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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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Rodrigues R, Jing A, Anderson KK, Alonzo R, Wilk P, Reid GJ, Gilliland J, Zou G, Nicholson K, Guaiana G, Stranges S. Who sleeps well in Canada? The social determinants of sleep health among middle-aged and older adults in the Canadian Longitudinal Study on Aging. Sleep Health 2024; 10:104-113. [PMID: 37977986 DOI: 10.1016/j.sleh.2023.09.015] [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: 02/21/2023] [Revised: 09/25/2023] [Accepted: 09/30/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Sleep health inequities likely contribute to disparities in health outcomes. Our objective was to identify social determinants of sleep health among middle-aged/older adults in Canada, where prior evidence is limited. METHODS We analyzed cross-sectional data from the Canadian Longitudinal Study on Aging, a survey of over 30,000 community-dwelling adults aged 45-85years. Self-reported measures included sleep duration, sleep satisfaction, and sleep efficiency. We explored associations between sleep measures and social determinants of health. We used modified Poisson regression to estimate prevalence ratios for sleep satisfaction and sleep efficiency, and linear regression for sleep duration. Estimates were adjusted for all social, lifestyle, and clinical covariates. We explored effect modification by sex. RESULTS Of the 11 social determinants explored, all were significantly associated with at least one domain of sleep health. These associations were reduced to 9 variables with adjustment for all social variables, and 7 with further adjustment for lifestyle and clinical covariates, including differences by sex, age, education, marital status, employment, race/ethnicity, and sexual orientation. Better sleep health in >1 domain was observed among males, older age groups (65 and older), higher income groups, the retired group, and homeowners with adjustment for social variables, and only in males and older age groups with additional adjustment for lifestyle and clinical variables. Only sleep duration associations were modified by sex. CONCLUSIONS Sleep health disparities among Canadian adults exist across socioeconomic gradients and racial/ethnic minority groups. Poor sleep health among disadvantaged groups warrants increased attention as a public health problem in Canada.
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Affiliation(s)
- Rebecca Rodrigues
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Amy Jing
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Kelly K Anderson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Rea Alonzo
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Piotr Wilk
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Paediatrics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Graham J Reid
- Department of Paediatrics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Psychology, Western University, London, Ontario, Canada; Robarts Research Institute, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada
| | - Jason Gilliland
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Paediatrics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Geography and Environment, Western University, London, Ontario, Canada; School of Health Studies, Western University, London, Ontario, Canada; Human Environments Analysis Laboratory, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada
| | - Guangyong Zou
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Robarts Research Institute, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Kathryn Nicholson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Giuseppe Guaiana
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg.
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3
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Yadollahi P, Mavaddatnia S, Zarshenas M, Ghaemmaghami P. Relationship between sleep quality and marital satisfaction of working women during the premenopausal period. Sci Rep 2024; 14:1248. [PMID: 38218900 PMCID: PMC10787744 DOI: 10.1038/s41598-024-51440-w] [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: 07/01/2023] [Accepted: 01/04/2024] [Indexed: 01/15/2024] Open
Abstract
Sleep disorders can adversely affect physical, sexual, and marital health, particularly among middle-aged women. This study aimed to determine the relationship between sleep quality and marital satisfaction of working women during the premenopausal period. In this cross-sectional study, we selected 150 women working at Shiraz University of Medical Sciences in Iran was selected using random cluster sampling. A demographic information form, the Pittsburgh Sleep Quality Index (PSQI), and the Evaluation and Nurturing Relationship Issues, Communication, and Happiness (ENRICH) marital satisfaction scale were used for data collection. The Data were analyzed using SPSS.22 software at a significance level of P < 0.05. Multiple linear regression analysis was employed to predict sleep quality based on marital satisfaction. Our results showed that 79 (52.7%) of the participants had undesirable sleep quality, 87 (58%) had high marital satisfaction, and 32 (21.3%) had very high marital satisfaction. Regression analysis revealed that the total marital satisfaction score could not predict the sleep quality score of the participants. However, as dimensions of marital satisfaction, personality issues negatively (β = 0.327, P < 0.05) and ideological orientation positively (β = 0.336, P < 0.01) predicted the sleep quality score. Based on the prediction of the sleep quality score by personality issues and ideological orientations among the dimensions of marital satisfaction, it seems that life skills training, especially in these two dimensions, may improve the quality of sleep and, as a result, the physical and mental health of working women.
