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Solelhac G, Imler T, Strippoli MPF, Marchi NA, Berger M, Haba-Rubio J, Raffray T, Bayon V, Lombardi AS, Ranjbar S, Siclari F, Vollenweider P, Marques-Vidal P, Geoffroy PA, Léger D, Stephan A, Preisig M, Heinzer R. Sleep disturbances and incident risk of major depressive disorder in a population-based cohort. Psychiatry Res 2024; 338:115934. [PMID: 38833937 DOI: 10.1016/j.psychres.2024.115934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/25/2024] [Accepted: 04/27/2024] [Indexed: 06/06/2024]
Abstract
Sleep disturbances are well-known symptoms of major depressive disorder (MDD). However, the prospective risk of MDD in the presence of sleep disturbances in a general population-based cohort is not well known. This study investigated associations between both polysomnography (PSG)-based or subjective sleep features and incident MDD. Participants representative of the general population who had never had MDD completed sleep questionnaires (n = 2000) and/or underwent PSG (n = 717). Over 8 years' follow-up, participants completed psychiatric interviews enabling the diagnosis of MDD. Survival Cox models were used to analyze associations between sleep features and MDD incidence. A higher Epworth Sleepiness Scale and presence of insomnia symptoms were significantly associated with a higher incidence of MDD (hazard ratio [HR] [95 % confidence interval (CI)]: 1.062 [1.022-1.103], p = 0.002 and 1.437 [1.064-1.940], p = 0.018, respectively). Higher density of rapid eye movements in rapid eye movement (REM) sleep was associated with a higher incidence of MDD in men (HR 1.270 [95 % CI 1.064-1.516], p = 0.008). In women, higher delta power spectral density was associated with a lower MDD incidence (HR 0.674 [95 % CI 0.463-0.981], p = 0.039). This study confirmed the associations between subjective and objective sleep features and the incidence of MDD in a large community dwelling cohort.
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Affiliation(s)
- Geoffroy Solelhac
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
| | - Théo Imler
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Marie-Pierre F Strippoli
- Center for research in Psychiatric Epidemiology and Psychopathology (CEPP), Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Nicola Andrea Marchi
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Mathieu Berger
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Jose Haba-Rubio
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland; Florimont Sleep Center, Lausanne, Switzerland
| | - Tifenn Raffray
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland; Florimont Sleep Center, Lausanne, Switzerland
| | - Virginie Bayon
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Anne Sophie Lombardi
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Setareh Ranjbar
- Center for research in Psychiatric Epidemiology and Psychopathology (CEPP), Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Francesca Siclari
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland; Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands; The Sense Innovation and Research Center, Lausanne and Sion, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pierre-Alexis Geoffroy
- GHU Paris - Psychiatry & Neurosciences, Paris, France; Université de Paris, NeuroDiderot, Inserm, Paris, France; Département de Psychiatrie et d'Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
| | - Damien Léger
- Université Paris Cité, VIFASOM, AP-HP, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, Paris, France
| | - Aurélie Stephan
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Center for research in Psychiatric Epidemiology and Psychopathology (CEPP), Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Raphaël Heinzer
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
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Johnson CE, Duncan MJ, Murphy MP. Sex and Sleep Disruption as Contributing Factors in Alzheimer's Disease. J Alzheimers Dis 2024; 97:31-74. [PMID: 38007653 PMCID: PMC10842753 DOI: 10.3233/jad-230527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
Alzheimer's disease (AD) affects more women than men, with women throughout the menopausal transition potentially being the most under researched and at-risk group. Sleep disruptions, which are an established risk factor for AD, increase in prevalence with normal aging and are exacerbated in women during menopause. Sex differences showing more disrupted sleep patterns and increased AD pathology in women and female animal models have been established in literature, with much emphasis placed on loss of circulating gonadal hormones with age. Interestingly, increases in gonadotropins such as follicle stimulating hormone are emerging to be a major contributor to AD pathogenesis and may also play a role in sleep disruption, perhaps in combination with other lesser studied hormones. Several sleep influencing regions of the brain appear to be affected early in AD progression and some may exhibit sexual dimorphisms that may contribute to increased sleep disruptions in women with age. Additionally, some of the most common sleep disorders, as well as multiple health conditions that impair sleep quality, are more prevalent and more severe in women. These conditions are often comorbid with AD and have bi-directional relationships that contribute synergistically to cognitive decline and neuropathology. The association during aging of increased sleep disruption and sleep disorders, dramatic hormonal changes during and after menopause, and increased AD pathology may be interacting and contributing factors that lead to the increased number of women living with AD.
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Affiliation(s)
- Carrie E. Johnson
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
| | - Marilyn J. Duncan
- University of Kentucky, College of Medicine, Department of Neuroscience, Lexington, KY, USA
| | - M. Paul Murphy
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
- University of Kentucky, Sanders-Brown Center on Aging, Lexington, KY, USA
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Seo K, Ryu S, Jeong S, Kang HT, Kim SK, Koh SB, Jeong KS, Oh SS. Risk of insomnia symptoms according to Work-Family Conflict by workers' characteristics. Ann Occup Environ Med 2023; 35:e36. [PMID: 37701485 PMCID: PMC10493379 DOI: 10.35371/aoem.2023.35.e36] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/05/2023] [Accepted: 07/31/2023] [Indexed: 09/14/2023] Open
Abstract
Background Work-Family Conflict means that the demands of work and family roles cannot be met simultaneously, so one cannot concentrate on one's work or family role. This conflict can negatively affect mental health and cause insomnia symptoms. Methods This study was conducted on 20,442 subjects. Insomnia symptoms were assessed using the Minimal Insomnia Symptom Scale, and other variables were assessed using the questionnaire method. Logistic regression analyses were performed to evaluate the effect of Work-Family Conflict on insomnia symptoms, and subgroup logistic regression analyses were also performed. Results The number of people with insomnia symptoms was 4,322 (15.1%). Compared with Low Work-Family Conflict, the odds ratios (ORs) for the risk of insomnia symptoms were 1.84 (95% confidence interval: 1.56-2.16) in High work-to-family conflict, 1.16 (1.02-1.32) in High family-to-work conflict, and 3.19 (2.87-3.55) in High Work-Family Conflict. The ORs were higher for men than women in High WFC but higher for women than men in High Work-Family Conflict. Conclusions The risk of insomnia symptoms was highest in High Work-Family Conflict.
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Affiliation(s)
- Kwanghyun Seo
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seungjun Ryu
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Saebomi Jeong
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Hee-Tae Kang
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sung-Kyung Kim
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sang-Baek Koh
- Department of Preventive Medicine and Genomic Cohort Institute, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyoung Sook Jeong
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sung-Soo Oh
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Korea
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Huang DR, Goodship A, Webber I, Alaa A, Sasco ER, Hayhoe B, El-Osta A. Experience and severity of menopause symptoms and effects on health-seeking behaviours: a cross-sectional online survey of community dwelling adults in the United Kingdom. BMC Womens Health 2023; 23:373. [PMID: 37452317 PMCID: PMC10347781 DOI: 10.1186/s12905-023-02506-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Almost all women will experience menopause, and the symptoms can have a severely detrimental impact on their quality of life. However, there is limited research exploring health-seeking behaviours and alternative service design or consultation formats. Group consultations have been successfully deployed in perinatal and diabetic care, improving accessibility and outcomes. This cross-sectional online survey was conducted to explore women's personal experiences of menopause, including perspectives on group consultations. METHODS An online survey investigated the experiences of individuals at all stages of menopause and their receptiveness towards group consultations for menopause. Respondents were categorised by menopause stage according to the STRAW + 10 staging system. Associations between menopause stage, acceptability of group consultations and participant demographics were assessed using logistic regression. RESULTS Respondents experienced an average of 10.7 menopausal symptoms, but only 47% of respondents felt they had the knowledge and tools to manage their symptoms. Advice on menopause was sought from a healthcare professional (HCP) by 61% of respondents, the largest trigger for this being severity of symptoms and the main barrier for this was the perception that menopause wasn't a valid enough reason to seek help. Of the respondents seeking advice from HCPs, 32% were prescribed transdermal HRT, 29% received oral HRT, 19% were offered antidepressants, 18% received local oestrogen and 6% were prescribed testosterone. Over three quarters (77%) of respondents indicated that they would join a group consultation for menopause and would be comfortable sharing their experiences with others (75%). Logistic regression indicated premenopausal respondents were 2.84 times more likely than postmenopausal women to be interested in a group consultation where they can meet or learn from others' experiences. CONCLUSIONS This study highlighted a strong willingness of women aged 35-70 to participate in group consultations for menopause, with motivation being strongest amongst premenopausal women. Low awareness of self-management and lifestyle interventions to manage the symptoms of menopause highlight the need for greater outreach, research and interventions to build knowledge and confidence in the general population at scale. Future studies should focus on investigating the effectiveness and economic impact of menopause group consultations and the lived experience of individuals participating in group consultations.
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Affiliation(s)
- David Roy Huang
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College, London, W6 8RF UK
| | - Abigail Goodship
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College, London, W6 8RF UK
| | - Iman Webber
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College, London, W6 8RF UK
| | - Aos Alaa
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College, London, W6 8RF UK
| | - Eva Riboli Sasco
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College, London, W6 8RF UK
| | - Benedict Hayhoe
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College, London, W6 8RF UK
| | - Austen El-Osta
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College, London, W6 8RF UK
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Benham JL, Booth JE, Goldfield G, Friedenreich CM, Rabi DM, Sigal RJ. Self-reported sleep quality and exercise in polycystic ovary syndrome: A secondary analysis of a pilot randomized controlled trial. Clin Endocrinol (Oxf) 2023; 98:700-708. [PMID: 36843192 DOI: 10.1111/cen.14900] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/30/2023] [Accepted: 02/23/2023] [Indexed: 02/28/2023]
Abstract
OBJECTIVE To examine the proportion of participants with poor sleep quality, evaluate the associations between sleep quality and anthropometric and cardiometabolic health markers, and evaluate the effect of high intensity interval training (HIIT) and continuous aerobic exercise training (CAET) on sleep quality in polycystic ovary syndrome (PCOS). DESIGN Secondary analysis of a pilot randomized controlled trial. PATIENTS Women with PCOS aged 18-40 years. MEASUREMENTS The Pittsburgh Sleep Quality Index (PSQI) was measured at baseline and following a 6-month exercise intervention. A PSQI score >5 indicates poor sleep. Linear regression was used to evaluate the associations between PSQI score and anthropometric and cardiometabolic health markers, and the effect of exercise training on these associations. RESULTS Thirty-four participants completed the PSQI at baseline, and 29 postintervention: no-exercise control (n = 9), HIIT (n = 12) and CAET (n = 8). At baseline, 79% had poor sleep quality. Baseline PSQI score was positively correlated with body mass index, waist circumference, body weight, haemoglobin A1c and insulin resistance. Mean PSQI score changes were -0.4 (SD 1.1), -0.7 (SD 0.6) and -0.5 (SD 0.9) for control, HIIT and CAET, respectively. For HIIT participants, change in PSQI score was associated with changes in body weight (B = .27, 95% CI 0.10-0.45) and waist circumference (B = .09, 95% CI 0.02-0.17). CONCLUSION Most participants had poor sleep quality which was associated with poorer anthropometric and cardiometabolic health markers. There were no statistically significant changes in PSQI score with exercise training. With HIIT training, decreases in the sleep efficiency score were associated with reductions in body weight and waist circumference. Further studies are needed to determine the effect of exercise training on sleep quality.
