Search results for: fiona baker

CONTEXT:
The changing hormonal milieu around menopause is implicated in the development of sleep disturbances. No studies have assessed the association between concurrent physiological measures of sleep and serum hormone concentrations in perimenopausal women.
OBJECTIVE:
This study aimed to assess the interaction between physiological sleep and reproductive hormone measures in perimenopausal women.
DESIGN AND PARTICIPANTS:
This was a cross-sectional laboratory study of 33 perimenopausal women age 43-52 years (17 with no sleep complaints and 16 with a clinical diagnosis of insomnia). Eleven premenopausal women without sleep complaints (18-27 y), were included to determine whether hormone-sleep relationships differed depending on reproductive stage.
MAIN OUTCOME MEASURES:
Concurrent polysomnographic sleep indices and serum hormone levels (estradiol and follicle stimulating hormone [FSH]) were measured.
RESULTS:
FSH was positively associated with polysomnographic-defined wakefulness after sleep onset, and number of awakenings and arousals in perimenopausal women (P < .05) without sleep complaints independent of age, body mass index, and hot flashes. Similarly, FSH correlated with wakefulness after sleep onset and light N1 sleep in premenopausal women (P < .05). In contrast, in perimenopausal insomniacs amount of sleep correlated with anxiety and depression (P < .05) but not with FSH. Estradiol did not correlate with sleep in perimenopausal groups but correlated negatively with arousals in premenopausal women (P < .01). CONCLUSION: Our results suggest an interaction between the hypothalamic-pituitary-ovarian (HPO) axis and sleep-wake regulatory systems in pre- and peri-menopausal women without sleep complaints. There was no relationship between hormones and sleep in perimenopausal insomniacs, whose sleep may be influenced by other factors intrinsic to insomnia, such as hyperactivity, poor mood, and night-to-night variability.

Sleep complaints are common in women, and women are more likely to suffer from insomnia than men. Multiple factors across a woman’s lifespan, including hormonal changes, age-related physiological changes, psychosocial factors, the presence of sleep disorders, and physical and mental health conditions, can contribute to complaints of poor sleep in women. This article reviews the literature on the characteristics of, and contributing factors to, subjectively and objectively measured sleep during the menstrual cycle, pregnancy, and post-partum period, as well as the menopausal transition and postmenopause. Evidence from both subjective and objective measurements supports the presence of chronic sleep fragmentation associated with pregnancy, acute sleep deprivation during labour and the immediate post-partum periods, as well as disrupted sleep during the first few months after childbirth. While there is evidence for menstrual cycle and menopause related sleep disturbance based on women’s self report, findings from objectively measured sleep have been mixed. Observational and intervention studies on the relationship between sleep and women’s psychological well-being suggest that underlying causes of sleep disturbance across a woman’s lifespan are often multi-factorial. Comprehensive assessments and targeted interventions are needed in managing sleep problems in women. Cognitive behavioural interventions have been shown to reduce sleep complaints during the perinatal and menopausal periods, and improvements in sleep are likely to lead to improvements in women’s overall well-being.

We investigated cardiac vagal and sympathetic activity in 13 young primary insomniacs (PI; 24.4 ± 1.6 years) and 14 good sleepers (GS; 23.3 ± 2.5 years) during nocturnal sleep. Pre-ejection period (PEP; inversely related to beta-adrenergic sympathetic activity), interval between consecutive R-waves (RR), and vagal-related indices of time- and frequency-domain heart rate variability were computed during pre-sleep wakefulness and undisturbed arousal-free sleep stages (N2, SWS, REM) as well as across the whole night irrespective of the presence of disruptive sleep events (e.g. sleep arousals/awakenings) and/or sleep stage transitions. Groups exhibited a similar vagal activity throughout each undisturbed sleep stage as well as considering the whole night, with a higher modulation during sleep compared to prior wakefulness. However, PEP was constantly shorter (higher sympathetic activity) during pre-sleep wakefulness and each sleep stage in PI compared to GS. Moreover, pre-sleep RR intervals were positively associated with sleep efficiency and negatively associated with wake after sleep onset in PI. Altogether our findings indicated a dysfunctional sympathetic activity but a normal parasympathetic modulation before and during sleep in young adults with insomnia.

