This information could serve as the basis for developing more targeted treatment strategies.

Effects of light therapy on sleep, mood, and temperature in women with nonseasonal major depression

Research has supported the applicability and efficacy of light therapy in the treatment of nonseasonal depression. The investigators examined the effects of light therapy on sleep, core temperature, depressed mood, and perception of fatigue and energy in a sample of pre-menopausal and post-menopausal women diagnosed with nonseasonal, nonbipolar depression. Women were randomly assigned to either light therapy (n = 16) or placebo (n = 13) for a 28-day period. Pre and post measures of sleep and core temperature were collected. In addition, measures of depressed mood, fatigue, and energy were collected throughout the study period. Significant changes in depression and energy were found in the treatment group, but not in the placebo group. There was a significant reduction in the temperature mesor and less wake time during the first third of the sleep period in the treatment group but not in the placebo group. Light therapy yielded significant improvement in depression when compared with placebo intervention and core temperature mesor returned to normal. There was no significant phase shift, perhaps due in part to the absence of any baseline circadian phase disturbances. Relationships between temperature, sleep, depressed mood, fatigue, and energy variables offer potential directions for future research and clinical intervention.

Menstrual factors in sleep

The changing endocrine profile in premenopausal women alters aspects of sleep and circadian rhythms. Subjectively women appear to feel a greater need for sleep and report poor and insufficient sleep more often than men. This greater sleep requirement may manifest with a higher amplitude of slow-wave sleep in the EEG in women. Healthy young women, with biphasic body temperature rhythms of ovulatory menstrual cycles, have more stage 2 sleep, higher spindle frequency activity and less rapid-eye movement (REM) sleep when progesterone predominates in the luteal phase. These sleep-EEG changes may largely be caused by neurosteroids acting on the brain. Sleep regulatory mechanisms, indicated by the onset to sleep, slow-wave sleep (SWS) and slow-wave activity, appear to be unaffected by menstrual phase in women with normal cycles. Women with premenstrual mood symptoms have more stage 2 sleep and seemingly less SWS and REM sleep, a blunted circadian rhythm of melatonin and an earlier minimum body temperature than asymptomatic women. Subjective repercussions include increased daytime sleepiness, lethargy and fatigue. Treatment strategies for menstrual-associated complaints include using oral contraceptives and sleep deprivation but the physiology and pharmacology of normal menstrual changes, the disorders and their treatment need to be better understood.

Women's sleep in health and disease

A huge amount of knowledge about sleep has accumulated during the last 5 decades following the discovery of rapid eye movement (REM) sleep. Nevertheless, there are numerous areas of considerable ignorance. One of these concerns the particularities of sleep in women. Most basic and clinical studies have been performed in male subjects, and only very recently research groups around the world have addressed women's sleep in health and disease. In this review, we summarize the present knowledge on the influence of oestrogens on the brain and on the distinctive changes of sleep across the menstrual cycle, during pregnancy and menopause. In addition, studies in female rodents are reviewed as well as the knowledge on female peculiarities regarding the interactions between sleep regulation and age-related changes in circadian rhythms. We also address specific aspects of sleep loss and sleep disorders in women. Finally, very recent studies on the sociology of sleep are summarized and future directions in the field are discussed.

Long-term rectal temperature measurements in a patient with menstrual-associated sleep disorder

The international classification of sleep disorders has proposed menstrual-associated sleep disorder. However, few studies have investigated its pathophysiological mechanism. A 34-year-old woman complaining of insomnia in the late luteal phase underwent continuous rectal temperature measurements and simultaneous actigraphic monitoring for 146 days. The acrophase of rectal temperature rhythm was delayed in the luteal phase, compared with that in the follicular phase. Her bedtime and risetime did not differ across the menstrual cycle. These results suggest that her insomnia in the luteal phase may have been a consequence of desynchronization between her temperature rhythm and sleep phase in the luteal phase.