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Affiliation(s)
- Jamie L Benham
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jane E Booth
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gary Goldfield
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Christine M Friedenreich
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Doreen M Rabi
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ronald J Sigal
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Karimi FZ, Hosseini H, Mazlom SR, Rakhshandeh H, Asadpour H. The effect of oral capsule of Ocimum basilicum leaf extract on sleep quality and insomnia severity in menopausal women: A randomized clinical trial. Phytother Res 2023. [PMID: 36750371 DOI: 10.1002/ptr.7753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/18/2022] [Accepted: 10/09/2022] [Indexed: 02/09/2023]
Abstract
One of the complications of menopause is sleep disorders, which affect women's health. Ocimum basilicum contains compounds that may affect sleep. The aim of this study was to determine the effect of an oral capsule of O. basilicum leaf extract on sleep quality and the severity of insomnia in menopausal women. This triple-blind, randomized clinical trial study was performed on 60 Iranian menopausal women aged 40 to 65 years. Subjects were randomly assigned into two groups of intervention (each capsule containing 250 mg of O. basilicum extract and 250 mg Avicel) per day for 1 month and placebo. The Pittsburgh Sleep Quality and Insomnia Intensity Index were used to assess sleep quality and severity of insomnia before, 2 weeks after and 1 month after the intervention. There was no statistically significant difference in the baseline variables between the intervention and placebo groups (p > .05). The total sleep quality scores in the two groups of intervention and placebo were 6.2 ± 0.3 versus 9.3 ± 0.3 (p < .001) and 3.7 ± 0.3 versus 9.1 ± 0.3 (p = .015) 2 weeks and 1 month after the intervention, respectively. The total insomnia severity scores in the two groups of intervention and placebo were 9.0 ± 0.3 versus 12.1 ± 0.3 (p < .001) and 5.6 ± 0.5 versus 11.0 ± 0.5 (p < .001) 2 weeks and 1 month after the intervention, respectively. Consumption of O. basilicum capsules improved sleep quality and insomnia in menopausal women. This study was approved (code IR.MUMS.NURSE.REC.1398.070) by the Ethic committee of Mashhad University of Medical Sciences and registered at the Iranian Registry of Clinical Trials, with the No. IRCT20200104046001N1 in January 2020.
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Affiliation(s)
- Fatemeh Zahra Karimi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Hosseini
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyad Reza Mazlom
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University Medical of Medical Sciences, Mashhad, Iran
| | - Hassan Rakhshandeh
- Medicinal Plants Pharmacological Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Asadpour
- Sleep Clinic of Ebn-e-Sina Hospital, Psychiatry and Behavioral Sciences Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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The role of ovarian hormones in the pathophysiology of perimenopausal sleep disturbances: A systematic review. Sleep Med Rev 2022; 66:101710. [PMID: 36356400 DOI: 10.1016/j.smrv.2022.101710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
Sleep disturbance is a common clinical concern throughout the menopausal transition. However, the pathophysiology and causes of these sleep disturbances remain poorly understood, making it challenging to provide appropriate therapy. Our goal was to i) review the literature about the influence of ovarian hormones on sleep in perimenopausal women, ii) summarize the potential underlying pathophysiology of menopausal sleep disturbances and iii) evaluate the implications of these findings for the therapeutic approach to sleep disturbances in the context of menopause. A systematic literature search using the databases Embase, MEDLINE and Cochrane Library was conducted. Keywords relating to ovarian hormones, sleep disturbances and menopause were used. Ultimately, 86 studies were included. Study Quality Assessment Tools of the National Institutes of Health were used for quality assessment. Results from good-quality studies demonstrated that the postmenopausal decline in estrogen and progesterone contributes to sleep disturbances in women and that timely treatment with estrogen and/or progesterone therapy improved overall sleep quality. Direct and indirect effects of both hormones acting in the central nervous system and periphery, as well as via secondary effects (e.g. reduction in vasomotor symptoms), can contribute to improvements in sleep. To strengthen external validity, studies examining neurobiological pathways are needed.
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Mediating Effect of Self-Cognitive Oral Health Status on the Effect of Obstructive Sleep Apnea Risk Factors on Quality of Life (HINT-8) in Middle-Aged Korean Women: The Korea National Health and Nutrition Examination Survey. Life (Basel) 2022; 12:life12101569. [PMID: 36295003 PMCID: PMC9605353 DOI: 10.3390/life12101569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 11/05/2022] Open
Abstract
Background: Obstructive sleep apnea and oral health are highly correlated with quality of life. The purpose of this study is to determine the mediating effect of self-cognitive oral health status on the effect of obstructive sleep apnea (OSA) risk factors on quality of life in middle-aged Korean women using the 2019 National Health and Nutrition Examination Survey data. Methods: A hierarchical regression analysis was performed on the mediating effect of self-cognitive oral health status on the effects of OSA risk factors on health-related quality of life (Korean health-related quality of life instrument with 8 items; HINT-8). Results: Self-cognitive oral health status as a parameter had a significant effect on quality of life (β = 0.713, p < 0.001). Compared to the effect of the OSA risk factor of the second stage on the quality of life (β = −1.329, p < 0.001), the input of the third stage of self-cognitive oral health was partially mediated (β = −1.280, p <0.001). Conclusions: Therefore, if middle-aged women have OSA risk factors, they should try to improve their quality of life by managing oral health as well as OSA treatment.
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Effect of Docosahexaenoic Acid and Eicosapentaenoic Acid Supplementation on Sleep Quality in Healthy Subjects: A Randomized, Double-Blinded, Placebo-Controlled Trial. Nutrients 2022; 14:nu14194136. [PMID: 36235788 PMCID: PMC9573173 DOI: 10.3390/nu14194136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 11/17/2022] Open
Abstract
Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA)-omega-3 fatty acids with various functions-influence sleep in children and young adults. However, only limited studies on their effects on sleep in middle- and old-aged adults have been reported. Therefore, we investigated the effects of DHA and EPA on sleep quality in subjects aged ≥ 45 years. We performed a randomized, placebo-controlled, double-blinded, parallel-grouped study, in which we randomly assigned 66 healthy Japanese males and females. Each individual received six 480 mg capsules containing 576 mg DHA and 284 mg EPA per day (DHA/EPA group, n = 33), or corn oil (placebo group, n = 33), for 12 weeks. Before and after the intervention, the Oguri-Shirakawa-Azumi sleep inventory MA version (OSA-MA) and the sleep state test were conducted. In the DHA/EPA group, factor III (frequent dreaming) scores among the OSA-MA scores were significantly improved compared to the placebo group. Additionally, sleep state tests revealed that sleep efficiency improved in the DHA/EPA group. To our knowledge, this study is the first to report that DHA/EPA improves sleep quality in middle- and old-aged individuals, even at doses lower than those administered in previous studies.
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Exploring the Effects of Perceived Stress on the Within-Person Relationships Between Daily Activity Levels and Sleep in Women: An Ecological Momentary Assessment Study. Int J Behav Med 2022:10.1007/s12529-022-10123-4. [PMID: 36161390 DOI: 10.1007/s12529-022-10123-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Many studies show positive bidirectional associations between physical activity (PA) and sleep at the between-person level. There is an increased interest in investigating these associations at the within-person level. Few studies examined the effects of time-varying moderators on the within-person bidirectional associations between PA and sleep. This study aimed to examine the bidirectional within-person day-level associations between activity levels and self-reported sleep duration and explore the moderating effects of perceived stress on these day-level associations. METHOD Data from 158 women that included 7-day free-living monitoring over 4 measurement periods was analyzed using multilevel modeling to explore the moderating effects of daily stress on the bidirectional, within-person associations between activity levels and self-reported sleep duration. Moderate-to-vigorous PA (MVPA) and sedentary behavior (SB) were estimated from a waist-worn accelerometer. Self-reported sleep duration and perceived stress were collected by ecological momentary assessment. RESULTS No significant within-person associations between MVPA minutes and self-reported sleep duration were found in either direction. However, engaging in more MVPA than one's usual level was associated with longer sleep later that night when perceived stress was higher than usual (p = .04). Bidirectional negative within-person association between SB minutes and self-reported sleep duration was found (ps < .01). The negative association between SB and sleep duration later that night was stronger when perceived stress was lower than usual (p = .01). CONCLUSION Daily stress played an important role in the day-to-day associations between activity levels and sleep.
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11
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Examining negative affect, sleep duration, and using food to cope as predictors of weight in midlife women. J Behav Med 2022; 45:894-903. [PMID: 35933573 DOI: 10.1007/s10865-022-00338-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/20/2022] [Indexed: 10/15/2022]
Abstract
Midlife women are vulnerable to developing obesity. Behavioral and psychosocial factors including sleep duration, stress eating, and negative emotionality are risk factors. However, little is known about the complex daily interplay between sleep, eating, emotion, and weight among midlife women. The current study examined how daily sleep, using food to cope, and negative emotionality are associated with weight using a daily process research design. An archival analysis was performed using the Midlife in the United States-II study (MIDUS II). The sample consisted of 489 midlife women (40-64 years of age). Variables included ecological momentary assessments of daily sleep duration, using food to cope, and negative affect (means and intraindividual variability) and a standardized measurement of BMI. Sleep duration variability was a significant predictor of BMI, albeit the model only accounted for .8% of the variance in BMI (b = .019, p < .05). In the final adjusted model, sleep duration variability, using food to cope, age, and physical activity were all significant predictors of BMI F(5, 559) = 21.503, p < .001, R2 = .161, ⨂R2 = .024, p = .001. Variability in negative affect, mean sleep duration or negative affect and the interactions between sleep duration (mean, variability) and negative affect (mean, variability) were not significant. Greater variability in sleep duration and greater use of food to cope predicted higher BMI in this sample across age and physical activity levels. Results highlight that daily health and psychosocial factors play an important role in weight.