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Affiliation(s)
- P Yadollahi
- Department of Midwifery, Maternal-Fetal Medicine Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - S Mavaddatnia
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M Zarshenas
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - P Ghaemmaghami
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
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Hou SY, Chiu CJ, Shea JL, Wang CL, Tang HH, Kuo PC, Yang YC, Wu CH. Role of age, menopausal status, and symptoms in midlife women: Examination of sleep patterns and rest-activity circadian rhythms. Sleep Med 2024; 113:172-179. [PMID: 38039943 DOI: 10.1016/j.sleep.2023.11.015] [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: 06/19/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Midlife women experience menopausal transition at different ages with a variety of symptoms. This study aimed to identify the effects of age, menopausal status, and symptoms in women on their actigraphy-based sleep patterns and circadian rhythms. METHODS A total of 87 women aged 45-60 from the community and a gynecology clinic in Taiwan who had their sleep and circadian rhythms recorded with a 7-day actigraphy were analyzed. Multiple linear regression was used to estimate the association of age, menopausal status, and symptoms with sleep parameters and circadian rhythms. RESULTS A sleep efficiency below 85 % was observed in 46.0 % of women, and those with severe somatic-vegetative or psychological symptoms tended to have problems with sleep latency (β = 0.22 and β = 0.42, respectively) and efficiency (β = -0.26 and β = -0.36, respectively). Women with more severe urogenital symptoms only experienced significantly longer sleep latency (β = 0.33). There was a weak correlation between circadian rhythms and symptoms. Additionally, perimenopausal (β = 0.30 and β = 0.35, respectively) and late postmenopausal (β = 0.67 and β = 0.59, respectively) women had higher relative amplitude and stability in circadian rhythms than premenopausal women. Age had no significant effect on sleep parameters or circadian rhythms. CONCLUSIONS Premenopausal women had the most unstable day-to-day rhythms compared to their peri- and postmenopausal counterparts. Women with higher somatic-vegetative, psychological, and urogenital symptoms showed greater sleep problems. Psychological symptoms (e.g., depression, irritability, anxiety, exhaustion) were the strongest predictors for all sleep parameters. The mechanisms underlying these associations warrant investigation.
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Affiliation(s)
- Szu-Yu Hou
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Ju Chiu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Jeanne Laraine Shea
- Department of Anthropology, University of Vermont, Burlington, VT, 05405, USA
| | - Chih-Liang Wang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiao-Han Tang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Ching Kuo
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Chieh Yang
- Yang's Clinic of Obstetrics and Gynecology, Tainan, Taiwan
| | - Chih-Hsing Wu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Li Z, Yin S, Feng J, Gao X, Yang Q, Zhu F. Acupuncture combined with Chinese herbal medicine in the treatment of perimenopausal insomnia: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e35942. [PMID: 37960761 PMCID: PMC10637479 DOI: 10.1097/md.0000000000035942] [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: 07/11/2023] [Accepted: 10/12/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Perimenopausal insomnia (PMI) is a relatively common menopausal symptom that can cause serious problems for the women themselves and their families. Today, the world is facing the trend and challenges of an aging population. It is reported that about 1.5 million women worldwide enter menopause every year, with sleep disorder identified as a core symptom. The efficacy of acupuncture combined with traditional Chinese medicine for treating PMI has been recognized by patients and doctors. METHODS We searched 8 databases to identify 15 randomized controlled trials evaluating the effects of acupuncture combined with traditional Chinese medicine on sleep in patients with PMI compared with Western medicine alone. Subsequently, data extraction and analysis were performed to assess the quality and risk of bias of the study method design, and a meta-analysis of the data was performed. RESULTS This study included 15 randomized controlled trials involving 1188 patients with PMI. The results show that acupuncture combined with traditional Chinese medicine seems to be more effective than Western medicine in the treatment of PMI: efficiency (RR: 1.18; 95% CI: 1.08, 1.29; P = .001); the Pittsburgh Sleep Quality Index (PSQI) (WMD: -2.77; 95% CI: 4.15-1.39; P < .0001); follicle-stimulating hormone (FSH) (WMD: -31.45; 95% CI: 42.7-20.2; P < .001) and the Hamilton Anxiety Score (HAMA) (WMD: -2.62, 95% CI: -3.93, -1.32; P < .0001). Compared with western medicine, E2 (WMD: 5.07; 95% CI: 5.78-15.92; P = .36) and LH (WMD: -4.86; 95% CI: 11.5-1.78; P = .151) had no difference. CONCLUSION The current analysis results show that acupuncture combined with Chinese medicine seems to have a more positive effect than western medicine alone in improving sleep and FSHF in PMI patients, but no difference has been found in improving E2 and LH. This study provides a basis for acupuncture combined with Chinese medicine to treat PMI. However, due to the higher risk of evaluation in included studies, more rigorous randomized controlled trials and higher quality studies are needed to validate included studies.