OBJECTIVE:
The aim of this study was to determine the role of personality factors in the development of DSM-IV insomnia coincident with perimenopause.
METHODS:
Perimenopausal women (35 women with DSM-IV insomnia and 28 women with self-reported normal sleep) underwent clinical assessments and completed menopause-related questionnaires, the NEO Five Factor Inventory and the Structured Interview for DSM-IV Personality. Logistic regressions determined whether personality factors and hot flash-related interference were associated with an insomnia diagnosis concurrent with the menopausal transition.
RESULTS:
Women with insomnia reported higher neuroticism, lower agreeableness, and lower conscientiousness than controls on the NEO Five Factor Inventory. Moreover, women with insomnia were more likely to meet DSM-IV criteria for cluster C personality disorders, particularly obsessive-compulsive personality disorder, on the Structured Interview for DSM-IV Personality. Women with insomnia were more likely to have had a past depressive episode and a history of severe premenstrual symptoms. Findings from regressions revealed that higher neuroticism and greater interference from hot flashes were associated with insomnia classification even after controlling for history of depression, suggesting that sensitivity to hot flashes and a greater degree of neuroticism are independent contributors toward establishing which women are most likely to have sleep problems during perimenopause.
CONCLUSIONS:
Findings show the relevance of personality factors, particularly neuroticism and obsessive-compulsive personality, to a woman’s experience of insomnia as she goes through the menopausal transition.

PURPOSE:
Primary dysmenorrhea, which refers to painful, spasmodic cramping in the lower abdomen just before/or during menstruation, is the most common gynecological complaint in women of reproductive age. Non-steroidal anti-inflammatory drugs have been prescribed as the first-line therapy for pain relief from dysmenorrhea. We aimed to investigate the efficacy of the daily recommended dose (150 mg) of diclofenac potassium, administered at set intervals across the first 24 h of menstruation, in treating severe menstrual pain in 24 women with severe primary dysmenorrhea.
METHODS:
In a randomized, placebo-controlled, double-blind cross-over study, women rated their menstrual pain intensity on a 100-mm visual analog scale across set time intervals over a 24-h period.
RESULTS:
Menstrual pain intensity was significantly reduced after taking the first capsule of diclofenac, and remained consistently lower (P < 0.0001), compared with initial pain intensity, in the morning (before treatment), throughout the day, evening, and into the next morning. Also, women rated their pain intensity as significantly lower (P < 0.001) at each time point across the 24-h time interval of the cycle when receiving diclofenac compared with the cycle when they received placebo. No woman required rescue medication when taking diclofenac potassium compared with six women taking rescue medications during the placebo trial. When taking only placebo, women rated their menstrual pain intensity as persistently severe across the first 24 h of menstruation. CONCLUSION: These results show that the recommended daily dose of diclofenac potassium, in three 50 mg doses across the day and evening, offers effective menstrual pain relief across 24 h, compared with placebo, in women with severe primary dysmenorrhea.

Background
Alcoholism is considered an important risk factor for cardiovascular (CV) disease. Autonomic nervous system (ANS) function is a major indicator of CV health. Sleep is a suitable model to investigate ANS activity free from wake-related confounders. We investigated nighttime ANS functioning, and the relation between ANS activity and severity of alcohol dependence in chronic alcoholism.
Methods
Fourteen recently abstaining alcoholics (age: 42.0 ± 9.0 years, 7 women) and 16 age- and sex-matched controls (age: 45.2 ± 9.1 years, 8 women) underwent a night of standard clinical polysomnography, including electrocardiographic recording. Time- and frequency-domain spectral analysis of heart rate variability (HRV) was performed across hours of the night and during artifact-free epochs of stable sleep and wakefulness (presleep wakefulness, rapid-eye-movement [REM], and non-REM sleep).
Results
Alcoholics had a poorer subjective and objective sleep quality compared to controls. Across the night, alcoholic men and women had elevated heart rate, reduced total HRV, that is, lower standard deviation of normal-to-normal interbeat intervals, and reduced high frequency (HF) activity (assessed by the HF power and by the square root of the mean squared of successive heart period differences). This ANS pattern was most apparent at the beginning of the night. None of the ANS measures was associated with lifetime alcohol consumption or duration of alcohol dependence.
Conclusions
Our results show that ANS functioning is disrupted during the night, even in undisturbed sleep periods, indicating poor CV functioning in recently detoxified alcohol-dependent men and women.

SRI Authors: Ian M. Colrain, Fiona C Baker, Massimiliano de Zambotti

SRI Authors: Fiona C Baker