Autonomic regulation across phases of the menstrual cycle and sleep stages in women with premenstrual syndrome and healthy controls

Zambotti, Massimiliano de; Nicholas, Christian L.; Colrain, Ian M.; Trinder, John; Baker, Fiona C.

doi:10.1016/j.psyneuen.2013.06.005

Cited by 65 publications

(63 citation statements)

References 47 publications

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“…Most studies based on short-duration ECG recordings found that there is a reduction in cardiac vagal activity and a shift to sympathetic dominance in the luteal phase compared with the follicular phase (see von Holzen et al, 2016, for review). We had similar findings based on recordings made during sleep in young healthy women in the mid-luteal phase relative to the follicular phase (de Zambotti et al, 2013c) and also showed that women with severe premenstrual syndrome had altered sleep-related HRV measures in response to the luteal phase compared with controls (Baker et al, 2008; de Zambotti et al, 2013c). HRV measures also change with age and in association with menopausal hormone changes: there is a reduction in vagal activity and a shift to sympathetic dominance that emerges one year after menopause, when estradiol levels are low (von Holzen et al, 2016).…”

Section: Introductionsupporting

confidence: 66%

Menstrual cycle-related variation in autonomic nervous system functioning in women in the early menopausal transition with and without insomnia disorder

Zambotti

Trinder

Colrain

et al. 2017

Psychoneuroendocrinology

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Insomnia is considered a hyperarousal disorder, in which several psychophysiological domains including the autonomic nervous system (ANS) are over-activated, potentially contributing to increased risk for cardiovascular (CV) disease. Here, we aimed to determine whether insomnia that develops in the context of the transition to menopause (menopausal transition insomnia, MTI) is similarly characterized by autonomic arousal. We also took into account modulation of the ANS by the hormonal changes of the menstrual cycle, a factor that has not previously been considered in studies on insomnia. Twenty one women with insomnia (49.0±3 y) and 25 controls (48.8±2.6 y), also in the menopausal transition, had overnight laboratory-based polysomnographic recordings, including electrocardiograph, during the follicular and/or luteal (progesterone ≥ 3 ng.ml−1) phases of the menstrual cycle, with 21 women having recordings in both phases. Nocturnal time and frequency-domain heart rate variability (HRV) measures were calculated. Heart rate (HR) was significantly elevated (by ~4bpm) in MTI compared to controls in both follicular and luteal phases, across hours of the night, including during undisturbed periods of NREM and REM sleep (p<0.05). A higher HR tended to be associated with lower frequency- and time-domain vagal HRV indices in MTI compared with controls. In both groups, HR was significantly higher and total and high frequency HRV measures were lower in the luteal phase compared to the follicular phase (p<0.05). In addition, REM compared to NREM sleep was characterized by increased HR coupled with decreased vagal modulation and increased sympathovagal balance (p<0.01). Insomnia in the menopausal transition is characterized by nocturnal autonomic hyperarousal during both follicular and luteal phases of the menstrual cycle, which could be a factor in the etiology of MTI as well as a potential CV risk factor.

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Section: Introductionsupporting

confidence: 66%

Menstrual cycle-related variation in autonomic nervous system functioning in women in the early menopausal transition with and without insomnia disorder

Zambotti

Trinder

Colrain

et al. 2017

Psychoneuroendocrinology

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“…Cajochen et al suggested that the observed rhythm in sleep variables represents a circalunar rhythm property, running in synchrony with the lunar phases, reminiscent of other endogenous rhythms such as the circadian and circannual rhythms [31]. In addition, as mentioned before, there is a strong link between female sex hormones and sleep [32], and female reproductive steroids appear to be involved in the cardiac autonomic control during sleep in women [59]. This implies the existence of sex differences in the structure of sleep, as well as in the association between lunar phases and sleep.…”

