Evaluation and Management of Sleep Disturbance during the Menopause Transition

Joffe, Hadine; Massler, Anda; Sharkey, Katherine M.

doi:10.1055/s-0030-1262900

Cited by 163 publications

(137 citation statements)

References 145 publications

(235 reference statements)

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“…Studies of midlife women with hot flashes commonly show self-reported sleep disturbance, 27,28 which the current study corroborates with actigraphy data. The baseline actigraphy measures in this study showed no difficulty falling asleep, but moderate amounts of WASO (54-57 min), along with mildly reduced sleep efficiency (85% to 86%).…”

Section: Discussionsupporting

confidence: 88%

Effects of Yoga and Aerobic Exercise on Actigraphic Sleep Parameters in Menopausal Women with Hot Flashes

Buchanan

Landis

Hohensee

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: To determine effects of yoga and aerobic exercise compared with usual activity on objective assessments of sleep in midlife women. Methods: Secondary analyses of a randomized controlled trial in the Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) network conducted among 186 late transition and postmenopausal women aged 40-62 y with hot flashes. Women were randomized to 12 w of yoga, supervised aerobic exercise, or usual activity. The mean and coefficient of variation (CV) of change in actigraph sleep measures from each intervention group were compared to the usual activity group using linear regression models. Results: Baseline values of the primary sleep measures for the entire sample were mean total sleep time (TST) = 407.5 ± 56.7 min; mean wake after sleep onset (WASO) = 54.6 ± 21.8 min; mean CV for WASO = 37.7 ± 18.7 and mean CV for number of long awakenings > 5 min = 81.5 ± 46.9. Changes in the actigraphic sleep outcomes from baseline to weeks 11-12 were small, and none differed between groups. In an exploratory analysis, women with baseline Pittsburgh Sleep Quality Index higher than 8 had significantly reduced TST-CV following yoga compared with usual activity. Conclusions: This study adds to the currently scant literature on objective sleep outcomes from yoga and aerobic exercise interventions for this population. Although small effects on self-reported sleep quality were previously reported, the interventions had no statistically significant effects on actigraph measures, except for potentially improved sleep stability with yoga in women with poor self-reported sleep quality. Keywords: actigraphy, exercise, insomnia symptoms, menopause, variability, vasomotor symptoms, yoga Citation: Buchanan DT, Landis CA, Hohensee C, Guthrie KA, Otte JL, Paudel M, Anderson GL, Caan B, Freeman EW, Joffe H, LaCroix AZ, Newton KM, Reed SD, Ensrud KE. Effects of yoga and aerobic exercise on actigraphic sleep parameters in menopausal women with hot flashes.

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Section: Discussionsupporting

confidence: 88%

Effects of Yoga and Aerobic Exercise on Actigraphic Sleep Parameters in Menopausal Women with Hot Flashes

Buchanan

Landis

Hohensee

et al. 2017

Journal of Clinical Sleep Medicine

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“…However, the lack of a control group can be considered as the limitation of our study. Suggesting our results, previous studies have shown that the frequency and severity of sleep apnea increases during menopause because of weight gain and decrease in estrogen and progesterone levels (12,13). Moreover, a previous report revealed that approximately 75% of the patients with OSA are suffering from obesity.…”

Section: Discussionsupporting

confidence: 85%

Evaluation of sleep in women with menopause: results of the Pittsburg Sleep Quality Index and polysomnography