Regulation of the 24h body temperature rhythm of women in luteal phase: role of gonadal steroids and prostaglandins

An investigation into whether the rise in the 24h body temperature rhythm observed in the luteal menstrual phase is antagonized by the administration of prostaglandin synthesis inhibitors has been made. Intravaginal body temperature was monitored continuously for 24h, once in the follicular and twice in the luteal phase. In the luteal phase, women were studied both without and with the simultaneous administration of a prostaglandin synthesis inhibitor (lysine acetylsalicylate; 1.8 g every 6 h orally). The progesterone/estradiol ratio (measured at 17:00h each day) was related to mesor (r = 0.825; P < 0.001), acrophase (r = 0.682; P < 0.02), and amplitude (r = -0.731; P < 0.001) of the 24h body temperature rhythm. Luteal phase elevation of the progesterone/estradiol ratio was associated with a 0.32 +/- 0.07 degrees C increase in mesor (P < 0.01), a 0.11 +/- 0.02 degrees C decrease in amplitude (P < 0.001), and a 34.8 +/- 11.6 min delay in acrophase (P < 0.03) of the 24h body temperature rhythm. Prostaglandin synthesis inhibitors did not counteract these modifications. The present data shows that the modifications of the circadian parameters of the 24h body temperature rhythm observed during the luteal phase of the menstrual cycle are strictly related to modifications of the progesterone/estradiol ratio, and presumably independent of prostaglandin synthesis.

Acetaminophen does not affect 24-h body temperature or sleep in the luteal phase of the menstrual cycle

Body temperature and sleep change in association with increased progesterone in the luteal phase of the menstrual cycle in young women. The mechanism by which progesterone raises body temperature is not known but may involve prostaglandins, inducing a thermoregulatory adjustment similar to that of fever. Prostaglandins also are involved in sleep regulation and potentially could mediate changes in sleep during the menstrual cycle. We investigated the possible role of central prostaglandins in mediating menstrual-associated 24-h temperature and sleep changes by inhibiting prostaglandin synthesis with a therapeutic dose of the centrally acting cyclooxygenase inhibitor acetaminophen in the luteal and follicular phases of the menstrual cycle in young women. Body temperature was raised, and nocturnal amplitude was blunted, in the luteal phase compared with the follicular phase. Acetaminophen had no effect on the body temperature profile in either menstrual cycle phase. Prostaglandins, therefore, are unlikely to mediate the upward shift of body temperature in the luteal phase. Sleep changed during the menstrual cycle: on the placebo night in the luteal phase the women had less rapid eye movement sleep and more slow-wave sleep than in the follicular phase. Acetaminophen did not alter sleep architecture or subjective sleep quality. Prostaglandin inhibition with acetaminophen, therefore, had no effect on the increase in body temperature or on sleep in the midluteal phase of the menstrual cycle in young women, making it unlikely that central prostaglandin synthesis underlies these luteal events.

Sleep and 24 hour body temperatures: a comparison in young men, naturally cycling women and women taking hormonal contraceptives

Body temperature has a circadian rhythm, and in women with ovulatory cycles, also a menstrual rhythm. Body temperature and sleep are believed to be closely coupled, but the influence on their relationship of gender, menstrual cycle phase and female reproductive hormones is unresolved. We investigated sleep and 24 h rectal temperatures in eight women with normal menstrual cycles in their mid-follicular and mid-luteal phases, and in eight young women taking a steady dose of oral progestin and ethinyl oestradiol (hormonal contraceptive), and compared their sleep and body temperatures with that of eight young men, sleeping in identical conditions. All subjects maintained their habitual daytime schedules. Rectal temperatures were elevated throughout 24 h in the luteal phase compared with the follicular phase in the naturally cycling women, consistent with a raised thermoregulatory set-point. Rectal temperatures in the women taking hormonal contraceptives were similar to those of the naturally cycling women in the luteal phase. Gender influenced body temperature: the naturally cycling women and the women taking hormonal contraceptives attained their nocturnal minimum body temperatures earlier than the men, and the naturally cycling women had blunted nocturnal body temperature drops compared with the men. Sleep architecture was essentially unaffected by either menstrual cycle phase or gender. The women taking hormonal contraceptives had less slow wave sleep (SWS), however, than the naturally cycling women. Gender, menstrual cycle phase and hormonal contraceptives significantly influenced body temperature, but had only minor consequences for sleep, in the young men and women in our study.

