Insomnia related to postmenopausal syndrome and hormone replacement therapy: sleep laboratory studies on baseline differences between patients and controls and double‐blind, placebo‐controlled investigations on the effects of a novel estrogen–progestogen combination (Climodien<sup>®</sup>, Lafamme<sup>®</sup>) versus estrogen alone

Saletu-Zyhlarz, Gerda; Anderer, P.; Gruber, Georg; Mandl, Magdalena; Gruber, Doris; Metka, M.; Huber, Johannes; Oettel, M; Gräser, T; Abu-Bakr, Manal Hassan; Grätzhofer, Elisabeth; Saletu, B.

doi:10.1046/j.1365-2869.2003.00356.x

Cited by 74 publications

(48 citation statements)

References 66 publications

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“…A confirmatory part, in which techniques for coping with multiplicity are applied for a predefined subarea of variable/region combinations which appear most important with respect to the goals of the study (adjusted alpha probability = 5%). The primary target variable in the present study in postmenopausal insomnia patients was 'wakefulness during the total sleep period', as determined by polysomnographic recordings evaluated according to Rechtschaffen and Kales [60], and has been reported elsewhere [61]. The ERP variables were included in the second, descriptive part.…”

Section: Statistical Analysesmentioning

confidence: 99%

Brain Regions Activated during an Auditory Discrimination Task in Insomniac Postmenopausal Patients before and after Hormone Replacement Therapy: Low-Resolution Brain Electromagnetic Tomography Applied to Event-Related Potentials

Anderer

Saletu²,

Saletu-Zyhlarz³

et al. 2004

Neuropsychobiology

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Electrical sources of auditory event-related potentials (ERPs) determined by means of low-resolution brain electromagnetic tomography (LORETA) in 48 unmedicated insomniac postmenopausal patients aged between 46 and 67 years were compared with those obtained in 48 age-matched normal female controls. Subsequently, the patients were included in a double-blind, placebo-controlled, comparative, randomized 3-arm trial phase – Climodien 2/3 [estradiol valerate (EV) 2 mg + the progestin dienogest 3 mg] was compared with EV 2 mg and placebo – followed by an open-label phase in which all of them received Climodien 2/2 (EV 2 mg + dienogest 2 mg). The double-blind and the open-label phase lasted 2 months. ERPs were recorded from 19 EEG leads in a two-tone oddball paradigm and electrical sources of standard N1 and P2 as well as target N2 and P300 components were estimated. In both patients and controls, LORETA revealed an activation of the superior temporal gyrus [auditory cortex, Brodmann areas (BA) 41, 42, 22] for all four components. For standard P2, an additional activation was observed medially parietally in the precuneus (BA 7, 5). For target N2, also a medial frontal source (BA 9, 10, 32) was identified. Finally, for the target P300 component – in addition to the aforementioned sources – activations in the prefrontal cortex (BA 9, 10, 46, 47), the inferior parietal cortex (supramarginal gyrus, BA 40, 39) and the posterior cingulum (BA 31) were found. Thus, patients and controls did not differ in the structural processes engaged in these fundamental aspects of information processing. However, patients demonstrated significantly reduced source strength – for standard ERP components predominantly in the temporal lobe and for target components predominantly in the frontal lobe, indicating reduced energetic resources available for perceptual and cognitive demands of the discrimination task. While, as compared with placebo, estrogen alone had only minor effects on ERP source strength, Climodien generally increased the impressed current density at the ERP peak latencies, predominantly in the temporal lobe, indicating an increased stimulus-induced cortical arousal in the primary and higher-order auditory cortex. Specifically, Climodien enhanced P300 source strength in the left middle temporal gyrus and in the left superior frontal gyrus, brain regions that on the one hand have been shown to be affected by hormone therapy in positron emission tomography and functional magnetic resonance neuroimaging studies and that on the other hand are among those critical for encoding and memory processes.