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12
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Lehrer HM, Yao Z, Krafty RT, Evans MA, Buysse DJ, Kravitz HM, Matthews KA, Gold EB, Harlow SD, Samuelsson LB, Hall MH. Comparing polysomnography, actigraphy, and sleep diary in the home environment: The Study of Women's Health Across the Nation (SWAN) Sleep Study. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2022; 3:zpac001. [PMID: 35296109 PMCID: PMC8918428 DOI: 10.1093/sleepadvances/zpac001] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 12/04/2021] [Indexed: 01/28/2023]
Abstract
Study Objectives Polysomnography (PSG) is considered the "gold standard" for assessing sleep, but cost and burden limit its use. Although wrist actigraphy and self-report diaries are feasible alternatives to PSG, few studies have compared all three modalities concurrently across multiple nights in the home to assess their relative validity across multiple sleep outcomes. This study compared sleep duration and continuity measured by PSG, actigraphy, and sleep diaries and examined moderation by race/ethnicity. Methods Participants from the Study of Women's Health Across the Nation (SWAN) Sleep Study included 323 White (n = 147), African American (n = 120), and Chinese (n = 56) middle-aged community-dwelling women (mean age: 51 years, range: 48-57). PSG, wrist actigraphy (AW-64; Philips Respironics, McMurray, PA), and sleep diaries were collected concurrently in participants' homes over three consecutive nights. Multivariable repeated-measures linear models compared time in bed (TIB), total sleep time (TST), sleep efficiency (SE), sleep latency (SL), and wake after sleep onset (WASO) across modalities. Results Actigraphy and PSG produced similar estimates of sleep duration and efficiency. Diaries yielded higher estimates of TIB, TST, and SE versus PSG and actigraphy, and lower estimates of SL and WASO versus PSG. Diary SL was shorter than PSG SL only among White women, and diary WASO was lower than PSG and actigraphy WASO among African American versus White women. Conclusions Given concordance with PSG, actigraphy may be preferred as an alternative to PSG for measuring sleep in the home. Future research should consider racial/ethnic differences in diary-reported sleep continuity.
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Affiliation(s)
- H Matthew Lehrer
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Zhigang Yao
- Department of Statistics and Applied Probability, National University of Singapore, Singapore, Singapore
| | - Robert T Krafty
- Deparment of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Marissa A Evans
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Howard M Kravitz
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA,Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ellen B Gold
- Department of Public Health Sciences, University of California, Davis School of Medicine, Davis, CA, USA
| | - Sioban D Harlow
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | | | - Martica H Hall
- Corresponding author. Martica H. Hall, University of Pittsburgh, 3811 O’Hara Street, Room E-1131, Pittsburgh, PA 15213, USA.
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13
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The association between laryngopharyngeal reflux and insomnia. Eur Arch Otorhinolaryngol 2022; 279:3535-3541. [PMID: 35129631 DOI: 10.1007/s00405-022-07280-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/19/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To evaluate the prevalence of insomnia in patients with laryngopharyngeal reflux (LPR) and to analyze the relationship between the severity of insomnia and LPR-related symptoms. METHODS We analyzed 69 patients with LPR and 61 healthy controls. The LPR was confirmed via the 24-h hypopharyngeal-esophageal multichannel intraluminal impedance pH monitoring. Reflux symptoms and sleep disturbances were assessed using the Reflux Symptom Index and Insomnia Severity Index. We compared the prevalence of insomnia between the two groups. We analyzed the relationship between reflux symptoms and severity of insomnia. RESULTS The prevalence of insomnia was significantly higher in patients with LPR than in healthy controls (46.3% vs. 29.5%; p = 0.049). The severity of reflux-related symptoms was correlated with insomnia severity (rho = 0.44; p < 0.001). Patients with LPR with nighttime reflux were more likely to have sleep disturbances than patients with LPR without nighttime reflux. CONCLUSION Patients with LPR are more likely to experience insomnia than healthy controls, and the severity of reflux symptoms was related to the severity of insomnia.
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14
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Li GY, Qian XD, Ma CM, Yin FZ. The dose-response relationship between sex hormones and hyperuricemia in different gender: NHANES 2013-2016. Front Endocrinol (Lausanne) 2022; 13:1035114. [PMID: 36387910 PMCID: PMC9663851 DOI: 10.3389/fendo.2022.1035114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To access the dose-response relationship between sex hormones and hyperuricemia (HUA), and to find the cut-off value in different gender. METHODS 9,685 participants were derived from the database of National Health and Nutrition Examination Survey (NHANES). Restricted cubic spline (RCS) analysis were applied to explore the relationship between sex hormones and HUA after adjusting for confounding factors by propensity score match (PSM). Logistic regression was used to estimate the odds ratio (OR) and 95% CI. RESULTS The prevalence of HUA was 15.13% in female participants and 22.30% in male participants. Logistic regression analysis showed that estradiol (E2) was independently associated with HUA for a P value of 0.003 and 0.01in female and male participants, respectively. Testosterone (T) was only independently associated with HUA in male participants (P<0.001) but not in female participants (P = 0.59). RCS analysis showed a dose-response relationship between sex hormones and HUA. The risk of HUA increased as E2 lower than 29.6pg/mL in female participants and T lower than 389.1ng/dL in male participants. E2 higher than 23.6pg/ml was an independent risk factor for HUA in male participants. CONCLUSION A dose-response relationship was found between sex hormones and HUA. The cut-off value of E2 in male and female participants was 29.6pg/mL and 23.6pg/mL, respectively, and the cut-off value of T in male participants was 389.1ng/dL. These results provide a reference for preventing HUA and hormone supplement therapy.
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Affiliation(s)
- Guo-yun Li
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
- Department of Endocrinology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| | - Xu-dong Qian
- Department of Neurology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| | - Chun-ming Ma
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
| | - Fu-zai Yin
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
- *Correspondence: Fu-zai Yin,
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15
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Moradi Farsani H, Afshari P, Sadeghniiat Haghighi K, Gholamzadeh Jefreh M, Abedi P, Haghighizadeh MH. The effect of group cognitive behavioural therapy for insomnia in postmenopausal women. J Sleep Res 2021; 30:e13345. [PMID: 33818845 DOI: 10.1111/jsr.13345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 11/30/2022]
Abstract
The menopausal period is associated with several complications in women. One of these complications is sleep disorders including insomnia disorder that can affect all aspects of personal life. The present study aimed to evaluate the effectiveness of cognitive behavioural therapy for insomnia (CBT-I) on insomnia severity and sleep quality among postmenopausal women. This was a randomised clinical trial in which 46 women were recruited and randomly allocated into two groups, one receiving CBT-I and a control group. The CBT-I group received six sessions of training, while the control group received only usual care. A demographic questionnaire, Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI), were used to collect the data. The ISI and PSQI were measured at baseline, 3 and 6 weeks after intervention, and in a 4-week follow-up. The Independent t test, the chi-square test, generalised estimating equation models, and Bonferroni correction were applied to analyse the data. According to our results, in the CBT-I group compared to the control group, the mean ISI, PSQI, sleep onset latency, sleep time, and sleep quality score reduced continuously from baseline to week 3 and from week 3 to week 6, and remained constant from week 6 to week 10. The mean sleep efficiency score improved significantly from baseline to week 3 in the CBT-I group and remained unchanged until the end of the study. CBT-I could significantly improve insomnia severity and sleep quality in postmenopausal women. Therefore, using this method is recommended for menopausal women with insomnia.
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Affiliation(s)
- Hadis Moradi Farsani
- Midwifery Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Poorandokht Afshari
- Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | | | - Parvin Abedi
- Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Hossein Haghighizadeh
- Faculty of Public Health, Department of Statistics and Epidemiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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16
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Lounassalo I, Hirvensalo M, Palomäki S, Salin K, Tolvanen A, Pahkala K, Rovio S, Fogelholm M, Yang X, Hutri-Kähönen N, Raitakari OT, Tammelin TH. Life-course leisure-time physical activity trajectories in relation to health-related behaviors in adulthood: the Cardiovascular Risk in Young Finns study. BMC Public Health 2021; 21:533. [PMID: 33740917 PMCID: PMC7977567 DOI: 10.1186/s12889-021-10554-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 03/04/2021] [Indexed: 12/14/2022] Open
Abstract
Background Evidence on whether leisure-time physical activity (LTPA) facilitates individuals’ adoption of multiple healthy behaviors remains scarce. This study investigated the associations of diverse longitudinal LTPA trajectories from childhood to adulthood with diet, screen time, smoking, binge drinking, sleep difficulties, and sleep duration in adulthood. Methods Data were drawn from the Cardiovascular Risk in Young Finns Study. Participants were aged 9–18 years (N = 3553; 51% females) in 1980 and 33–49 years at the latest follow-up in 2011. The LTPA trajectories were identified using a latent profile analysis. Differences in self-reported health-related behaviors across the LTPA trajectories were studied separately for women and men by using the Bolck-Croon-Hagenaars approach. Models were adjusted for age, body mass index, education level, marital status, total energy intake and previous corresponding behaviors. Results Persistently active, persistently low-active, decreasingly and increasingly active trajectories were identified in both genders and an additional inactive trajectory for women. After adjusting the models with the above-mentioned covariates, the inactive women had an unhealthier diet than the women in the other trajectories (p < 0.01; effect size (ES) > 0.50). The low-active men followed an unhealthier diet than the persistently and increasingly active men (p < 0.01; ES > 0.50). Compared to their inactive and low-active peers, smoking frequency was lower in the increasingly active women and men (p < 0.01; ES > 0.20) and persistently active men (p < 0.05; ES > 0.20). The increasingly active men reported lower screen time than the low-active (p < 0.001; ES > 0.50) and persistently active (p < 0.05; ES > 0.20) men. The increasingly and persistently active women reported fewer sleep difficulties than the inactive (p < 0.001; ES > 0.80) and low-active (p < 0.05; ES > 0.50 and > 0.80, respectively) women. Sleep duration and binge drinking were not associated with the LTPA trajectories in either gender, nor were sleep difficulties in men and screen time in women. Conclusions Not only persistently higher LTPA but also an increasing tendency to engage in LTPA after childhood/adolescence were associated with healthier diet and lower smoking frequency in both genders, having less sleep difficulties in women and lower screen time in increasingly active men. Inactivity and low activity were associated with the accumulation of several unhealthy behaviors in adulthood. Associations were stronger in women. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10554-w.