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Affiliation(s)
- Zhao Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shao Yin
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jie Feng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xu Gao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qicheng Yang
- Department of Medical Information Engineering, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fengya Zhu
- Zigong First People’s Hospital, Zigong, China
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6
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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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Zak R, Zitser J, Jones HJ, Gilliss CL, Lee KA. Sleep symptoms signaling the menopausal transition. J Clin Sleep Med 2023; 19:1513-1521. [PMID: 37086049 PMCID: PMC10394374 DOI: 10.5664/jcsm.10618] [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: 09/23/2022] [Revised: 03/30/2023] [Accepted: 03/30/2023] [Indexed: 04/23/2023]
Abstract
STUDY OBJECTIVES To describe changes in sleep quality and associated sleep symptoms as women begin menopausal transition compared with premenopausal controls. METHODS In a repeated-measures design, we analyzed data collected every 2-6 months from a community-based sample of 223 women aged 40-50 (45.6 ± 2.3) years old over a 2-year period. Each 6-month visit included urinary follicle-stimulating hormone (FSH) as a marker of ovarian function and the Pittsburgh Sleep Quality Index (PSQI) and other questionnaires (Center for Epidemiological Studies-Depression Scale; Perceived Stress Scale). Menstrual cycle and vasomotor symptoms (Seattle Women's Health Symptom Checklist) were tracked every 2 months by phone. For women entering menopausal transition (n = 68) we used data from the two consecutive visits prior to their FSH rise and the next two visits. Data from the last four consecutive visits were used for controls remaining premenopausal (n = 155). RESULTS The transition group did not differ from controls on age, vasomotor symptoms (hot flashes/night sweats), stress, or depression but did have a higher body mass index. Measures were stable over time for controls. However, the transition group experienced an increase in PSQI scores (initial PSQI = 5.7 ± 3.2 and final PSQI = 6.3 ± 3.8; P = .030) and frequency of trouble sleeping because of feeling too hot (P = .016), which lagged the FSH rise by 6 months with no notable change in report of hot flashes/night sweats. CONCLUSIONS Trouble sleeping because of feeling too hot, distinct from awareness of vasomotor symptoms, was the only uniform contribution to higher PSQI scores after the initial FSH increase and may signal the onset of the menopausal transition. CITATION Zak R, Zitser J, Jones HJ, Gilliss CL, Lee KA. Sleep symptoms signaling the menopausal transition. J Clin Sleep Med. 2023;19(8):1513-1521.
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Affiliation(s)
- Rochelle Zak
- Sleep Disorders Center, University of California, San Francisco, San Francisco, California
| | - Jennifer Zitser
- Global Brain Health Institute, Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Holly J. Jones
- The Martha S. Pitzer Center for Women, Children, and Youth, College of Nursing, The Ohio State University, Columbus, Ohio
| | - Catherine L. Gilliss
- School of Nursing, University of California, San Francisco, San Francisco, California
| | - Kathryn A. Lee
- School of Nursing, University of California, San Francisco, San Francisco, California
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Zamora AN, Peterson KE, Goodrich JM, Téllez-Rojo MM, Song PXK, Meeker JD, Dolinoy DC, A Torres-Olascoaga L, Cantoral A, Jansen EC. Associations between exposure to phthalates, phenols, and parabens with objective and subjective measures of sleep health among Mexican women in midlife: a cross-sectional and retrospective analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:65544-65557. [PMID: 37086320 PMCID: PMC10464830 DOI: 10.1007/s11356-023-26833-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
Endocrine-disrupting chemicals (EDCs) may impact sleep during the menopausal transition by altering sex hormones. However, these studies are scarce among Latin American women. This investigation utilized cross-sectional and retrospective data from midlife women enrolled in the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) study to examine associations between exposure to EDCs (phthalates, phenols, and parabens) and sleep health measures. For cross-sectional analyses, single spot urine samples were collected between 2017-2019 from a pilot sample of women (N = 91) of midlife age to estimate the urinary concentration of individual phthalates, phenols, and parabens and to calculate the summary concentration of phthalate mixtures. Seven-day nightly sleep duration, midpoint, and fragmentation were obtained from wrist-actigraphy devices and estimated from the actigraphy data using a pruned dynamic programming algorithm. Self-reported poor sleep quality was assessed by one item from the Pittsburgh Sleep Quality Index (PSQI). We examined associations between urinary summary phthalate mixtures, phthalate metabolites, phenol, and paraben analytes with each sleep measure using linear or logistic (to compute odds of poor sleep quality only) regression models adjusted for specific gravity, age, and socioeconomic status. We ran similar regression models for retrospective analyses (N = 74), except that urine exposure biomarker data were collected in 2008 when women were 24-50 years old. At the 2017-2019 midlife visit, 38% reported poor sleep quality. Cross-sectionally, EDCs were associated with longer sleep duration, earlier sleep timing, and more fragmented sleep. For example, every 1-unit IQR increase in the phenol triclosan was associated with a 26.3 min per night (95% CI: 10.5, 42.2; P < 0.05) longer sleep duration and marginally associated with 0.2 decimal hours (95% CI: -0.4, 0.0; P < 0.10) earlier sleep midpoint; while every 1-unit IQR increase in the phthalate metabolite MEHP was associated with 1.1% higher sleep fragmentation (95% CI: 0.1, 2.1; P < 0.05). Retrospective study results generally mirrored cross-sectional results such that EDCs were linked to longer sleep duration, earlier sleep timing, and more fragmented sleep. EDCs were not significantly associated with odds of self-reported poor sleep quality. Results from cross-sectional and retrospective analyses revealed that higher exposure to EDCs was predictive of longer sleep duration, earlier sleep timing, and more fragmented sleep among midlife women.