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Section: Statistical Analysesmentioning

confidence: 99%

Brain Regions Activated during an Auditory Discrimination Task in Insomniac Postmenopausal Patients before and after Hormone Replacement Therapy: Low-Resolution Brain Electromagnetic Tomography Applied to Event-Related Potentials

Anderer

Saletu²,

Saletu-Zyhlarz³

et al. 2004

Neuropsychobiology

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“…studies conducted by saletu-zyhlarz et al revealed that the total amount of sleep and its efficacy increased after applying climodien and Estradiol, but they remained unchanged with the placebo. Unfortunately, the described changes did not reach a statistically significant level [31].…”

Section: Discussionmentioning

confidence: 88%

Factors causing insomnia in postmenopausal women

Karpeta-Pawlak¹,

Wolińska²,

Mroczek³

2017

fmpcr

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A -study Design, B -Data collection, C -statistical analysis, D -Data Interpretation, E -Manuscript preparation, F -literature search, G -Funds collection Background. Insomnia is the most common sleep disorder among adult people. It causes tiredness, difficulties in focusing, loss of energy, increased sensitivity, and irritability. Insomnia may develop into a chronic sleep disorder which has a direct negative impact on the quality of life of the affected person and it limits their capabilities of functioning in society. Objectives. the study objective was to seek relationships between age, the use of Hrt, occurrence of depression symptoms and chronic conditions and insomnia in postmenopausal women. Material and methods. the study was conducted on 128 women, students of the University of the third age in stargard. the median age was 65 years and ranged from 47 to 82 years old. the study was conducted with the use of the Insomnia severity Index, the Beck Depression Inventory and the authors' own questionnaire. Results. Various degrees of insomnia were diagnosed in 69 women (53.91%). a statistically significant relationship was found between insomnia and age (x 2 = 27.48; p = 0.007), occurrence of depression (x 2 = 12.93; p = 0.005), and depression symptoms (x 2 = 81.86; p < 0.001). the study revealed no statistically significant relationship between insomnia and the use of Hrt, or the existence of chronic conditions. Conclusions. age and depression symptoms have a significant impact on the occurrence of insomnia. However, the use of Hrt or preexisting chronic conditions have no key influence on the occurrence of insomnia. Key words: insomnia, Insomnia severity Index (IsI), Beck Depression Inventory (BDI), chronic conditions, Hrt.

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“…Several previous sleep EEG studies resulted in confl icting results probably refl ecting differences in studied subjects and used hormonal treatments [e.g. [41][42][43] . Several possible direct or indirect mechanisms of action of estrogens or progestins have been discussed in this context [ for reviews, see 11,44] .…”

Section: Discussionmentioning

confidence: 99%

Investigating the Effects of Estradiol or Estradiol/Progesterone Treatment on Mood, Depressive Symptoms, Menopausal Symptoms and Subjective Sleep Quality in Older Healthy Hysterectomized Women: A Questionnaire Study

Heinrich¹,

Wolf²

2005

Neuropsychobiology

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Clinical studies have documented that estrogen treatment often ameliorates mood disturbances and depressive symptoms occurring during the menopausal transition. The relevance of gonadal hormones for mood and well-being in healthy older nondepressed women is less well understood. Fifty-one healthy hysterectomized women (mean age 64) participated in a placebo-controlled double-blind study on the effects of gonadal hormones on cognition. They received either estradiol (2 mg estradiol valerate), estradiol plus progesterone (100 mg micronized progesterone) or placebo. Mood, well being, menopausal symptoms, depressive symptoms and subjective sleep quality were measured at baseline and after 4 and 24 weeks of treatment using three questionnaires. Thirty-five women could be included into the final analysis. Strong increases in estradiol and progesterone levels occurred in response to the treatment. The two hormones, however, had no effects on mood, well-being, menopausal symptoms, sleep quality and depressive symptoms. The current small study suggests that older healthy nondepressed hysterectomized women do not react with positive or negative mood changes to estradiol or estradiol/progesterone treatment.

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Cited by 74 publications

References 66 publications

Brain Regions Activated during an Auditory Discrimination Task in Insomniac Postmenopausal Patients before and after Hormone Replacement Therapy: Low-Resolution Brain Electromagnetic Tomography Applied to Event-Related Potentials

Brain Regions Activated during an Auditory Discrimination Task in Insomniac Postmenopausal Patients before and after Hormone Replacement Therapy: Low-Resolution Brain Electromagnetic Tomography Applied to Event-Related Potentials

Factors causing insomnia in postmenopausal women

Investigating the Effects of Estradiol or Estradiol/Progesterone Treatment on Mood, Depressive Symptoms, Menopausal Symptoms and Subjective Sleep Quality in Older Healthy Hysterectomized Women: A Questionnaire Study

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