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Affiliation(s)
- Irinja Lounassalo
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland.
| | - Mirja Hirvensalo
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - Sanna Palomäki
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - Kasper Salin
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - Asko Tolvanen
- Methodology Center for Human Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Suvi Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Xiaolin Yang
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Tuija H Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
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17
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Deater-Deckard K, Chary M, McQuillan ME, Staples AD, Bates JE. Mothers' sleep deficits and cognitive performance: Moderation by stress and age. PLoS One 2021; 16:e0241188. [PMID: 33411778 PMCID: PMC7790244 DOI: 10.1371/journal.pone.0241188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 10/10/2020] [Indexed: 11/18/2022] Open
Abstract
There are well-known associations between stress, poor sleep, and cognitive deficits, but little is known about their interactive effects, which the present study explored in a sample of mothers of toddlers. Since certain types of cognitive decline start during the 20s and continue into later ages, we also explored whether mothers’ age interacted with stress and sleep in the prediction of cognitive functioning. We hypothesized that poorer sleep [measured using one week of 24-hour wrist actigraphy data] and having more chronic stressors [e.g., life events, household chaos, work/family role conflict] would be linked with poorer cognitive performance [both executive function and standardized cognitive ability tasks], and that the interactive combination of poorer sleep and more stressors would account for the effect. We also explored whether this process operated differently for younger versus older women. In a socioeconomically and geographically diverse community sample of 227 women with toddler-age children [age, M = 32.73 yrs, SD = 5.15 yrs], poorer cognitive performance was predicted by greater activity during the sleep period, shorter sleep duration, and lower night-to-night consistency in sleep; it was not associated with higher levels of stress. The interactive effects hypothesis was supported for sleep activity [fragmented sleep] and sleep timing [when mothers went to bed]. The combination of more exposure to stressors and frequent night waking was particularly deleterious for older women’s performance. For younger women, going to bed late was associated with poorer performance if they were experiencing high levels of stress; for those experiencing low levels of stress, going to bed late was associated with better performance.
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Affiliation(s)
- Kirby Deater-Deckard
- University of Massachusetts at Amherst, Amherst, Massachusetts, United States of America
| | - Mamatha Chary
- University of Massachusetts at Amherst, Amherst, Massachusetts, United States of America
- * E-mail:
| | - Maureen E. McQuillan
- Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Angela D. Staples
- Eastern Michigan University, Ypsilanti, Michigan, United States of America
| | - John E. Bates
- Indiana University, Bloomington, Indiana, United States of America
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18
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Hwang JH, Lee K, Choi E, Cho HN, Park B, Rhee Y, Choi KS. Sleep Quality and Associated Factors in Premenopausal, Perimenopausal, and Postmenopausal Women in Korea: Findings from the K-Stori 2016. Nat Sci Sleep 2021; 13:1137-1145. [PMID: 34285618 PMCID: PMC8286781 DOI: 10.2147/nss.s298397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 07/04/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Poor sleep quality is a common problem among middle-aged women. Few studies, however, have assessed differences in sleep quality among premenopausal, perimenopausal, and postmenopausal women and related risk factors in Korea women. The aim of this study was to assess sleep quality and factors associated therewith according to menopausal status in Korean women. PATIENTS AND METHODS This study was based on the 2016 Korean Study of Women's Health Related Issues (K-Stori), a cross-sectional survey employing nationally representative random sampling. In total, 3000 Korean women aged 45 to 64 years completed the Pittsburgh Sleep Quality Index (PSQI). Comparison of demographic characteristics and sleep quality among pre-, peri-, and postmenopausal women was conducted. RESULTS Among the participants, 26% suffered from poor sleep quality based on the PSQI. The prevalence of poor sleep quality increased with later menopausal stage (from 18.8% in the premenopausal stage to 29.5% in the postmenopausal stage P <0.001). Multivariate logistic regression analysis showed that peri- and postmenopausal women were 1.50 and 1.73 times more likely to have poor sleep quality in comparison to premenopausal women, respectively. Chronic disease, depression, at-risk drinking, taking dietary supplements, and single women were associated with a higher likelihood of having poor sleep quality. Health status, at-risk drinking, chronic illness, dietary supplementation, and depression were significantly associated with poor sleep quality. CONCLUSION Poor sleep quality appears to be prevalent in peri- and postmenopausal women in Korea. The management of sleep quality during menopause transition is important, and further research on how sleep disturbances influence the health status of women in menopausal transition is required.
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Affiliation(s)
- Ji Hae Hwang
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea.,Center for Emergency Operations, Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea
| | - Kyeongmin Lee
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea
| | - Eunji Choi
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea.,Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, CA, USA
| | - Ha Na Cho
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea
| | - Boyoung Park
- Department of Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Yumie Rhee
- Department of Internal Medicine, Endocrine Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kui Son Choi
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea
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19
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Bogaerts S, van Woerkom M, Erbaş Y, De Caluwé E, Garofalo C, Frowijn I, Jeandarme I, Masthoff E, Janković M. Associations Between Resilience, Psychological Well-Being, Work-Related Stress and Covid-19 Fear in Forensic Healthcare Workers Using a Network Analysis. Front Psychiatry 2021; 12:678895. [PMID: 34177662 PMCID: PMC8226029 DOI: 10.3389/fpsyt.2021.678895] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/18/2021] [Indexed: 11/13/2022] Open
Abstract
Forensic healthcare workers deal with patients with severe psychiatric and behavioral problems that put them at an increased risk of developing work-related stress and burnout. Working with this target group of patients during the Coronavirus disease 2019 (Covid-19) pandemic with far-reaching restrictive measures can negatively affect the psychological well-being of forensic workers. Research suggests that resilience can buffer workplace stress and contribute positively to psychological well-being. However, research on resilience, psychological well-being and work-related stress among forensic healthcare workers is still lacking. Therefore, in this study, we investigated the interrelations between psychological well-being and resilience on the one hand and work-related stress and Covid-19 fear-related symptoms on the other hand. Self-report data were obtained from 318 healthcare workers (73.9% women) working in three Forensic Psychiatric Centers (M age = 44.20, SD = 14.31) and are in direct contact with forensic patients. The data were analyzed using network analysis. Consistent with previous research, the results showed that workplace stress and fear associated with the Covid-19 pandemic can be detrimental to workers' psychological well-being, while resilience can serve as a protective factor against being personally attacked or threatened by patients at the workplace. Last but not least, we identified highly central symptoms, namely tremors due to the fear of the coronavirus and anxiety when other people coughing, which would be the best candidates for future treatment targets. This knowledge can help clinicians optimize interventions to reduce workplace stress and fear due to the pandemic. Future studies should aim to replicate our findings in a larger and more representative sample of forensic healthcare workers.
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Affiliation(s)
- Stefan Bogaerts
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands.,Fivoor Academy of Research, Innovation and Development (FARID), Rotterdam, Netherlands
| | - Marianne van Woerkom
- Department of Human Resource Studies, Tilburg University, Tilburg, Netherlands.,Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Yasemin Erbaş
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
| | - Elien De Caluwé
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
| | - Carlo Garofalo
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
| | - Iris Frowijn
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
| | - Ingeborg Jeandarme
- Department of Criminal Law and Criminology, Katholieke Universiteit Leuven, Leuven, Belgium.,Knowledge Center Forensic Psychiatric Care, Openbaar Psychiatrisch Zorgcentrum Rekem, Rekem, Belgium
| | - Erik Masthoff
- Fivoor Academy of Research, Innovation and Development (FARID), Rotterdam, Netherlands
| | - Marija Janković
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands.,Fivoor Academy of Research, Innovation and Development (FARID), Rotterdam, Netherlands
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20
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Serotonergic antidepressants for sleep disturbances in perimenopausal and postmenopausal women: a systematic review and meta-analysis. Menopause 2020; 28:207-216. [DOI: 10.1097/gme.0000000000001647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Abstract
The reproductive function of humans is regulated by several sex hormones which are secreted in synergy with the circadian timing of the body. Sleep patterns produce generic signatures that physiologically drive the synthesis, secretion, and metabolism of hormones necessary for reproduction. Sleep deprivation among men and women is increasingly reported as one of the causes of infertility. In animal models, sleep disturbances impair the secretion of sexual hormones thereby leading to a decrease in testosterone level, reduced sperm motility and apoptosis of the Leydig cells in male rats. Sleep deprivation generates stressful stimuli intrinsically, due to circadian desynchrony and thereby increases the activation of the Hypothalamus-Pituitary Adrenal (HPA) axis, which, consequently, increases the production of corticosterone. The elevated level of corticosteroids results in a reduction in testosterone production. Sleep deprivation produces a commensurate effect on women by reducing the chances of fertility. Sleeplessness among female shift workers suppresses melatonin production as well as excessive HPA activation which results in early pregnancy loss, failed embryo implantation, anovulation and amenorrhea. Sleep deprivation in women has also be found to be associated with altered gonadotropin and sex steroid secretion which all together lead to female infertility. Poor quality of sleep is observed in middle-aged and older men and this also contributes to reduced testosterone concentrations. The influence of sleep disturbances post-menopausal is associated with irregular synthesis and secretion of female sex steroid hormones.