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Affiliation(s)
- Astrid N Zamora
- Department of Nutritional Sciences, University of Michigan School of Public Health, 3863 SPH 1, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, 3863 SPH 1, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Jaclyn M Goodrich
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Martha M Téllez-Rojo
- Center for Research On Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Peter X K Song
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Dana C Dolinoy
- Department of Nutritional Sciences, University of Michigan School of Public Health, 3863 SPH 1, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Libni A Torres-Olascoaga
- Center for Research On Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Erica C Jansen
- Department of Nutritional Sciences, University of Michigan School of Public Health, 3863 SPH 1, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
- Department of Neurology, Division of Sleep Medicine, Michigan Medicine, Ann Arbor, MI, USA.
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Goldstein LA, Jakubowski KP, Huang AJ, Seal KH, Maguen S, Inslicht SS, Byers AL, Gibson CJ. Lifetime history of interpersonal partner violence is associated with insomnia among midlife women veterans. Menopause 2023; 30:370-375. [PMID: 36753121 PMCID: PMC10038868 DOI: 10.1097/gme.0000000000002152] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE Over a third of women in the United States report a lifetime history of intimate partner violence. Although a recent review found that intimate partner violence is related to poor subjective sleep, the majority of studies involved reproductive-aged women and used suboptimal measures of interpersonal violence and/or insomnia. We examined the relationship between lifetime intimate partner violence and current clinical insomnia in a cross-sectional sample of midlife women veterans. METHODS Cross-sectional data were drawn from the Midlife Women Veterans Health Survey. Women Veterans (N = 232) aged 45 to 64 years enrolled in Department of Veterans Affairs health care in Northern California completed an adapted version of the Extended-Hurt, Insult, Threaten, Scream to assess lifetime history of intimate partner violence (screening threshold score and any physical, sexual, and psychological intimate partner violence) and the Insomnia Severity Index to assess current insomnia. RESULTS In multivariable analyses, lifetime history of intimate partner violence was associated with twofold to fourfold odds of current clinical insomnia, including overall intimate partner violence (odds ratio, 3.24; 95% confidence interval, 1.57-6.69), physical intimate partner violence (odds ratio, 2.01; 95% confidence interval, 1.09-3.70), psychological intimate partner violence (odds ratio, 3.98; 95% confidence interval, 2.06-7.71), and sexual intimate partner violence (odds ratio, 2.09; 95% confidence interval, 1.08-4.07). CONCLUSIONS Lifetime history of intimate partner violence is common and may be associated with clinical insomnia during midlife. Findings highlight the importance of screening midlife women for intimate partner violence and recognizing the potential role of this traumatic exposure on women's health.
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Cortés YI, Coslov N, Richardson MK, Woods NF. Symptom experience during the late reproductive stage versus the menopausal transition in the Spanish-language Women Living Better survey. Menopause 2023; 30:260-266. [PMID: 36630255 PMCID: PMC9974803 DOI: 10.1097/gme.0000000000002132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The aim of this study was to characterize and compare the symptoms women self-report during the late reproductive stage and the menopausal transition. METHODS This cross-sectional analysis used data from the Spanish-language Women Living Better survey. Women aged 35 to 55 years completed an 82-item online survey to assess menstrual cycle patterns, changes, and 61 symptoms sometimes associated with menopause. Women's menstrual patterns were classified as late reproductive stage or menopausal transition using the Stages of Reproductive Aging Workshop. Demographic and health-related data were collected, including age, country of residence, race/ethnicity, education, parity, smoking, and alcohol use. Descriptive statistics characterized reported symptoms, and logistic regression models examined associations between reproductive stage and symptoms. RESULTS Of 853 respondents, 358 women were included in the sample analyzed. Participants were on average 40 ± 4.1 years old, 46% reported difficulty paying for basics, 34% lived in Spain, and 20% lived in Mexico. A similar proportion of women in the late reproductive stage and menopausal transition reported 8 of 18 symptom groups. Women in the late reproductive stage had a lower age-adjusted odds of musculoskeletal pain (odds ratio, 0.35; 95% CI, 0.19-0.66) and lower odds of decreased interest in sex (odds ratio, 0.49; 95% CI, 0.25-0.92). Both groups of women reported a similar interference with personal relationships. CONCLUSIONS Late-reproductive-stage women experience multiple symptoms often associated with menopause. A better understanding of symptoms experienced among Spanish-speaking women may lead to more personalized health care and facilitate anticipatory guidance about menopause. Future cross-cultural studies focusing on symptoms during the late reproductive stage are necessary.
