Nocturnal sleep, daytime sleepiness, and napping among women with significant emotional/behavioral premenstrual symptoms

Abstract

SUMMARY The objective of this study is to examine daytime sleepiness and alertness and nap characteristics among women with significant emotional ⁄ behavioral premenstrual symptoms, and to determine their relationship with nocturnal sleep. Participants spent one night during the follicular phase and two nights during the late-luteal phase, one of which occurred after a 40 min opportunity to nap, sleeping in the laboratory. Subjective measures of sleepiness and alertness were completed during the afternoon of each recording. Setting took place at the sleep laboratory at the University of Ottawa. A total number of participants were 10 women with significant and nine women with minimal emotional ⁄ behavioral premenstrual symptoms (mean age 26 years). The results were compared with the follicular phase, both groups of women had less slow wave sleep and more stage 2 sleep at night, as well as a higher daytime and nocturnal mean and maximum temperature during the late-luteal phase. Women with significant symptoms were sleepier and less alert during the late-luteal phase and had a higher overall mean nocturnal temperature compared with women with minimal symptoms. No significant differences were found between the two groups on nap characteristics and nocturnal sleep characteristics. Results show that women with more severe premenstrual symptoms are sleepier during the late-luteal phase than women with minimal symptoms. The increased daytime sleepiness seems to be unrelated to nocturnal sleep or nap characteristics.

Sleep quality in university students with premenstrual dysphoric disorder

“…[11] Similar results were shown in a study by Lamarche and colleagues who found decreased SWS and REM sleep and increased stage 2 sleep during the LP in both healthy and women with PMS. [35] A reduction in REM sleep during LP compared to FP has also been reported by Shechter and colleagues who observed this variation in healthy women and patients with PMDD. [36] Similarly, in their sleep EEG study Parry and colleagues examined eight women with moderate to severe premenstrual depression and eight controls, two nights per week over the course of one menstrual cycle and found that depressed women had more stage 2 sleep and less REM sleep than controls.…”

Sleep, Hormones, and Circadian Rhythms throughout the Menstrual Cycle in Healthy Women and Women with Premenstrual Dysphoric Disorder

“…The most consistently observed menstrual cycle-related changes in the sleep profile of healthy women are a reduction of REM sleep [49, 51–53, 56], with a maintenance of homeostatic sleep mechanisms throughout the cycle [90], and a robust variation of SFA across the menstrual cycle [48, 49, 55], which increases in association with progesterone during the LP. Similarly, women with PMS/PMDD have also shown decreases in REM sleep [52, 56] and increases in SFA [55] during the LP compared to the FP.…”

“…Another study revealed that, compared to controls, PMS patients had more stage 2 sleep (%) and less REM sleep (%), and within these patients, stage 3 sleep (min; peaks near the late-FP/early-LP) and intermittent awakenings (peaks near the late-LP) varied significantly across the menstrual cycle [45]. More recently, a study including healthy women and those with PMS found decreased SWS (%) and REM sleep (%) as well as increased stage 2 (%) during the LP in both groups [56]. …”

Actigraphy-defined measures of sleep and movement across the menstrual cycle in midlife menstruating women

“…The National Sleep Foundation Sleep in America survey (2007) identified that 25%–33% of menstruating women complained of sleep disturbances during the premenstrual week or during menses; women who reported severe premenstrual symptoms (PMS) also experienced symptoms of insomnia and daytime sleepiness 6 . Smaller studies of women with premenstrual mood disorders have identified substantial sleep disturbances, including either hypersomnia or insomnia during the premenstrual period 8–9 . The extent to which findings from these studies can be extrapolated to midlife women as they approach menopause remains in question, thereby limiting our understanding of the extent to which increased sleep disturbances in midlife women are associated with alterations in menstrual cycles and hormone dynamics 4, 10 .…”