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22
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Schreiber DR, Dautovich ND. Sleep Duration as an Indirect Link Between Sleep Timing and Weight in Midlife Women. J Womens Health (Larchmt) 2019; 28:1543-1554. [PMID: 31170032 PMCID: PMC7366270 DOI: 10.1089/jwh.2018.7088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Objective: Midlife women are at risk of obesity. Poor sleep outcomes including inadequate sleep duration and variable sleep timing are risk factors for obesity, but there is a lack of understanding on how specific sleep constructs uniquely or concurrently are associated with weight outcomes in this population. This study examined the unique association of sleep timing with weight outcomes and how sleep timing works in conjunction with sleep duration to influence weight in midlife women. Materials and Methods: An archival analysis was performed using the Midlife in the United States-II study (MIDUS-II). The sample consisted of 132 midlife women (40-64; M = 52.9, standard deviation = 6.94). Sleep timing (mean sleep time, variability) and duration were measured through actigraphy and daily sleep diaries. Weight was assessed using body mass index (BMI) and waist circumference measures. Results: PROCESS mediation and moderation analyses assessed direct, indirect, and moderating pathways. Sleep duration emerged as an indirect link between sleep timing (mean and variability) and weight outcomes (95% CI = 0.0001-0.0123; 95% CI = 0.0007-0.0378; 95% CI = 0.0079-0.1006). Sleep timing (95% CI = -0.0144 to 0.0076; 95% CI = -0.0358 to 0.0219) and sleep time variability (95% CI = -0.0124 to 0.0438; 95% CI = -0.0533 to 0.0939) were not directly associated with BMI or waist circumference. Also, sleep timing and duration did not interact to influence weight outcomes. Conclusions: Sleep duration, rather than sleep timing, is associated with weight outcomes, and is an indirect link in the sleep timing and weight outcomes association. Future work is needed to further disentangle the impact of sleep on weight in midlife women using prospective studies, implementing daily assessments of sleep behavior.
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Affiliation(s)
- Dana R. Schreiber
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
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23
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Li D, Kong J, Yang Y, Wang S, Wu J, Chao J. Group cognitive behavioural therapy of physical and psychological menopausal symptoms of Chinese women, delivered via Internet and mobile phone versus face to face: A protocol for a randomized non-inferiority trial. Maturitas 2019; 129:23-29. [PMID: 31547909 DOI: 10.1016/j.maturitas.2019.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 06/05/2019] [Accepted: 08/12/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Menopause syndrome generally includes psychological problems. Group treatment delivered via the Internet and mobile phone (imGT) may improve women's physiological and psychological conditions. OBJECTIVE To investigate the efficacy of group cognitive behavioural therapy of menopause-related mood swings and quality of life, delivered face to face or via the Internet and mobile phone. METHODS This protocol is for a randomized controlled clinical trial with a sample of 140 menopausal women divided into 2 groups: imGT and face-to-face group treatment (ffGT). The primary outcome will be the improvement in the menopausal symptoms of the two groups, as assessed by the Greene Climacteric Scale. The secondary outcomes will be: quality of life, assessed by the Short Form 36 Health Survey Questionnaire; insomnia, assessed by the Pittsburgh Sleep Quality Inventory; anxiety, assessed by the Hamilton Anxiety Rating Scale; and therapeutic alliance, assessed by the Working Alliance Inventory-Short Revised and Client Sat-is-fac-tion Qes-tion-naire-8. imGT will be performed once a week for 1.5 h for 10 weeks with a daily 'Punched-in' on the WeChat app; ffGT will be performed once a week for 1.5 h for 10 weeks. All outcomes will be assessed at baseline, at a post-intervention evaluation (week 10), and at a follow-up evaluation (week 22). DISCUSSION This study will be the first clinical trial to examine the effects of imGT on menopausal women in China. If imGT is found to be non-inferior to ffGT, it will facilitate access to menopausal health services.
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Affiliation(s)
- Dan Li
- Southeast University, China
| | - Jing Kong
- Nanjing Maternity and Child Health Care Hospital, China
| | - Ying Yang
- Nanjing Maternity and Child Health Care Hospital, China
| | - Suli Wang
- Nanjing Maternity and Child Health Care Hospital, China
| | - Jiangping Wu
- Nanjing Maternity and Child Health Care Hospital, China
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Wilson S, Anderson K, Baldwin D, Dijk DJ, Espie A, Espie C, Gringras P, Krystal A, Nutt D, Selsick H, Sharpley A. British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: An update. J Psychopharmacol 2019; 33:923-947. [PMID: 31271339 DOI: 10.1177/0269881119855343] [Citation(s) in RCA: 137] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This British Association for Psychopharmacology guideline replaces the original version published in 2010, and contains updated information and recommendations. A consensus meeting was held in London in October 2017 attended by recognised experts and advocates in the field. They were asked to provide a review of the literature and identification of the standard of evidence in their area, with an emphasis on meta-analyses, systematic reviews and randomised controlled trials where available, plus updates on current clinical practice. Each presentation was followed by discussion, aiming to reach consensus where the evidence and/or clinical experience was considered adequate, or otherwise to flag the area as a direction for future research. A draft of the proceedings was circulated to all speakers for comments, which were incorporated into the final statement.
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Affiliation(s)
- Sue Wilson
- 1 Centre for Psychiatry, Imperial College London, London, UK
| | - Kirstie Anderson
- 2 Regional Sleep Service, Freeman Hospital, Newcastle Upon Tyne, UK
| | - David Baldwin
- 3 Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Derk-Jan Dijk
- 4 Sleep Research Centre, University of Surrey, Guildford, UK
| | - Audrey Espie
- 5 Psychology Department, NHS Fife, Dunfermline, UK
| | - Colin Espie
- 6 Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Paul Gringras
- 7 Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Andrew Krystal
- 8 Psychiatry and Behavioral Science, University of California, San Francisco, CA, USA
| | - David Nutt
- 1 Centre for Psychiatry, Imperial College London, London, UK
| | - Hugh Selsick
- 9 Royal London Hospital for Integrated Medicine, London, UK
| | - Ann Sharpley
- 10 Department of Psychiatry, University of Oxford, Oxford, UK
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Lima AM, Rocha JSB, Reis VMCP, Silveira MF, Caldeira AP, Freitas RF, Popoff DAV. [Loss of quality of sleep and associated factors among menopausal women]. CIENCIA & SAUDE COLETIVA 2019; 24:2667-2678. [PMID: 31340284 DOI: 10.1590/1413-81232018247.19522017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 10/19/2017] [Indexed: 11/22/2022] Open
Abstract
The scope of this article is to identify the prevalence of the loss of quality of sleep and associated factors among menopausal women. It is a quantitative, cross-sectional and analytical study, the variables of which were investigated by applying a structured/pre-tested questionnaire and the Pittsburgh Sleep Quality Index with 819 menopausal women cared for under the Family Health Strategy. Simple Poisson regression was used to screen the variables (p < 0.25). For multiple analysis, Poisson regression was used based on a hierarchical model, at a significance level of 5%. Loss of quality of sleep was identified in 67% of the sample. Variables such as advanced age (PR = 1.09; CI = 1.03-1.16), moderate and severe menopausal symptoms (PR = 1.18; CI = 1.10-1.27), moderate to severe anxiety (PR = 1.17; CI = 1.10-1.25), moderate to severe depression (PR = 1.08; CI = 1.01-1.15) and arthritis/arthrosis/rheumatism (PR = 1. 07; CI = 1.01 - 1.14) revealed statistically significant associations with loss of quality of sleep. The loss of quality of sleep was highly prevalent in the population studied. Factors associated with loss of quality of sleep were advanced age, moderate to severe menopausal symptoms, moderate to severe anxiety and depression, and the presence of arthritis/arthrosis/rheumatism.
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Affiliation(s)
- Agamenon Monteiro Lima
- Programa de Pós-Graduação em Cuidado Primário em Saúde, Universidade Estadual de Montes Montes Claros (Unimontes). Av. Dr. Ruy Braga s/n, Vila Mauriceia. 39401-089 Montes Claros MG Brasil.
| | - Josiane Santos Brant Rocha
- Programa de Pós-Graduação em Cuidado Primário em Saúde, Universidade Estadual de Montes Montes Claros (Unimontes). Av. Dr. Ruy Braga s/n, Vila Mauriceia. 39401-089 Montes Claros MG Brasil.
| | - Viviane Margareth Chaves Pereira Reis
- Programa de Pós-Graduação em Cuidado Primário em Saúde, Universidade Estadual de Montes Montes Claros (Unimontes). Av. Dr. Ruy Braga s/n, Vila Mauriceia. 39401-089 Montes Claros MG Brasil.
| | - Marise Fagundes Silveira
- Programa de Pós-Graduação em Cuidado Primário em Saúde, Universidade Estadual de Montes Montes Claros (Unimontes). Av. Dr. Ruy Braga s/n, Vila Mauriceia. 39401-089 Montes Claros MG Brasil.
| | - Antônio Prates Caldeira
- Programa de Pós-Graduação em Cuidado Primário em Saúde, Universidade Estadual de Montes Montes Claros (Unimontes). Av. Dr. Ruy Braga s/n, Vila Mauriceia. 39401-089 Montes Claros MG Brasil.
| | | | - Daniela Araújo Veloso Popoff
- Programa de Pós-Graduação em Cuidado Primário em Saúde, Universidade Estadual de Montes Montes Claros (Unimontes). Av. Dr. Ruy Braga s/n, Vila Mauriceia. 39401-089 Montes Claros MG Brasil.
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Dunican IC, Walsh J, Higgins CC, Jones MJ, Maddison K, Caldwell JA, David H, Eastwood PR. Prevalence of sleep disorders and sleep problems in an elite super rugby union team. J Sports Sci 2018; 37:950-957. [PMID: 30372656 DOI: 10.1080/02640414.2018.1537092] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The aim of this study was to determine the prevalence of sleep disorders in an elite rugby union team using in-laboratory polysomnography (PSG) and sleep questionnaires. Twenty-five elite rugby union players underwent a night of PSG during the "off-season" of the Super Rugby competition to assess their sleep. Of interest were measurements that detected the presence of obstructive sleep apnea (OSA; apnea-hypopnea index ≥5 events/hr) and the presence of moderate-severe periodic leg movements during sleep (PLMs; ≥15 events/hr). Players completed sleep-related questionnaires to assess daytime sleepiness, perception of insomnia, risk of OSA, and the presence of restless legs syndrome (RLS) and underwent basic anthropometric assessments including body mass index and neck circumference. OSA was present in 24% (n=6) of players and PLMs ≥15 events/hr in 12% (n=3). Questionnaire responses showed that all players had insomnia defined subthreshold insomnia and excessive daytime sleepiness, two players were identified as being at risk for OSA and none were classified as having RLS. In conclusion, sleep disorders and excessive sleepiness are common in elite rugby union players. A process to identify and manage sleep disorders should be considered by teams to optimise their physical recovery, athletic performance and to safeguard their health.