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Affiliation(s)
- Yamnia I. Cortés
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Nancy Fugate Woods
- Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA
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11
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Hatcher KM, Smith RL, Chiang C, Flaws JA, Mahoney MM. Nocturnal Hot Flashes, but Not Serum Hormone Concentrations, as a Predictor of Insomnia in Menopausal Women: Results from the Midlife Women's Health Study. J Womens Health (Larchmt) 2023; 32:94-101. [PMID: 36450126 PMCID: PMC10024068 DOI: 10.1089/jwh.2021.0502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: Sleep disruptions are among the most common symptoms experienced during menopause and can be associated with depression, hot flashes, and fluctuating hormones. However, few studies have examined how such risk factors influence sleep in midlife women in a network-based approach that will establish the complex relationship between variables. Materials and Methods: We used a Bayesian network (BN) to examine the relationship between multiple factors known to influence sleep and depression in midlife women, including hormone concentrations, hot flashes, and menopause status among participants of the longitudinal Midlife Women's Health Study. In year 1, 762 women (45-54 years of age) answered questions regarding the frequency of insomnia, hot flashes, and depression; 389 of the same women answered similar questions at year 4. We measured serum hormones and calculated free estradiol index, free testosterone index, and ratios of estradiol:progesterone, and estradiol:testosterone. For our model, we calculated the change in frequency of insomnia, depression, and covariates (body mass index, menopause status, hot flashes at night, and present quality of life) from year 1 to 4. Results: Using a BN, we found that self-reported hot flashes at night, and no other factors, were direct predictors of self-reported insomnia in year 1. Surprisingly, we did not identify an association between hormone concentrations and self-reported insomnia. Frequency of insomnia in year 4 was only predicted by frequency of insomnia in year 1, whereas frequency of depression in year 4 was predicted by year 4 insomnia and frequency of depression in year 1. No other factors were direct predictors of insomnia or depression in our model. Conclusions: Therefore, hot flashes at night, previous insomnia, and depression are stronger predictors of how women will self-report frequency of sleep disruptions and treatment may reduce menopausal sleep complaints.
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Affiliation(s)
- Katherine M. Hatcher
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Rebecca L. Smith
- Department of Pathobiology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Catheryne Chiang
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Jodi A. Flaws
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Megan M. Mahoney
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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12
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Association of hormone therapy and changes of objective sleep quality in women of late menopausal transition with sleep disorder: a preliminary study. Menopause 2022; 29:1296-1307. [PMID: 36219812 DOI: 10.1097/gme.0000000000002055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to investigate changes in objective sleep quality with hormone therapy (HT) in women with late menopausal transition. METHODS Healthy midlife women with sleep difficulty who received HT were included. Those undergoing late menopausal transition were screened. Sleep patterns and self-reported questionnaires were collected before and 10 weeks after starting HT. RESULTS Ten women who met the criteria (age, 50.1 ± 2.8 years) showed higher sleep efficiency and shorter wakefulness after sleep onset (WASO) 10 weeks after starting HT. However, no significant change was found in objective sleep quality after adjustment for multiple comparisons: sleep efficiency, 84.2 ± 7.7 versus 88.2% ± 4.7%, P = 0.037, adjusted P = 0.259; WASO, 59.0 ± 27.2 minutes versus 41.4 ± 17.4 minutes, P = 0.020, adjusted P = 0.140; average duration per awakening, 2.9 ± 1.0 minutes versus 2.2 ± 0.5 minutes, P = 0.033, adjusted P = 0.231. A better score of subjective sleep quality in the Pittsburgh Sleep Quality Index was observed 10 weeks after starting HT (2.0 ± 0.0 vs 1.2 ± 0.4, P = 0.006, adjusted P = 0.042), but sensitivity analysis did not show consistent results after adjustment for multiple comparisons (2.0 ± 0.0 vs 1.1 ± 0.4, P = 0.020, adjusted P = 0.140). Total scores of the Insomnia Severity Index and Menopause Rating Scale were better 10 weeks after starting HT (Insomnia Severity Index, 14.7 ± 3.0 vs 9.1 ± 3.8, P = 0.010; Menopause Rating Scale, 29.0 ± 5.2 vs 21.6 ± 3.0, P = 0.009) with consistent results in sensitivity analyses. There was no difference in the Epworth Sleepiness Scale before and after HT (7.2 ± 1.7 vs 8.6 ± 4.5, P = 0.309). The change in each objective sleep quality variable before and after HT showed strong positive or negative correlations with the change in only a few items in subjective sleep quality. CONCLUSION Women in the late menopausal transition period showed higher sleep efficiency and shorter WASO after HT; however, multiple comparisons showed no statistically significant difference in objective sleep quality between before and after HT.