Ağan¹,

Özmerdivenli²,

Değirmenci³

et al. 2015

J Turkish German Gynecol Assoc

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Results: Mean PSQI score of women with normal PSG evaluation was 12.00±3.16, while it was 11.00±2.32 in women with abnormal PSG evaluation (p=0.466); 59.7% (n=40) of women had poor sleep quality. Among these, 11 (64.7%) had abnormal results in the PSG evaluation and were diagnosed with obstructive sleep apnea syndrome (OSAS); 54.5% had mild OSAS, 27.3% had moderate, and 18.2% had severe OSAS. PSQI and PSG evaluations would give a chance to demonstrate sleep problems and shed a light on treatment options according to the underlying causes of sleep disturbances in menopause. (J Turk Ger Gynecol Assoc 2015; 16: 149-52) Keywords: Menopause, sleep disturbance, Pittsburg Sleep Quality Index, polysomnography Received: 27 April, 2015 Accepted: 07 June, 2015 Available Online Date: 14 July, 2015 Evaluation Abstract and at our city's State Hospital were enrolled in the study between January 2014 and November 2014. Menopause, as a retrospective diagnosis, was determined as the perpetual cessation of menstruation with 12 months of amenorrhea because of the loss of ovarian hormonal activity without other underlying reasons (5). Before enrolment, the content of the study was explained to the patients and written approvals with an informed consent were gathered from them. The local ethical committee of the Düzce University School of Medicine approved the study. Sociodemographic characteristics of the participants, including the characteristics of menopause, were recorded via face-toface interview with an open questionnaire. Pittsburgh Sleep Quality Index (PSQI) was used to assess the subjective sleep quality in all patients. This questionnaire is self-rated and evaluates sleep quality and disturbances over a 1-month period. It has 19 individual items with seven "component" scores: subjective dysfunction. The scores of each item of the index vary between 0 and 3. Total score of these seven components makes one score of 0-21. A total score >5 indicates insufficient sleep quality. PSQI of ≤5 indicates good sleepers, while PSQI of >5 corresponds with poor sleepers (6). Patients with a PSQI of >5 and who accepted this noninvasive procedure were referred to the sleep laboratory of our university and underwent an overnight PSG evaluation (Alice 5 Sleep System, Philips, Respironics, Pennsylvania, United States) to confirm the existence of sleep disturbance objectively. PSG consists of a simultaneous recording of multiple physiological parameters, including electroencephalogram (EEG), electrooculogram (EOG), electromyogram (EMG), electrocardiogram (ECG), oral and nasal air flow cannula, thorax and abdomen movements, body position, snoring, and pulse oxymeter. At least 6 hours overnight PSG records were obtained for each patient. The all-night PSG sleep records were manually scored in a computer program. Apnea was defined as the complete lack of or an airflow reduction of >90% through the mouth and nose. Hypopnea scoring criteria defined as an airflow reduction of at least ≥30% for 10 seconds associated with oxygen desaturatio...

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“…One prevailing theory with strong supportive evidence is that sleep serves a restorative function for the brain and body. Chronic insufficient sleep is a risk factor for a variety of psychological [9][10][11][12][13], neurological [14][15][16][17][18][19] and neurodegenerative pathologies [16], as well as cardiovascular and metabolic dysfunctions [20][21][22][23][24]. More recent findings from clinical studies reveal that women suffering from sleep disturbances and insufficient sleep are at greater risk compared with men for mood disorders such as depression [25], as well as metabolic [26] and cardiovascular dysfunction [23,[27][28][29].…”

Section: Overview Of Sleepmentioning

confidence: 99%

Sex differences in sleep: impact of biological sex and sex steroids

Mong

Cusmano

2016

Phil. Trans. R. Soc. B

411

300

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One contribution of 16 to a theme issue 'Multifaceted origins of sex differences in the brain'. Men and women sleep differently. While much is known about the mechanisms that drive sleep, the reason for these sex differences in sleep behaviour is unknown and understudied. Historically, women and female animals are underrepresented in studies of sleep and its disorders. Nevertheless, there is a growing recognition of sex disparities in sleep and rhythm disorders. Women typically report poorer quality and more disrupted sleep across various stages of life. Findings from clinical and basic research studies strongly implicate a role for sex steroids in sleep modulation. Understanding how neuroendocrine mediators and sex differences influence sleep is central to advancing our understanding of sleep-related disorders. The investigation into sex differences and sex steroid modulation of sleep is in its infancy. Identifying the mechanisms underlying sex and gender differences in sleep will provide valuable insights leading to tailored therapeutics that benefit each sex. The goal of this review is to discuss our current understanding of how biological sex and sex steroids influence sleep behaviour from both the clinical and pre-clinical perspective.

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Evaluation and Management of Sleep Disturbance during the Menopause Transition

Cited by 163 publications

References 145 publications

Effects of Yoga and Aerobic Exercise on Actigraphic Sleep Parameters in Menopausal Women with Hot Flashes

Effects of Yoga and Aerobic Exercise on Actigraphic Sleep Parameters in Menopausal Women with Hot Flashes

Evaluation of sleep in women with menopause: results of the Pittsburg Sleep Quality Index and polysomnography

Sex differences in sleep: impact of biological sex and sex steroids

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