Section: Discussionmentioning

confidence: 92%

Association between lunar phase and sleep characteristics

et al. 2014

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230Main text: 2938 Tables: 4 3 ABSTRACT Objectives: Popular belief holds that the lunar cycle affects human physiology, behavior and health, including sleep. To date, only a few and conflicting analyses have been published about the association between lunar phases and sleep. Our aim was to analyze the relationship between lunar phases and sleep characteristics. Methods:In this retrospective, cross-sectional analysis data from 319 patients who had been referred for sleep study were included. Individuals with apnea-hypopnea index≥15/h were excluded. Sociodemographic parameters were recorded. All participants underwent one-night standard polysomnography. Associations between lunar cycle (new moon, full moon and alternate moon) and sleep parameters were examined in unadjusted and adjusted models.Results: 57% of patients were males. Mean age for men was 45±14 years and 51±12 years for women. 224 persons had their sleep study done during alternate moon, 47 during full moon and 48 during new moon. There were no significant differences regarding age and gender between groups.Full moon was associated with lower sleep efficiency (median(%) [ Conclusion:Our results are consistent with a recent report and the widely held belief that sleep characteristics may be associated with the full moon.

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“…Estrogen levels reportedly have effects on the cardiovascular system and the autonomic nervous system, increasing parasympathetic and decreasing sympathetic activity (6). In contrast, progesterone reportedly correlated with the LF/HF ratio in both non-REM sleep and REM sleep and negatively correlated with HF power in non-REM sleep among non-PMS women (32). Sympathetic hyperactivity is associated with anxiety and mood disturbance (33).…”

Section: Discussionmentioning

confidence: 99%

The Impact of Menstrual Cycle Phases on Cardiac Autonomic Nervous System Activity: An Observational Study Considering Lifestyle (Diet, Physical Activity, and Sleep) among Female College Students

Tada

Yoshizaki

Tomata

et al. 2017

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

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Summary Studies examining the impact of menstrual cycle phases on the cardiac autonomic nervous system have produced inconsistent results. This study aimed to investigate this relationship, controlling for the confounding effects of diet, physical activity, and sleep, which can be affected by the menstrual cycle. Fifteen female college students with regular menses were enrolled. Data regarding 24-h heart rate variability (HRV), dietary intake, eating behavior, menstrual distress, and sleep and activity parameters were obtained during the follicular and luteal phases. Power spectral analysis of HRV was used to calculate low-frequency (0.04-0.15 Hz, LF), high-frequency (.0.15 Hz, HF), and total spectral power (TP). Cardiac sympathetic and parasympathetic nervous system activity indicators were evaluated as LF/HF and HF/TP, respectively. Intake of protein and fat, as well as total sleep time and number of awakenings, were higher in the luteal phase than in the follicular phase (p,0.05). Tendencies for increased mean activity counts, emotional eating scores, and behavioral change scores in the Menstrual Distress Questionnaire were observed in the luteal phase (p,0.10). Although LF/HF was higher in the luteal phase (p50.036), the relationship was weakened after controlling for diet, physical activity, and sleep (p50.113). Our findings suggest that altering sympathetic nervous system activity during the menstrual cycle was not independent from major lifestyle factors (diet, physical activity, and sleep). Menstrual cycle phase and changes of these parameters should be considered when assessing the cardiac autonomic function among menstruating woman.

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Autonomic regulation across phases of the menstrual cycle and sleep stages in women with premenstrual syndrome and healthy controls

Cited by 65 publications

References 47 publications

Menstrual cycle-related variation in autonomic nervous system functioning in women in the early menopausal transition with and without insomnia disorder

Menstrual cycle-related variation in autonomic nervous system functioning in women in the early menopausal transition with and without insomnia disorder

Association between lunar phase and sleep characteristics

The Impact of Menstrual Cycle Phases on Cardiac Autonomic Nervous System Activity: An Observational Study Considering Lifestyle (Diet, Physical Activity, and Sleep) among Female College Students

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