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13
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Zhao C, Grubbs A, Barber EL. Sleep and gynecological cancer outcomes: opportunities to improve quality of life and survival. Int J Gynecol Cancer 2022; 32:669-675. [PMID: 35331996 PMCID: PMC9064983 DOI: 10.1136/ijgc-2022-003404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Sleep is important for immune function, metabolic function and physical repair. Sleep is more commonly disrupted in women compared with men and is disrupted by surgery, chemotherapy, and cancer itself, making gynecological oncology patients at higher risk of insomnia and sleep disruption. Insomnia and sleep disruption are linked to increased pain, poorer quality of life, depression, and anxiety which can all negatively affect patient outcomes. A number of environmental, behavioral, and pharmacological interventions have been investigated to improve patient sleep and aid in the recovery process. It is vital to understand and address patient sleep quality in order to give patients the highest quality care and improve outcomes.
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Affiliation(s)
- Caroline Zhao
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Allison Grubbs
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Emma L Barber
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA .,Institute for Public Health in Medicine, Chicago, Illinois, USA
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14
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Zak RS, Zitser J, Jones HJ, Gilliss CL, Lee KA. Sleep Self-Report and Actigraphy Measures in Healthy Midlife Women: Validity of the Pittsburgh Sleep Quality Index. J Womens Health (Larchmt) 2022; 31:965-973. [DOI: 10.1089/jwh.2021.0328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Rochelle S. Zak
- Sleep Disorders Center, University of California, San Francisco, California, USA
| | - Jennifer Zitser
- Department of Neurology, Memory and Aging Center, Global Brain Health Institute, University of California, San Francisco, San Francisco, California, USA
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Holly J. Jones
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA
| | - Catherine L. Gilliss
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, California, USA
| | - Kathryn A. Lee
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, California, USA
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15
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Bogale B, Wolde A, Mohammed N, Midaksa G, Bekele BB. Poor Sleep Quality and Factors Among Reproductive-Age Women in Southwest Ethiopia. Front Psychiatry 2022; 13:913821. [PMID: 35911253 PMCID: PMC9326157 DOI: 10.3389/fpsyt.2022.913821] [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: 04/06/2022] [Accepted: 06/17/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Adequate sleep is vital for physical and mental wellbeing. Sleep-related problems including poor quality of sleep have been increasing throughout the world among reproductive-aged women. Poor sleep quality has been related with number of diseases and health problems However, evidences are scarce regarding poor sleep quality and its associated factors among women of the reproductive age group in Ethiopia. OBJECTIVE To assess sleep quality and associated factors among women of reproductive age group in Mizan Aman town, Southwest Ethiopia. METHOD Community-based cross-sectional study was conducted among 606 reproductive-aged women from 06 November to 20 December 2020, in Mizan Aman town. Data were collected using structured interview administered questionnaires. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Multivariable logistic regression was applied using an adjusted odds ratio with a corresponding 95% confidence interval to evaluate the statistical significance of associated factors. RESULT The overall prevalence of poor sleep quality was 71.3%. The late age group of 42-49 (AOR, 95% CI; 1.21 (1.08-5.76), palpable/visible thyroid gland (AOR, 95% CI; 2. 12 (1.08-3.82), current substance use (AOR, 95% CI; 1.76 (1.11-6.10) and having premenstrual syndrome (AOR, 95% CI; 1.86 (1.38-3.12) were significantly associated with poor sleep quality among reproductive age group women. CONCLUSION Significant majority of reproductive age group women faced poor sleep quality. Therefore, screening of sleep patterns among this particular age group is warranted. Moreover, education about sleep hygiene needs to be given considering the identified factors to improve sleep quality.
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Affiliation(s)
- Biruk Bogale
- School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia
| | - Asrat Wolde
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Aman, Ethiopia
| | - Nuredin Mohammed
- Department of Nursing, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Aman, Ethiopia
| | - Gachana Midaksa
- School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia
| | - Bayu Begashaw Bekele
- School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia.,Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Association of phthalate exposure and endogenous hormones with self-reported sleep disruptions: results from the Midlife Women's Health Study. ACTA ACUST UNITED AC 2021; 27:1251-1264. [PMID: 33110041 DOI: 10.1097/gme.0000000000001614] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Follicle-stimulating hormone and estradiol (E2) have been associated with sleep in midlife women, however, few studies have examined the association of other hormones or environmental chemical exposure such as phthalates, with self-reported sleep quality. We assessed the relationship of self-reported sleep with hormones and phthalates. METHODS In total, 762 women (aged 45-54 y, 459 premenopausal, and 303 perimenopausal) from the Midlife Women's Health Study answered self-reported questions regarding the frequency of sleep disturbances, insomnia, and restless sleep. Serum E2, progesterone, testosterone, serum hormone binding globulin, free E2 index, free testosterone index, E2:progesterone, and E2:testosterone were measured. Summary measures of phthalate mixtures, including the phthalates from plastic sources (sumPLASTIC), personal care products (sumPCP), di-(2-ethyhexyl) phthalate (sumDEHP), anti-androgenic phthalates (sumAA), and all phthalate metabolites measured (sumALL), were calculated from urinary phthalate metabolites. Ordinal logistic regression was used to fit each outcome sleep measure with all hormones and summary phthalates. RESULTS Progesterone and testosterone were significantly negatively associated with the frequency of sleep disturbances and insomnia. Free testosterone index was also negatively associated with insomnia frequency. E2:progesterone was positively associated with frequency of sleep disturbances and restless sleep in self-reported nonsmokers. SumPCP and sumALL were significantly negatively associated with frequency of sleep disturbances, insomnia, and restless sleep. SumDEHP and sumPLASTIC were negatively associated with insomnia frequency. Further, the direction of association between phthalates and sleep appears to be dependent on the quartile of phthalate exposure. All significant associations between phthalates and sleep were in self-reported nonsmokers or former smokers. CONCLUSIONS Our study supports previous literature that hormones beyond follicle-stimulating hormone and E2 are associated with sleep disruptions in menopause. Further, we are among the first to show that phthalate exposure is associated with sleep disruptions in midlife women.