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Affiliation(s)
- Ian C Dunican
- a Centre for Sleep Science, School of Human Sciences , The University of Western Australia , Crawley , WA , Australia
| | - Jennifer Walsh
- a Centre for Sleep Science, School of Human Sciences , The University of Western Australia , Crawley , WA , Australia
| | - Charles C Higgins
- b Western Force , Rugby Western Australia , Floreat , WA , Australia
| | - Maddison J Jones
- c School of Human Sciences , The University of Western Australia , Crawley , WA , Australia
| | - Kathleen Maddison
- a Centre for Sleep Science, School of Human Sciences , The University of Western Australia , Crawley , WA , Australia
| | | | - Hillman David
- a Centre for Sleep Science, School of Human Sciences , The University of Western Australia , Crawley , WA , Australia
| | - Peter R Eastwood
- a Centre for Sleep Science, School of Human Sciences , The University of Western Australia , Crawley , WA , Australia
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Abstract
Although more than 80% of women experience some degree of psychological or physical symptoms around menopause, both women and clinicians have misconceptions about how hormonal changes relate to menopausal symptoms and psychological conditions. Recently, several large-scale, longitudinal studies have been conducted to better characterize symptoms and changes that occur around menopause. This article offers current evidence for symptoms that occur in the early menopause transition, including vasomotor symptoms, mood changes, sleep problems, and changes in sexual functioning.
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Convergence in Sleep Time Accomplished? Gender Gap in Sleep Time for Middle-Aged Adults in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040803. [PMID: 29671824 PMCID: PMC5923845 DOI: 10.3390/ijerph15040803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/11/2018] [Accepted: 04/18/2018] [Indexed: 11/17/2022]
Abstract
Although the gender gap in sleep time has narrowed significantly in the last decade, middle-aged women between ages 35 and 60 still sleep less than their male counterparts in Korea. This study examines and provides evidence for factors contributing to the gender gap in this age group. Using Korean Time Use Survey (KTUS) data from 2004, 2009 and 2014, we find that middle-aged women’s difficulty in managing work-life balance and traditional role expectations placed upon women are the main causes of the gender gap in sleep time. The decomposition analysis reveals that the improved socioeconomic status and recent changes in familial expectations for women may have helped them sleep more than in the past. However, there remain fundamental differences in attitude and time use patterns between men and women that prevent middle-aged women from getting the same amount of sleep.
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Kim MJ, Yim G, Park HY. Vasomotor and physical menopausal symptoms are associated with sleep quality. PLoS One 2018; 13:e0192934. [PMID: 29462162 PMCID: PMC5819793 DOI: 10.1371/journal.pone.0192934] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 01/25/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Sleep disturbance is one of the common complaints in menopause. This study investigated the relationship between menopausal symptoms and sleep quality in middle-aged women. METHOD This cross-sectional observational study involved 634 women aged 44-56 years attending a healthcare center at Kangbuk Samsung Hospitals. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI).Multiple linear regression analysis was performed to assess the associations between Menopause-specific Quality of Life (MENQOL) scores and PSQI scores and Menopause-specific Quality of Life (MENQOL)scores. RESULTS The mean PSQI score was 3.6±2.3, and the rates of poor sleep quality(PSQI score > 5) in premenopausal, perimenopausal, and postmenopausal women were 14.4%, 18.2%, and 30.2%, respectively. Total PSQI score, specifically the sleep latency, habitual sleep efficiency and sleep disturbances scores, were significantly increased in postmenopausal women. Multiple linear regression analysis adjusted for age, BMI, hypertension, diabetes, smoking, marital status, family income, education, employment status, parity, physical activity, depression symptoms, perceived stress and menopausal status showed that higher PSQI score was positively correlated with higher vasomotor(ß = 0.240, P = 0.020)and physical(ß = 0.572, P<0.001) scores. CONCLUSIONS Vasomotor and physical menopause symptoms was related to poor sleep quality. Effective management strategies aimed at reducing menopausal symptoms may improve sleep quality among women around the time of menopause.
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Affiliation(s)
- Min-Ju Kim
- Division of Cardiovascular Diseases, Center for Biomedical Science, National Research Institute of Health, Chungbuk, Korea
| | - Gyeyoon Yim
- Division of Cardiovascular Diseases, Center for Biomedical Science, National Research Institute of Health, Chungbuk, Korea
| | - Hyun-Young Park
- Division of Cardiovascular Diseases, Center for Biomedical Science, National Research Institute of Health, Chungbuk, Korea
- * E-mail:
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Roveda E, Montaruli A, Galasso L, Pesenti C, Bruno E, Pasanisi P, Cortellini M, Rampichini S, Erzegovesi S, Caumo A, Esposito F. Rest-activity circadian rhythm and sleep quality in patients with binge eating disorder. Chronobiol Int 2017; 35:198-207. [PMID: 29144185 DOI: 10.1080/07420528.2017.1392549] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Recent findings suggest that altered rest-activity circadian rhythms (RARs) are associated with a compromised health status. RARs abnormalities have been observed also in several pathological conditions, such as cardiovascular, neurological, and cancer diseases. Binge eating disorder (BED) is the most common eating disorder, with a prevalence of 3.5% in women and 2% in men. BED and its associate obesity and motor inactivity could induce RARs disruption and have negative consequences on health-related quality of life. However, the circadian RARs and sleep behavior in patients with BED has been so far assessed only by questionnaires. Therefore, the purpose of this study was to determine RARs and sleep parameters by actigraphy in patients with BED compared to a body mass index-matched control group (Ctrl). Sixteen participants (eight obese women with and eight obese women without BED diagnosis) were recruited to undergo 5-day monitoring period by actigraphy (MotionWatch 8®, CamNtech, Cambridge, UK) to evaluate RARs and sleep parameters. In order to determine the RARs, the actigraphic data were analyzed using the single cosinor method. The rhythmometric parameters of activity levels (MESOR, amplitude and acrophase) were then processed with the population mean cosinor. The Actiwatch Sleep Analysis Software (Cambridge Neurotecnology, Cambridge, UK) evaluated the sleep patterns. In each participant, we considered seven sleep parameters (sleep onset: S-on; sleep offset: S-off; sleep duration: SD; sleep latency: SL; movement and fragmentation index: MFI; immobility time: IT; sleep efficiency: SE) calculated over a period of five nights. The population mean cosinor applied to BED and Ctrl revealed the presence of a significant circadian rhythm in both groups (p < 0.001). The MESOR (170.0 vs 301.6 a.c., in BED and Ctrl, respectively; p < 0.01) and amplitude (157.66 vs 238.19 a.c., in BED and Ctrl, respectively p < 0.05) differed significantly between the two groups. Acrophase was not different between BED and Ctrl, as well as all sleep parameters. Both groups displayed a low level of sleep quality (SE 80.7% and 75.7% in BED and Ctrl, respectively). These data provided the first actigraphy-based evidence of RARs disruption and sleep behavior disorder in patients with BED. However, while sleep disorders could be reasonably ascribed to overweight/obesity and the related lower daily physical activity, RARs disruption in this pathology should be ascribed to factors other than reduced physical activity. The circadian timing approach can represent a novel potential tool in the treatment of patients with eating disorders. These data provide exploratory evidence of behavioral association in a small population of patients that, if confirmed in a wider number of subjects and across different populations, may lead to a revision and enhancement of interventions in BED patients.
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Affiliation(s)
- E Roveda
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - A Montaruli
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - L Galasso
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - C Pesenti
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - E Bruno
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy.,b Department of Preventive and Predictive Medicine , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy
| | - P Pasanisi
- b Department of Preventive and Predictive Medicine , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy
| | - M Cortellini
- b Department of Preventive and Predictive Medicine , Fondazione IRCCS Istituto Nazionale Tumori , Milan , Italy
| | - S Rampichini
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - S Erzegovesi
- c Department of Clinical Neuroscience , San Raffaele Scientific Institute , Milan , Italy
| | - A Caumo
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - F Esposito
- a Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
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Abstract
BACKGROUND Obesity and poor sleep are highly prevalent among Black women. PURPOSE We examined whether a weight gain prevention intervention improved sleep among Black women. METHODS We conducted a randomized trial comparing a 12-month weight gain prevention intervention that included self-monitoring through mobile technologies and phone coaching to usual care in community health centers. We measured sleep using the Medical Outcomes Study Sleep Scale at baseline, 12 months, and 18 months. The scale examines quantity of sleep, sleep disturbance, sleep adequacy, daytime somnolence, snoring, shortness of breath, and global sleep problems (sleep problem indices I and II). RESULTS Participants (n = 184) were on average 35.4 years and obese (BMI 30.2 kg/m2); 74% made <$30,000/year. At baseline, average sleep duration was 6.4 (1.5) hours. Controlling for weight change and sleep medication, the intervention group reported greater improvements in sleep disturbance [-8.35 (-16.24, -0.45)] and sleep problems at 12 months: sleep problem index I [-8.35 (-16.24, -0.45)]; sleep problem index II [-8.35 (-16.24, -0.45)]. However, these findings did not persist at 18 months. CONCLUSIONS Preventing weight gain may afford clinical benefit on improving sleep quality. TRIAL REGISTRATION NUMBER The trial was registered with the ClinicalTrials.gov database (NCT00938535).
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De Franciscis P, Grauso F, Luisi A, Schettino MT, Torella M, Colacurci N. Adding Agnus Castus and Magnolia to Soy Isoflavones Relieves Sleep Disturbances Besides Postmenopausal Vasomotor Symptoms-Long Term Safety and Effectiveness. Nutrients 2017; 9:E129. [PMID: 28208808 PMCID: PMC5331560 DOI: 10.3390/nu9020129] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 01/26/2017] [Accepted: 02/03/2017] [Indexed: 12/15/2022] Open
Abstract
The effectiveness for vasomotor symptoms and sleep disorders plus the long-term safety of a nutraceutical combination of agnus-castus and magnolia extracts combined with soy isoflavones (SI) and lactobacilli were assessed in postmenopausal women. A controlled study was carried out in menopausal women comparing this nutraceutical combination (ESP group) with a formulation containing isoflavones alone (C group) at the dosage recommended. The Kuppermann index, The Pittsburgh Sleep Quality Index (PSQI), and Short Form 36 (SF-36) were determined at baseline, three, six and 12 months. Endometrial thickness, mammary density and liver function were evaluated at baseline and after 12 months. One hundred and eighty women were enrolled in the study (100 in the ESP group and 80 in the C group). At the end of the treatment, mammary density, endometrial thickness, and hepatic function did not show substantial differences between groups. The Kuppermann index and particularly the tendency for hot flashes progressively and significantly decreased in frequency and severity during ESP versus C treatment. At the same time, a significant increase in sleep quality and psychophysical wellness parameters was observed in the ESP versus C groups. No adverse events were observed. Agnus-castus and magnolia, combined with SI + lactobacilli, can effectively and safely be used in symptomatic postmenopausal women, mainly when quality of sleep is the most disturbing complaint. The endometrium, mammary glands and liver function were unaffected after 12 months of treatment.
