Effects of hormone therapy with estrogen and/or progesterone on sleep pattern in postmenopausal women

Hachul, Helena; Bittencourt, Lia; Andersen, Mônica Levy; Haidar, Mauro Abi; Baracat, Edmund Chada; Tufik, Sérgio

doi:10.1016/j.ijgo.2008.07.009

Cited by 81 publications

(64 citation statements)

References 25 publications

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“…Combined estrogen-progesterone therapy attenuated breathing irregularities, periodic limb movements, nocturnal arousals, hot flashes and bruxism (teeth grinding) in a study involving 33 postmenopausal women [104]. In patients with central sleep apnea, progestins may alleviate hypoventilation by providing stimulatory drive to brainstem respiratory centers.…”

Section: Gonadal Hormones and Sleep Disordersmentioning

confidence: 99%

The Impact of Gonadal Hormones on the Expression of Human Neurological Disorders

Schipper

2015

Neuroendocrinology

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The effects of gonadal steroids on neurological well-being and disease constitute a rich and rapidly expanding area of basic and clinical neuroscience. Gonadal hormones exert potent effects on monoaminergic, cholinergic and peptidergic pathways as well as neurosteroidogenesis which, in turn, impact normal brain organization and function. A spectrum of human neurological conditions are influenced by hormonal fluctuations associated with the menstrual cycle, pregnancy, the menopause and use of oral contraceptives. An appreciation of these relationships may facilitate the development of specific hormonal and anti-hormonal therapies for neurological disorders as disparate as catamenial epilepsy and acute intermittent porphyria.

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Section: Gonadal Hormones and Sleep Disordersmentioning

confidence: 99%

The Impact of Gonadal Hormones on the Expression of Human Neurological Disorders

Schipper

2015

Neuroendocrinology

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“…11 Estrogen therapy has been reported to reduce PLMs, 12 and a later study observed that estrogen in addition to progesterone was more effective than estrogen alone in decreasing the prevalence of PLMs. 13 RLS is approximately twice as common in women as men, and its prevalence increases following the onset of menopause.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

Periodic Limb Movements Are Associated with Vasomotor Symptoms

Wesström

Ulfberg²,

Sundström‐Poromaa

et al. 2014

Journal of Clinical Sleep Medicine

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diagnosis of periodic limb movement disorder (PLMD) is established when the affected individual also has insomnia and/or excessive daytime drowsiness. By subjective reports, the prevalence of PLMD has been estimated to be 3.9% in the general population. Restless legs syndrome (RLS) is a common sensory-motor disorder that produces uncomfortable sensations and a constant urge to move the lower limbs, and has a typical diurnal pattern with a peak of symptoms during rest periods in the evening and at night. RLS has also been reported to be associated with cardiovascular disease (CVD). 8 In contrast to PLMs, the diagnosis of RLS is based on the patient's subjective symptoms. PLMs are related to RLS, and the majority of patients with RLS display PLMs during sleep. 9 Prior studies have discussed the S C I E N T I F I C I N V E S T I G A T I O N SP eriodic limb movements (PLMs) during sleep were fi rst described in 1953 as "nocturnal myoclonus," and were at that time thought to have similarities to nocturnal epilepsy. 1The pathophysiological mechanisms of PLMs are unclear, but abnormal hyperexcitability (or diminished inhibition) in the lumbosacral and cervical segments of the spinal cord have been hypothesized to be possible causes.2 PLMs are characterized by involuntary movements of the lower extremities, specifi cally the toes, ankle, knees, and hips, typically lasting between 0.5 and 10 seconds. The patient is usually unaware of the limb movements or the frequent sleep disruptions, and PLMs are often an incidental fi nding at polysomnography (PSG).3 PLMs may cause microarousals, leaving the affected patient fatigued the following day. Previously, it was assumed that PLMs were the cause of these arousals, but more recent studies have revealed that PLMs and arousals are associated in a more complex and non-unidirectional manner. Arousals can occur before, during, and after leg movements, indicating that the phenomenon is associated with an underlying arousal disorder. 4 The exact prevalence of PLMs is unknown. They appear to be rare in children, to progress with advancing age, and to be more common in females than in males. 5,6 In studies where PLMs have been objectively documented (PLM episodes/h of sleep > 5), the prevalence was 5% to 6% in younger adults, and 25% to 58% among elderly people. BRIEF SUMMARYCurrent Knowledge/Study Rationale: Sleep disturbances affect a substantial fraction of women during the menopausal transition, and female sex hormones are possibly involved in the origin of PLMs. It is currently unknown whether PLMs are associated with the menopausal transition and/or concomitant vasomotor symptoms. Study Impact: This study shows an association between symptoms related to declining levels of estrogen, i.e. vasomotor symptoms, and PLMs. Future studies should address the possibility of using hormone replacement therapy in postmenopausal women with PLMD.

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“…The principle of action of intraoral devices is to promote alterations in the anatomical structures of the upper airways to maintain the influence of these ways during the night breathing Regarding the pharmacological treatment specific to this syndrome, several studies involving different pharmacological groups has presented controversial results; there are still no clinical evidences about its effectiveness 34 . The speech therapy is considered a new treatment option to OSAHS and snoring, presenting satisfactory results and significant initial symptoms in life quality in a short time.…”

Section: Final Considerationsmentioning

confidence: 99%

Multidisciplinaridade na apneia do sono: uma revisão de literatura

et al. 2014

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Síndrome da Apneia/Hipopneia Obstrutiva do sono (SAHOS) é uma doença crônica, evolutiva que pode ocasionar graves repercussões comportamentais, cardiovasculares e neurológicos ao paciente.O objetivo deste estudo é realizar uma revisão sistematizada sobre a importância da abordagem multidisciplinar no diagnóstico e tratamento da Síndrome da Apneia e Hipopnéia Obstrutiva do sono. Vários profissionais da área de saúde podem atuar no diagnóstico e tratamento desta síndrome, destacando-se atuação dos médicos, dentistas, fisioterapeutas e fonoaudiólogos.

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Effects of hormone therapy with estrogen and/or progesterone on sleep pattern in postmenopausal women

Abstract: While not significantly affecting sleep quality, hormone therapy decreased the prevalence of arousal in both groups and that of PLM in the group treated with estrogen plus progesterone.

Cited by 81 publications

References 25 publications

The Impact of Gonadal Hormones on the Expression of Human Neurological Disorders

The Impact of Gonadal Hormones on the Expression of Human Neurological Disorders

Periodic Limb Movements Are Associated with Vasomotor Symptoms

Multidisciplinaridade na apneia do sono: uma revisão de literatura

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