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17
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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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18
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Aghamohammadi V, Salmani R, Ivanbagha R, Effati Daryani F, Nasiri K. Footbath as a safe, simple, and non-pharmacological method to improve sleep quality of menopausal women. Res Nurs Health 2020; 43:621-628. [PMID: 33112004 DOI: 10.1002/nur.22082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 09/05/2020] [Accepted: 10/15/2020] [Indexed: 12/21/2022]
Abstract
Due to the adverse effects of medication we decided to provide a safe, economic, and easy intervention to decrease sleep problems in menopausal women. This trial aimed to determine the effect of footbath on sleep disturbance in postmenopausal women. One hundred menopausal women were randomly stratified using a permuted block randomization procedure by Random Allocation Software, and assigned to one of two study groups: control (without intervention, n = 50) and intervention (footbath, n = 50). The footbath group was asked to lie their feet into the warm water for 20 min in a container with a depth of 10 cm one hour before the usual sleeping time for 6 weeks. To assess sleep quality, we used the Pittsburgh sleep quality index (PSQI). To evaluate severity of menopause symptoms, the Greene scale was applied. Before the intervention, 96% of the subjects in the footbath group and 94% in the control group were poor sleepers. The results of analysis of covariance showed significant improvement in sleep quality and decrease in severity of menopause signs in the footbath group compared to the control group. At the baseline, there was a statistically significant correlation between the severity of menopause signs and the global score of PSQI in all study individuals (p ≤ .001, r = .464). The present study findings showed that footbath intervention enhanced sleep quality in menopausal women. Thus, footbath as a safe, simple, and non-pharmacological application can improve quality of life in postmenopausal women and inhibit problems due to inadequate sleep quality.
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Affiliation(s)
| | - Roghayeh Salmani
- Department of Midwifery, Khalkhal University of Medical sciences, Khalkhal, Iran
| | - Reyhaneh Ivanbagha
- Department of Midwifery, Khalkhal University of Medical sciences, Khalkhal, Iran
| | - Fatemeh Effati Daryani
- Department of Midwifery, Faculty of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Khadijeh Nasiri
- Department of Medical-Surgical Nursing, Khalkhal University of Medical sciences, Khalkhal, Iran
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The association of depressive symptoms to sleep-related symptoms during menopausal transition: racial/ethnic differences. ACTA ACUST UNITED AC 2020; 27:1315-1321. [PMID: 33110048 DOI: 10.1097/gme.0000000000001611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Despite an increasing number of studies reporting significant associations of depression to sleep problems in general, few studies have been conducted on racial/ethnic variations in the associations among midlife women in their menopausal transition. The purpose of this study was to determine the associations between depressive symptoms and sleep-related symptoms in a multiethnic group of midlife women while considering the women's race/ethnicity and menopausal status. METHODS This was a secondary analysis of the data from 1,054 midlife women in two larger studies. The depression index for midlife women and the sleep index for midlife women were used to measure sleep-related symptoms and depressive symptoms. Descriptive and inferential statistics including hierarchical multiple regression analyses were used for data analyses. RESULTS In the regression models by race/ethnicity, the total numbers (0.294 in non-Hispanic [NH] African Americans ≤ β ≤ 0.410 in NH Asians), and total severity scores (0.141 in Hispanic ≤ β ≤ 0.365 in NH Whites) of depressive symptoms were positively associated with the total severity of sleep-related symptoms (all P < 0.01). In the regression models by menopausal status, the total numbers (β = 0.106 in premenopausal and 0.443 in postmenopausal) and total severity scores (0.272 ≤ β ≤ 0.561) of depressive symptoms were positively associated with the total severity scores of sleep-related symptoms (all P < 0.05). CONCLUSIONS Further studies with diverse groups of midlife women using objective measurements and biomarkers are warranted to confirm the findings.