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Affiliation(s)
- Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery-Second University of Naples, Largo Madonna delle Grazie, 1, 80138 Naples, Italy.
| | - Flavio Grauso
- Department of Woman, Child and General and Specialized Surgery-Second University of Naples, Largo Madonna delle Grazie, 1, 80138 Naples, Italy.
| | - Anna Luisi
- Department of Woman, Child and General and Specialized Surgery-Second University of Naples, Largo Madonna delle Grazie, 1, 80138 Naples, Italy.
| | - Maria Teresa Schettino
- Department of Woman, Child and General and Specialized Surgery-Second University of Naples, Largo Madonna delle Grazie, 1, 80138 Naples, Italy.
| | - Marco Torella
- Department of Woman, Child and General and Specialized Surgery-Second University of Naples, Largo Madonna delle Grazie, 1, 80138 Naples, Italy.
| | - Nicola Colacurci
- Department of Woman, Child and General and Specialized Surgery-Second University of Naples, Largo Madonna delle Grazie, 1, 80138 Naples, Italy.
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Tao MF, Sun DM, Shao HF, Li CB, Teng YC. Poor sleep in middle-aged women is not associated with menopause per se. ACTA ACUST UNITED AC 2016; 49:e4718. [PMID: 26577848 PMCID: PMC4678654 DOI: 10.1590/1414-431x20154718] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 08/06/2015] [Indexed: 11/22/2022]
Abstract
Whether sleep problems of menopausal women are associated with vasomotor symptoms and/or changes in estrogen levels associated with menopause or age-related changes in sleep architecture is unclear. This study aimed to determine if poor sleep in middle-aged women is correlated with menopause. This study recruited women seeking care for the first time at the menopause outpatient department of our hospital. Inclusion criteria were an age ≥40 years, not taking any medications for menopausal symptoms, and no sleeping problems or depression. Patients were assessed with the Pittsburgh Sleep Quality Index (PSQI), modified Kupperman Index (KI), and Menopause Rating Scale (MRS). A PSQI score of <7 indicated no sleep disorder and ≥7 indicated a sleep disorder. Blood specimens were analyzed for follicle-stimulating hormone and estradiol levels. A total of 244 women were included in the study; 103 (42.2%) were identified as having a sleep disorder and 141 as not having one. In addition, 156 (64%) women were postmenopausal and 88 (36%) were not menopausal. Follicle-stimulating hormone and estradiol levels were similar between the groups. Patients with a sleep disorder had a significantly higher total modified KI score and total MRS score (both, P<0.001) compared with those without a sleep disorder. Correlations of the PSQI total score with the KI and MRS were similar in menopausal and non-menopausal women. These results do not support that menopause per se specifically contributes to sleep problems.
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Affiliation(s)
- M F Tao
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated to the Sixth People's Hospital, Shanghai, China
| | - D M Sun
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated to the Sixth People's Hospital, Shanghai, China
| | - H F Shao
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated to the Sixth People's Hospital, Shanghai, China
| | - C B Li
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated to the Sixth People's Hospital, Shanghai, China
| | - Y C Teng
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated to the Sixth People's Hospital, Shanghai, China
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Abstract
Sleeping problems are a serious public health problem, imposing a substantial burden on individuals and society. Although sleeping problems occur throughout the lifespan, and in both sexes, menopause can be considered as one important milestone of increasing occurrence in sleeping problems. However, to determine whether sleeping problems are caused by the menopause or merely occur by coincidence during the menopause is not always easy because several, particularly age-related, changes take place at the same time. The most important factors are general diseases, medications, weight changes and mood symptoms. According to women's own judgment, hormone therapy significantly improves sleep quality. Hormone therapy can thus be considered as a first-line treatment for climacteric sleeping problems. If sleeping problems are accompanied by other disorders, hormone therapy should be kept in mind as an adjuvant therapy. According to worldwide consensus on hormone therapy, the main indication of hormone therapy is alleviation of climacteric symptoms, including climacteric sleeping problems. However, when choosing hormone therapy for a patient, contraindications and possible long-term side effects should be individually considered. This review illustrates the effect of menopause on sleep and evaluates different treatment options, especially hormone therapy, in alleviation of symptoms.
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Affiliation(s)
- Päivi Polo-Kantola
- University of Turku, Department of Obstetrics and Gynecology, University Central Hospital of Turku and Sleep Research Center Dentalia, FIN-20520 Turku, Finland, Tel.: +358 2313 0000; Fax: +358 2313 2340
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Abstract
OBJECTIVE The purpose of this study was to identify clusters of midlife women by sleep-related symptoms in multiethnic groups and to examine racial/ethnic differences in the clusters. METHODS This secondary analysis was conducted on data from 1,054 midlife women who participated in two cross-sectional descriptive national Internet surveys. The instruments included questions on background characteristics, health, and menopause status, and the Sleep Index for Midlife Women. The data were analyzed using hierarchical clustering methods, χ2 test, analysis of variance, and multinomial logistic regression analyses. RESULTS A four-cluster solution was adopted: cluster 1 (low total symptoms group), cluster 2 (moderate physical and psychosomatic symptoms group), cluster 3 (moderate psychological symptoms group), and cluster 4 (high total symptoms group). There were significant differences in education, employment status, family income, social support, country of birth, race/ethnicity, body mass index, perceived general health, diagnosed disease, access to health care, and menopause status among clusters (P < 0.05). In cluster 1 only, there were significant racial/ethnic differences in the total number of total severity scores for physical symptoms (P < 0.01). When racial/ethnic differences in individual symptoms in each cluster were determined, there were no consistent racial/ethnic differences. CONCLUSIONS Researchers need to consider that racial/ethnic differences could be prominent in midlife women with low sleep-related symptoms.
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36
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Mong JA, Cusmano DM. Sex differences in sleep: impact of biological sex and sex steroids. Philos Trans R Soc Lond B Biol Sci 2016; 371:20150110. [PMID: 26833831 DOI: 10.1098/rstb.2015.0110] [Citation(s) in RCA: 275] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2015] [Indexed: 12/19/2022] Open
Abstract
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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Affiliation(s)
- Jessica A Mong
- Program in Neuroscience, University of Maryland, School of Medicine, Baltimore, MD 21201, USA Department of Pharmacology, University of Maryland, School of Medicine, Baltimore, MD 21201, USA
| | - Danielle M Cusmano
- Program in Neuroscience, University of Maryland, School of Medicine, Baltimore, MD 21201, USA
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Min H, Um YJ, Jang BS, Shin D, Choi E, Park SM, Lee K. Association between Sleep Duration and Measurable Cardiometabolic Risk Factors in Healthy Korean Women: The Fourth and Fifth Korean National Health and Nutrition Examination Surveys (KNHANES IV and V). Int J Endocrinol 2016; 2016:3784210. [PMID: 27956898 PMCID: PMC5124459 DOI: 10.1155/2016/3784210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/17/2016] [Accepted: 09/15/2016] [Indexed: 11/17/2022] Open
Abstract
Study Objectives. To examine the association between sleep duration and prevalence of metabolic syndrome (MetS) and its components in healthy Korean women. Design. Cross-sectional study, using the Fourth and Fifth Korean National Health and Nutrition Examination Surveys. Methods. Among 8505 women (25-70 years) from KNHANES IV and V, participants were classified into five sleep groups based on self-reported sleep duration. MetS and its components were defined using the criteria set forth in National Cholesterol Education Program-Adult Treatment Panel III. We used multivariate logistic regression analysis. Results. After adjusting for various confounders, shorter sleep duration (≤6 h) was found to have an association with low risk of reduced high-density lipoprotein cholesterol and increased triglycerides, whereas very long sleep duration was found to have high risk of increased triglycerides. However, abdominal obesity showed an opposite trend: short sleep duration was associated with higher risk of abdominal obesity than long sleep duration. Fasting glucose levels increased as sleep duration increased, but without significance. Moreover, blood pressure was not significantly associated with sleep duration. Consequently, MetS was less prevalent in those with short sleep duration. Conclusions. Sleep duration was positively associated with MetS, especially dyslipidemia and fasting hyperglycemia, but inversely associated with abdominal obesity.
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Affiliation(s)
- Hyeyeon Min
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yoo Jin Um
- Department of Family Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bum Sup Jang
- Department of Education and Research, Seoul National University Hospital, Seoul, Republic of Korea
| | - Doosup Shin
- Department of Education and Research, Seoul National University Hospital, Seoul, Republic of Korea
| | - EunJoo Choi
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sang Min Park
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
- *Sang Min Park: and
| | - Kiheon Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
- *Kiheon Lee:
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Iwakura N, Fujiwara Y, Shiba M, Ochi M, Fukuda T, Tanigawa T, Yamagami H, Tominaga K, Watanabe T, Arakawa T. Characteristics of Sleep Disturbances in Patients with Gastroesophageal Reflux Disease. Intern Med 2016; 55:1511-7. [PMID: 27301498 DOI: 10.2169/internalmedicine.55.5454] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective Gastroesophageal reflux disease (GERD) is strongly associated with sleep disturbances; however, the detailed differences in the characteristics of sleep disturbances between GERD and non-GERD patients are unknown. The aim of the present study was to analyze the clinical characteristics as well as health-related quality of life in GERD and non-GERD patients with sleep disturbances. Methods Three hundred and fifty patients, including 124 patients with GERD and 226 patients without GERD, completed a self-administered questionnaire that evaluated clinical information. The Pittsburg Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and 8-item Short-Form Health Survey (SF-8) were also used. Sleep disturbance was considered to be present if the PSQI was >5.5. Results The prevalence of sleep disturbances was significantly higher in the GERD patients (66/124, 53.9%) than in the non-GERD patients (89/226, 39.3%). Depression and anxiety were significantly more common in the subjects with sleep disturbances than in those without sleep disturbances, although there were no differences between the GERD and non-GERD patients. Among the subjects with sleep disturbances, daytime sleepiness was more common in the GERD patients than in the non-GERD patients. The subjects with sleep disturbances had a poorer health-related quality of life. The physical components of quality of life were impaired, particularly in the GERD patients with sleep disturbances. Conclusion GERD patients with sleep disturbances commonly experience daytime sleepiness and an impaired health-related quality of life, especially in terms of physical components.
