Effects of oral versus transdermal menopausal hormone treatments on self-reported sleep domains and their association with vasomotor symptoms in recently menopausal women enrolled in the Kronos Early Estrogen Prevention Study (KEEPS)

Abstract

Background This study determined whether two different formulations of hormone therapy [HT: oral conjugated equine estrogens (o-CEE, 0.45 mg/d, n=209), transdermal 17β-estradiol (t-E2; 50μg/d, n=201) plus cyclic progesterone (Prometrium, 200 mg) or placebo (PBO, n=243)] affected sleep domains in participants of the Kronos Early Estrogen Prevention Study (KEEPS). Methods Participants completed the Pittsburgh Sleep Quality Index (PSQI) at baseline and during the intervention at 6, 18, 36, and 48 months. Global sleep quality and individual sleep domain scores were compared between treatments using analysis of covariance, and correlated with vasomotor symptom (VMS) scores using Spearman correlation coefficients. Results Global PSQI scores (mean 6.3; 24% with score >8) were similar across groups at baseline and were reduced (improved sleep quality) by both HT [average change: −1.27 (o-CEE) and −1.32 (t-E2)] when compared to PBO [−0.60; p=0.001 (o-CEE vs PBO]) and p=0.002 (t-E2 vs PBO)]. Domain scores for sleep satisfaction and latency improved with both HT. The domain score for sleep disturbances improved more with t-E2 than o-CEE or PBO. Global sleep scores significantly correlated with VMS severity (rS=0.170, p<0.001 for hot flashes; rS=0.177, p<0.001 for night sweats). Change in scores for all domains except sleep latency and sleep efficiency correlated with change in severity of VMS. Conclusion Poor sleep quality is common in recently menopausal women. Sleep quality improved with both HT formulations. The relationship of VMS with domains of sleep suggests that assessing severity of symptoms and domains of sleep may help direct therapy to improve sleep for postmenopausal women.

SLCO1B1 genetic variation and hormone therapy in menopausal women

“… 25 In an evaluation of sleep using the Pittsburgh Sleep Quality Index, sleep disturbances were alleviated to a greater extent with tE 2 than oCEE in women of KEEPS. 26 Together with the current findings, these data suggest that women with sleep disturbances, including night sweats, may respond better to tE 2 , particularly if they harbor a variant SLCO1B1 rs4149056 allele. Further studies are required to fully establish the impact of genetic variation in SLCO1B1 on levels of circulating E 2 and E 2 S.…”

Sleep in Women Across the Life Span

“…80,[82][83][84][85] Hormonal and nonhormonal therapies directed at vasomotor symptoms have been shown to improve subjective sleep quality. [85][86][87] Actigraphy and polysomnography confirm sleep fragmentation, increased wake after sleep onset chestjournal.org (WASO), and poor sleep efficiency associated with vasomotor symptoms. When vasomotor activity is measured objectively by using skin conductance, similar findings of objective sleep disturbances are found.…”

Investigation of Cognition Status of Menopausal Hormone Therapy in Medical Institutions Staff

“…A questionnaire designed by professional group was used in this study, and the investigators who received specialized training instructed the participant to ll the questionnaire one-to-one and face-toface. Details of the questionnaire covered age, professional quali cations, educational background, major, height, weight, menstrual status, intrauterine device,chronic diseases, surgical history and family history (gynecological cancer); the awareness and utilization of MHT, the understanding of MHT advantages, such as to relieve vasomotor symptoms [5] , prevent osteoporosis [4] and cardiovascular diseases [6][7][8] , and solve problems related to urinary and reproductive tract atrophy [9][10][11] ; whether to use, reasons for using or not; whether recommended to others.…”