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Chen MH, Korenic SA, Wickwire EM, Wijtenburg SA, Hong LE, Rowland LM. Sex Differences in Subjective Sleep Quality Patterns in Schizophrenia. Behav Sleep Med 2020; 18:668-679. [PMID: 31462084 PMCID: PMC7047560 DOI: 10.1080/15402002.2019.1660168] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE/BACKGROUND Sleep dysfunction is prevalent among patients with schizophrenia. Although sex differences have been identified in schizophrenia, sex differences in sleep patterns among patients with schizophrenia are not established. Therefore, the current study examined sex differences in subjective sleep quality patterns in people with schizophrenia utilizing a standardized inventory. PARTICIPANTS Study sample consisted of 75 patients with schizophrenia and 82 healthy controls (HC). METHODS Participants completed the Pittsburgh Sleep Quality Index (PSQI). RESULTS Compared to HC, patients with schizophrenia were more likely to report being poor sleepers (PSQI global score > 5), longer sleep duration, more sleep disturbances, longer sleep onset latency, increased daytime dysfunction due to poor sleep, and more frequent use of sleep medications. Regarding sex differences, female patients were more likely to report being poor sleepers and endorsed more sleep disturbances than female HC, while male patients reported longer sleep duration, more daytime dysfunction, and poorer overall sleep quality relative to male HC. Additionally, higher level of sleep dysfunction was linked to higher symptom severity in male patients only. CONCLUSIONS Patients with schizophrenia endorsed a range of sleep difficulties, and male and female patients with schizophrenia differ compared to their HC counterparts. Implications for treatment of sleep complaints among patients with schizophrenia are discussed.
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Affiliation(s)
- Michelle H. Chen
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, , Catonsville, MD, USA
| | - Stephanie A. Korenic
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, , Catonsville, MD, USA
| | - Emerson M. Wickwire
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA,Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - S. Andrea Wijtenburg
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, , Catonsville, MD, USA
| | - L. Elliot Hong
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, , Catonsville, MD, USA
| | - Laura M. Rowland
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, , Catonsville, MD, USA,Corresponding Author: Laura M. Rowland. Address: Maryland Psychiatric Research Center, Tawes Building, Catonsville, MD 21228, USA. Phone: 410-402-6803.
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Psychosomatic and vasomotor symptom changes during transition to menopause. MENOPAUSE REVIEW 2019; 18:110-115. [PMID: 31485208 PMCID: PMC6719639 DOI: 10.5114/pm.2019.86835] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 06/28/2019] [Indexed: 12/26/2022]
Abstract
Menopause is the condition in which the gradual decline in ovarian function finally leads to the permanent cessation of menstruation. Oestrogen deficiency may cause early symptoms during the menopausal transition and late symptoms after menopause. Menopause is a normal period of life. During this period, women need adaptation to new biological, social, and psychological parameters. Vasomotor symptoms are among the most common menopausal symptoms. Menopause per se is not correlated with specific psychiatric disorders, but data suggest that perimenopausal women are more likely to develop depressive disorders even without a previous history. Vasomotor symptoms are correlated with mood and sleep disturbances, neuroticism, anxiety, decreased cognitive function, and stress. Personality traits, social, and other factors are also important mediators of vasomotor symptoms during the menopausal transition phase. This is a review based on the existing evidence concerning the correlation between psychosomatic and vasomotor symptoms of menopause during the menopausal transition period. Healthcare providers should take these correlations into consideration when planning the treatment of vasomotor symptoms. Vasomotor symptoms during menopause are associated with significant social costs. There are numerous traditional hormone therapy, and complementary and alternative therapy including over-the-counter treatments and dietary supplements for managing menopause-related vasomotor symptoms. Additional costs include follow-up physician visits, laboratory testing, management of adverse events, and loss of productivity at work. Social support and planning may help women to deal with menopausal symptoms and may reduce overall social costs during this transitional phase.
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Zhang X, Lee S, Luo H, Liu H. A prediction model of sleep disturbances among female nurses by using the BP‐ANN. J Nurs Manag 2019; 27:1123-1130. [DOI: 10.1111/jonm.12782] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 03/14/2019] [Accepted: 04/15/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Xin Zhang
- Faculty of School of Nursing, Peking Union Medical College Chinese Academy of Medical Sciences Beijing China
| | - Shih‐Yu Lee
- Faculty of School of Nursing University of Texas at Tyler Tyler Texas
| | - Honghui Luo
- Faculty of Medical Examination Center Peking Union Medical College Hospital Beijing China
| | - Huaping Liu
- Director of WHO Collaborating Center for Nursing Policy‐Making and Quality Management Peking Union Medical College, Chinese Academy of Medical Sciences Beijing China
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Tobias L, Kryger M. Women's Sleep Across the Reproductive Life Span. J Clin Sleep Med 2018; 14:1095-1096. [PMID: 29991440 DOI: 10.5664/jcsm.7200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 06/27/2018] [Indexed: 11/13/2022]
Affiliation(s)
- Lauren Tobias
- Section of Pulmonary, Critical Care, and Sleep Medicine; Yale University Medical School of Medicine, New Haven, Connecticut
| | - Meir Kryger
- Section of Pulmonary, Critical Care, and Sleep Medicine; Yale University Medical School of Medicine, New Haven, Connecticut
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