Diurnal fluctuation of sleep propensity and hormonal secretion across the menstrual cycle

BACKGROUND

The fact that most women experience sleep changes across the menstrual cycle is thought to be associated with changes in circadian rhythms; however, few studies have investigated this relationship.

METHODS

We applied an ultrashort sleep-wake schedule to eight healthy women and studied diurnal fluctuations in sleep propensity, sleepiness, rectal temperature, and serum concentrations of melatonin, thyroid-stimulating hormone, and cortisol in the follicular and luteal phases.

RESULTS

In the luteal phase, amplitude of core body temperature, total melatonin secretions, and amplitudes of TSH and cortisol rhythms were significantly decreased, whereas sleepiness and occurrence of slow-wave sleep during the daytime were significantly increased. Differences in the amount of daytime slow-wave sleep across the menstrual cycle were positively correlated with differences in the daily mean rectal temperature.

CONCLUSIONS

The findings suggest that the amplitude of circadian oscillation may be dampened in the luteal phase. Increased daytime sleepiness in the luteal phase may be associated with increased daytime slow-wave sleep, due possibly to changes in thermoregulation in the luteal phase.

Circadian rhythm changes in core temperature over the menstrual cycle: method for noninvasive monitoring

The purpose of this study was to determine whether core temperature (T(c)) telemetry could be used in ambulatory women to track changes in the circadian T(c) rhythm during different phases of the menstrual cycle and, more specifically, to detect impending ovulation. T(c) was measured in four women who ingested a series of disposable temperature sensors. Data were collected each minute for 2-7 days and analyzed in 36-h segments by automated cosinor analysis to determine the mesor (mean temperature), amplitude, period, acrophase (time of peak temperature), and predicted circadian minimum core temperature (T(c-min)) for each cycle. The T(c) mesor was higher (P < or = 0.001) in the luteal (L) phase (37.39 +/-0.13 degrees C) and lower in the preovulatory (P) phase (36.91 +/-0.11 degrees C) compared with the follicular (F) phase (37.08 +/-0.13 degrees C). The predicted T(c-min) was also greater in L (37.06 +/- 0.14 degrees C) than in menses (M; 36.69 +/- 0.13 degrees C), F (36. 6 +/- 0.16 degrees C), and P (36.38 +/- 0.08 degrees C) (P < or = 0. 0001). During P, the predicted T(c-min) was significantly decreased compared with M and F (P < or = 0.0001). The amplitude of the T(c) rhythm was significantly reduced in L compared with all other phases (P < or = 0.005). Neither the period nor acrophase was affected by menstrual cycle phase in ambulatory subjects. The use of an ingestible temperature sensor in conjunction with fast and accurate cosinor analysis provides a noninvasive method to mark menstrual phases, including the critical preovulatory period.

Acute effects of bright light and caffeine on nighttime melatonin and temperature levels in women taking and not taking oral contraceptives

