The effect of estrogen plus progestin treatment on sleep: a randomized, placebo-controlled, double-blind trial in premenopausal and late postmenopausal women

Kalleinen, Nea; Polo, Olli; Himanen, Sari-Leena; Joutsen, Atte; Polo‐Kantola, Päivi

doi:10.1080/13697130802112033

Cited by 41 publications

(24 citation statements)

References 41 publications

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“…Seven of the nine trials included a placebo treatment arm [15, 24–29], while 2 had parallel comparisons of MHT formulations [30, 31]. Therefore, the seven RCTs with placebo arm as comparator had similar interventions and reported sufficient quantitative data to allow for statistical pooling (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Efficacy of menopausal hormone therapy on sleep quality: systematic review and meta-analysis

et al. 2016

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Sleep complaints are reported by 40–60 % of menopausal women. Poor sleep is a risk factor for cardiovascular disease, diabetes, and obesity. The effect of menopausal hormone therapy on sleep quality is unclear. A systematic review and meta-analysis were conducted to summarize the efficacy of menopausal hormone therapy on self-reported sleep quality. Electronic databases (PubMed, Scopus, Ovid MEDLINE, EMBASE, EBM Reviews CENTRAL, and Psyclnfo) were searched from 2002 to October 2015. Randomized trials assessing the effect of menopausal hormone therapy with a minimum follow up of 8 weeks were included. Titles, abstracts, and full texts were screened independently and in duplicate. Primary outcome included sleep items within a questionnaire, scale or diary. Standardized mean differences across trials were pooled using random-effects models. The search identified 424 articles, from which 42 trials were included. Seven trials at a moderate to high risk of bias enrolling 15,468 women were pooled in meta-analysis. Menopausal hormone therapy improved sleep quality in women who had vasomotor symptoms at baseline [standardized mean difference −0. 54 (−0. 91 to −0. 18), moderate quality evidence]. No difference was noted when women without such symptoms were analyzed separately or combined. Across 31 sleep quality questionnaires, daytime dysfunction was the most evaluated sleep domain. Menopausal hormone therapy improves sleep in women with concomitant vasomotor symptoms. Heterogeneity of trials regarding study population, formulations, and sleep scales; limit overall certainty in the evidence. Future menopausal hormone therapy trials should include assessment of self-reported sleep quality using standardized scales and adhere to reporting guidelines.

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Section: Resultsmentioning

confidence: 99%

Efficacy of menopausal hormone therapy on sleep quality: systematic review and meta-analysis

et al. 2016

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“…In the published literature, similar studies in aged female rodents are non-existent. Since young female rats are used in most, if not all, studies investigating the role of ovarian hormones in the modulation of sleep, it is not clear that they represent the best model to assess the controversial role of HT in improving sleep quality in peri-menopausal women (Hachul et al, 2008; Kalleinen et al, 2008). To address this question, middle-aged female rats (10-12 months) were treated with ovarian hormone implants for a two-week period.…”

Section: What Animal Models Can Tell Us About Gonadal Influences and mentioning

confidence: 99%

Sleep, Rhythms, and the Endocrine Brain: Influence of Sex and Gonadal Hormones

Mong¹,

Baker²,

Mahoney³

et al. 2011

J. Neurosci.

251

176

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While much is known about the mechanisms that underlie sleep and circadian rhythms, the investigation into sex differences and gonadal steroid modulation of sleep and biological rhythms is in its infancy. There is a growing recognition of sex disparities in sleep and rhythm disorders. Understanding how neuroendocrine mediators and sex differences influence sleep and biological rhythms is central to advancing our understanding of sleep-related disorders. While it is known that ovarian steroids affect circadian rhythms in rodents, the role of androgen is less understood. Surprising findings that androgens, acting via androgen receptors in the master “circadian clock” within the suprachiasmatic nucleus (SCN), modulate photic effects on activity in males points to novel mechanisms of circadian control. Work in aromatase deficient (ArKO) mice suggests that some sex differences in photic responsiveness are independent of gonadal hormone effects during development. In parallel, aspects of sex differences in sleep are also reported to be independent of gonadal steroids and may involve sex chromosome complement. This a summary of recent work illustrating how sex differences and gonadal hormones influence sleep and circadian rhythms that was presented at a mini-symposium at the 2011 annual meeting of the Society for Neuroscience.

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“…56 Hormone replacement therapy (HRT) seems to alleviate some of the sleep disturbances and improve quality of life; however, the role of HRT in improving sleep quality has been debatable and still continuous to be a major research gap, largely due to lack of concurrence between the study populations and study variables. [57][58][59][60] Recent longitudinal studies have begun to address major questions about the link between menopause and poor sleep in racially diverse populations. For example, Study of Women's Health Across the Nation (SWAN) and the Penn Ovarian Study have incorporated sleep-related items into their questionnaires and performed polysomnographic studies on subgroups.…”

Section: Impact Of Hormonal Transitions On Sleepmentioning

confidence: 99%

Exploring Sex and Gender Differences in Sleep Health: A Society for Women's Health Research Report

Mallampalli

Carter

2014

Journal of Women's Health

394

236

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Previous attempts have been made to address sleep disorders in women; however, significant knowledge gaps in research and a lack of awareness among the research community continue to exist. There is a great need for scientists and clinicians to consider sex and gender differences in their sleep research to account for the unique biology of women. To understand the role of sex differences in sleep and the state of women's sleep health research, the Society for Women's Health Research convened an interdisciplinary expert panel of wellestablished sleep researchers and clinicians for a roundtable meeting. Focused discussions on basic and clinical research along with a focus on specific challenges facing women with sleep-related problems and effective therapies led to the identification of knowledge gaps and the development of research-related recommendations. Additionally, sex differences in sleep disorders were noted and discussed in the context of underlying hormonal differences. Differences in sleep behavior and sleep disorders may not only be driven by biological factors but also by gender differences in the way women and men report symptoms. Progress has been made in identifying sex and gender differences in many areas of sleep, but major research gaps in the areas of epidemiology, sleep regulation, sleep quality, diagnosis, and treatment need to be addressed. Identifying the underlying nature of sex and gender differences in sleep research has potential to accelerate improved care for both men and women facilitating better diagnosis, treatment, and ultimately prevention of sleep disorders and related comorbid conditions.

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The effect of estrogen plus progestin treatment on sleep: a randomized, placebo-controlled, double-blind trial in premenopausal and late postmenopausal women

Cited by 41 publications

References 41 publications

Efficacy of menopausal hormone therapy on sleep quality: systematic review and meta-analysis

Efficacy of menopausal hormone therapy on sleep quality: systematic review and meta-analysis

Sleep, Rhythms, and the Endocrine Brain: Influence of Sex and Gonadal Hormones

Exploring Sex and Gender Differences in Sleep Health: A Society for Women's Health Research Report

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