Caffeine and bright light effects on nighttime melatonin and temperature levels in women were tested during the luteal phase of the menstrual cycle (n=30) or the pseudo luteal phase for oral contraceptive users (n=32). Participants were randomly assigned to receive either bright (5000 lux) or dim room light (<88 lux) between 20:00 and 08:00 h under a modified constant routine protocol. Half the subjects in each lighting condition were administered either caffeine (100 mg) or placebo in a double-blind manner at 20:00, 23:00, 02:00 and 05:00 h. Results showed that the combination of bright light and caffeine enhanced nighttime temperature levels to a greater extent than did either caffeine or bright light alone. Both of the latter groups had higher temperature levels relative to the dim light placebo condition and the two groups did not differ. Temperature levels in the bright light caffeine condition were maintained at near peak circadian levels the entire night in the luteal and pseudo luteal phase. Melatonin levels were reduced throughout the duration of bright light exposure for all women. Caffeine reduced the onset of melatonin levels for women in the luteal phase, but it had little effect on melatonin levels for oral contraceptive users. The results for women in the luteal phase of the menstrual cycle are consistent with our previous findings in men. The results also suggest that oral contraceptives may alter the effects of caffeine on nighttime melatonin levels.

Individual differences in the phase and amplitude of the human circadian temperature rhythm: with an emphasis on morningness-eveningness

We studied the relationship between the phase and the amplitude of the circadian temperature rhythm using questionnaires that measure individual differences in personality variables, variables that relate to circadian rhythms, age and sex. The ambulatory core body temperature of 101 young men and 71 young women was recorded continuously over 6 days. The temperature minimum (Tmin) and amplitude (Tamp) were derived by fitting a complex cosine curve to each day's data for each subject. Participants completed the Horne-Ostberg Morningness-Eveningness Questionnaire (MEQ), the Circadian Type Inventory (CTI) and the MMPI-2, scored for the Psychopathology-5 (PSY-5) personality variables. We found that the average Tmin occurred at 03.50 h for morning-types (M-types), 05.02 h for the neither-types and 06.01 h for evening-types (E-types). Figures were presented that could provide an estimate of Tmin given an individual's morningness-eveningness score or weekend wake time. The Tmin occurred at approximately the middle of the 8-h sleep period, but it occurred closer to wake in subjects with later Tmin values and increasing eveningness. In other words, E-types slept on an earlier part of their temperature cycle than M-types. This difference in the phase-relationship between temperature and sleep may explain why E-types are more alert at bedtime and sleepier after waking than M-types. The Tmin occurred about a half-hour later for men than women. Another interesting finding included an association between circadian rhythm temperature phase and amplitude, in that subjects with more delayed phases had larger amplitudes. The greater amplitude was due to lower nocturnal temperature.

Effects of menstrual cycle phase and oral contraceptives on alertness, cognitive performance, and circadian rhythms during sleep deprivation

The influence of menstrual cycle phase and oral contraceptive use on neurobehavioral function and circadian rhythms were studied in healthy young women (n = 25) using a modified constant routine procedure during 24 h of sleep deprivation. Alertness and performance worsened across sleep deprivation and also varied with circadian phase. Entrained circadian rhythms of melatonin and body temperature were evident in women regardless of menstrual phase or oral contraceptive use. No significant difference in melatonin levels, duration, or phase was observed between women in the luteal and follicular phases, whereas oral contraceptives appeared to increase melatonin levels. Temperature levels were higher in the luteal phase and in oral contraceptive users compared to women in the follicular phase. Alertness on the maintenance of wakefulness test and some tests of cognitive performance were poorest for women in the follicular phase especially near the circadian trough of body temperature. These observations suggest that hormonal changes associated with the menstrual cycle and the use of oral contraceptives contribute to changes in nighttime waking neurobehavioral function and temperature level whereas these factors do not appear to affect circadian phase.

Regulation of the 24-hour rhythm of body temperature in menstrual cycles with spontaneous and gonadotropin-induced ovulation

OBJECTIVE

To investigate the relation between gonadal steroids and the 24-hour body temperature rhythm.

PATIENT(S)

Nineteen normally cycling women.

DESIGN

Controlled clinical study in volunteer women.

SETTING

Clinical hospital.

INTERVENTION(S)

Eleven women were studied in the early follicular and luteal menstrual phases of cycles with spontaneous ovulation, and 8 women were studied in the early follicular, preovulatory, and luteal phases of cycles with multiple follicular development.

MAIN OUTCOME MEASURE(S)

Starting at 5:00 P.M., intravaginal body temperature was monitored continuously for 24 hours and its values were related to E2 and P levels.

RESULT(S)

Twenty-four-hour body temperature rhythm parameters were related to the P:E2 ratio. Very low P:E2 ratios in the preovulatory phase were associated with a reduced 24-hour mean and an elevated body temperature rhythm amplitude. The progressive increase in the P:E2 ratio in the early follicular and luteal phases was associated with an increase in the 24-hour mean body temperature and a decrease in the rhythm amplitude. Body temperature differences between the luteal and early follicular phases were less pronounced in cycles with multiple follicular development.

CONCLUSION(S)

A woman's body temperature is related to her P:E2 ratio. Even in the presence of elevated P values, alterations of this ratio may influence negatively the postovulatory rise in body temperature.

Influences of melatonin on human circadian rhythms

Administration of melatonin is useful in the treatment of desynchronized conditions. The mechanisms through which melatonin exerts its effect are not completely clear. Melatonin exerts direct effects on several biological functions, such as the regulation of body temperature, but there is no proof that these actions are important in the indirect regulation of main pacemaker activity. By contrast, it is very likely that melatonin exerts direct effects on circadian clocks, and that depending on the time of its administration/presence, it antagonizes or promotes the phase-shifting effects exerted by light. It is possible that melatonin regulates its own secretion and that its prolonged or shortened secretion in the period of the night-day transition is responsible for the lengthening or shortening, respectively, of the nocturnal melatonin rise. This possibility that needs to be confirmed by extensive studies may represent a physiological mechanism through which photoperiodic information is more rapidly and efficiently transformed by melatonin in a circadian signal to all the body.

Temperature circadian rhythms during the menstrual cycle and sleep deprivation in premenstrual dysphoric disorder and normal comparison subjects

The aim of this study was to test the hypothesis that the circadian rhythm of core body temperature is altered in premenstrual dysphoric disorder (PMDD) subjects compared to that in normal comparison (NC) subjects and that it is normalized in PMDD subjects after treatment with early night partial sleep deprivation (ESD) or late night partial sleep deprivation (LSD). A total of 23 subjects meeting DSM-IV criteria for PMDD and 18 NC subjects had 24-h core body temperature recordings taken during the following conditions: (1) baseline midfollicular (preovulatory) and (2) late luteal (postovulatory) menstrual cycle phases and after a randomized crossover trial in subsequent luteal phases of (3) ESD, in which subjects slept from 03:00 to 07:00 h, followed by (4) a night of recovery sleep (ESD-R: sleep 22:30 to 06:30 h), and (5) LSD, in which subjects slept from 21:00 to 01:00 h, also followed by (6) a night of recovery sleep (LSD-R: sleep 22:30 to 06:30 h). Temperature amplitudes were significantly decreased in the luteal phase compared to those in the follicular menstrual cycle phase and increased after nights of recovery sleep. Compared to the baseline late luteal phase, during LSD, temperature amplitude increased in PMDD subjects but decreased in NC subjects. During ESD, the temperature acrophase was delayed in PMDD subjects but was advanced in NC subjects; during LSD, the temperature acrophase was advanced in PMDD subjects but was delayed in NC subjects compared to the late luteal baseline. Nocturnal temperature and temperature maxima and mesors tended to be higher in PMDD subjects than in NC subjects; when not reduced during sleep deprivation interventions, these were not associated with therapeutic effects. Alterations in both phase and amplitude of temperature circadian rhythms characterize PMDD subjects as contrasted with NC subjects in response to sleep deprivation. The changes in phase reflected more shifts in temperature acrophase in response to shifts in sleep in PMDD subjects. This realignment of the timing of sleep and temperature in addition to the enhancement of blunted amplitude rhythms during recovery nights of sleep may provide corrective mechanisms that contribute to the therapeutic effects of sleep deprivation.