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Affiliation(s)
- Narika Iwakura
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Japan
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Davari-Tanha F, Soleymani-Farsani M, Asadi M, Shariat M, Shirazi M, Hadizadeh H. Comparison of citalopram and venlafaxine’s role in treating sleep disturbances in menopausal women, a randomized, double-blind, placebo-controlled trial. Arch Gynecol Obstet 2015; 293:1007-13. [DOI: 10.1007/s00404-015-3900-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 09/21/2015] [Indexed: 10/23/2022]
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How self-reported hot flashes may relate to affect, cognitive performance and sleep. Maturitas 2015; 81:449-55. [DOI: 10.1016/j.maturitas.2015.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 05/05/2015] [Accepted: 05/12/2015] [Indexed: 11/22/2022]
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Park YK, Cha NH, Sok SR. Relationships between menopausal syndrome and sleeping of middle-aged women. J Phys Ther Sci 2015; 27:2537-40. [PMID: 26357435 PMCID: PMC4563309 DOI: 10.1589/jpts.2015.2537] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 05/15/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to examine the correlation between menopausal syndrome and sleep state of middle-aged women, and to examine the factors influencing menopausal syndrome. [Subjects] The subjects included 59 middle-aged women in Seoul, South Korea. [Methods] A cross-sectional design was adopted. The measurement tools were a general characteristics form, Menopause Symptom Index (MENSI), and sleep state scale. [Results] There was a significantly negative correlation between menopausal syndrome and sleep state of middle-aged women. The analyses showed that the prediction model was significant. The value of the adjusted R(2) was 0.279, which corresponds to an explanatory power of 27.9%. The factor found to have the most influence on menopausal syndrome of middle-aged women was sleep state, followed by sexual life satisfaction, and health status. [Conclusion] Nursing intervention programs for alleviating menopausal syndrome of middle-aged women are essential in order to improve sleep state, sexual life satisfaction, and health status. The findings from this study will contribute to help them for controlling and relieving the menopausal syndrome of middle-aged women.
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Affiliation(s)
- Yi Kyun Park
- Department of Nursing, Graduate School, Kyung Hee
University, Republic of Korea
| | - Nam Hyun Cha
- Department of Nursing, Andong National University, Republic
of Korea
| | - Sohyune R. Sok
- College of Nursing Science, Kyung Hee University: 26
Kyungheedae-ro, Dongdaemun-gu, Seoul 130-701, Republic of Korea
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Examining the relationship between subjective sleep disturbance and menopause: a systematic review and meta-analysis. Menopause 2015; 21:1301-18. [PMID: 24800878 DOI: 10.1097/gme.0000000000000240] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to conduct a systematic review and meta-analysis of the relationship between menopausal stages and sleep disturbance reported using subjective methods. Secondary aims included examining the influence of culture/ethnicity on the relationship between menopausal stages and sleep disturbance. METHODS Multiple electronic databases were searched from the first available year to November 2013, and a manual search of the reference lists of review articles identified was also conducted. Twenty-four studies with a total of 63,542 midlife women were identified, coded, and analyzed. RESULTS The crude and adjusted odds of experiencing sleep disturbance were small but statistically significant for perimenopausal and postmenopausal women, using premenopause as the reference group. The ethnicity of the samples influenced effect sizes; Asian and white women both experienced an increased rate of sleep disturbance at the perimenopausal and postmenopausal stages compared with the premenopausal stage, whereas Hispanic women experienced no change in sleep disturbance across the menopausal transition. CONCLUSIONS The prevalence of sleep disturbance is higher in perimenopausal, postmenopausal, and surgical menopausal women than in premenopausal women. There is an independent relationship between menopausal stages and sleep disturbance beyond the effects of aging and other confounders, although the magnitude of the relationship is small. Culture, ethnicity, or both might affect the levels of sleep disturbance at various menopausal stages.
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Ebert RM, Wood A, Okun ML. Minimal Effect of Daytime Napping Behavior on Nocturnal Sleep in Pregnant Women. J Clin Sleep Med 2015; 11:635-43. [PMID: 25766712 DOI: 10.5664/jcsm.4774] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 01/29/2015] [Indexed: 12/30/2022]
Abstract
STUDY OBJECTIVES To assess whether daytime naps negatively impact nocturnal sleep. DESIGN Longitudinal, prospective cohort design. PARTICIPANTS 161 pregnant women recruited and evaluated in early gestation (10-20 weeks). MEASUREMENTS AND RESULTS Daily sleep information was collected in three 2-week periods (10-12, 14-16, and 18-20 weeks gestation) with a daily sleep diary and an actigraph. The average number of naps, as well as the average length of each nap, were calculated from sleep diaries. Women were categorized first as non nappers (0 naps/2-week period), moderate nappers (1-3 naps/2-week period), or frequent nappers (≥ 4 naps/2-week period). Then, based on the average nap length, they were categorized as short (< 90 min) or long (≥ 90 min) nappers. Nocturnal sleep parameters included SOL, WASO, SE, and TST. SAS procedure MIXED was used for modeling the main effects of nap group and time, and time by nap group interactions. Women who took naps had a decrease in diary-assessed nocturnal TST, but not actigraphy-assessed TST. This observation was group- and time-specific. There were no other group differences. Women who napped ≥ 90 min had poorer diary-assessed SE and lower diary-assessed TST than those who took shorter naps. Length of nap was not associated with any other sleep measures. CONCLUSIONS The number of daytime naps have minimal impact on nocturnal sleep parameters; however, long nappers did exhibit modestly impaired sleep continuity and sleep quality. Overall, we propose that daytime naps provide a beneficial countermeasure to the sleep disruption commonly reported by pregnant women. This may be clinically beneficial given that sleep continuity and quality are important correlates of pregnancy outcomes. COMMENTARY A commentary on this article appears in this issue on page 593.
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Affiliation(s)
| | | | - Michele L Okun
- University of Pittsburgh, Pittsburgh, PA.,University of Colorado, Colorado Springs, CO
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Abstract
OBJECTIVE This study aims to obtain preliminary data on the efficacy of yoga for reducing self-reported menopausal hot flashes in a randomized study including an attention control group. METHODS We randomized 54 late perimenopausal women (2-12 mo of amenorrhea) and postmenopausal women (>12 mo of amenorrhea)--aged 45 to 58 years and who experienced at least four hot flashes per day, on average, for at least 4 weeks--to one of three groups: yoga, health and wellness education (HW), and wait list (WL). Yoga and HW classes consisted of weekly 90-minute classes for 10 weeks. All women completed daily hot flash diaries throughout the trial (10 wk) to track the frequency and severity of hot flashes. The mean hot flash index score is based on the number of mild, moderate, severe, and very severe hot flashes. RESULTS Hot flash frequency declined significantly across time for all three groups, with the strongest decline occurring during the first week. There was no overall significant difference in hot flash frequency decrease over time by treatment groups, but the yoga and HW groups followed similar patterns and showed greater decreases than the WL group. On week 10, women in the yoga group reported an approximately 66% decrease in hot flash frequency, women in the HW group reported a 63% decrease, and women in the WL group reported a 36% decrease. The hot flash index showed a similar pattern. CONCLUSIONS Results suggest that yoga can serve as a behavioral option for reducing hot flashes but may not offer any advantage over other types of interventions.
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Melatonin in perimenopausal and postmenopausal women: associations with mood, sleep, climacteric symptoms, and quality of life. Menopause 2015; 21:493-500. [PMID: 24065140 DOI: 10.1097/gme.0b013e3182a6c8f3] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Melatonin synthesis and secretion are partly modulated by estrogen and progesterone. Changes in melatonin concentrations, possibly related to the menopausal transition, may be associated with climacteric mood, sleep, and vasomotor symptoms. The aims of this study were to compare the serum concentrations of melatonin in perimenopausal and postmenopausal women and to evaluate melatonin's influence on mood, sleep, vasomotor symptoms, and quality of life. METHODS We analyzed the data of 17 healthy perimenopausal women (aged 43-51 y) and 18 healthy postmenopausal women (aged 58-71 y) who participated in a prospective study. On study night (9:00 pm-9:00 am), serum melatonin was sampled at 20-minute (9:00 pm-12:00 midnight; 6:00-9:00 am) and 1-hour (12:00 midnight-6:00 am) intervals. Questionnaires were used to assess depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory), insomnia and sleepiness (Basic Nordic Sleep Questionnaire [BNSQ]), subjective sleep quality, vasomotor symptoms, and quality of life (EuroQoL). RESULTS Postmenopausal women had lower nighttime serum melatonin concentrations than perimenopausal women. The duration of melatonin secretion tended to be shorter in postmenopause, whereas melatonin peak time did not differ. Mean melatonin concentrations and exposure levels did not correlate with follicle-stimulating hormone level, estradiol level, body mass index, Beck Depression Inventory score, State-Trait Anxiety Inventory score, BNSQ insomnia score, BNSQ sleepiness score, subjective sleep score, climacteric vasomotor score, or quality of life. In perimenopause, the later is the melatonin peak, the higher is the level of anxiety (P = 0.022), and the longer is the melatonin secretion, the better is the quality of life (P < 0.001). CONCLUSIONS Longitudinal research is needed to better understand the possible contributory role of menopause in lower melatonin levels.
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Xu Q, Lang CP, Rooney N. A systematic review of the longitudinal relationships between subjective sleep disturbance and menopausal stage. Maturitas 2014; 79:401-12. [DOI: 10.1016/j.maturitas.2014.09.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 09/20/2014] [Indexed: 10/24/2022]
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Moran LJ, March WA, Whitrow MJ, Giles LC, Davies MJ, Moore VM. Sleep disturbances in a community-based sample of women with polycystic ovary syndrome. Hum Reprod 2014; 30:466-72. [PMID: 25432918 DOI: 10.1093/humrep/deu318] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
STUDY QUESTION Is there an excess of sleep disturbances in women with polycystic ovary syndrome (PCOS) in a community-based sample? STUDY ANSWER Sleep disturbances are almost twice as common in women with PCOS compared with women of similar age without PCOS, with the association slightly accounted for by body weight and, to a greater extent, by depressive symptoms. WHAT IS KNOWN ALREADY There is an excess of sleep-disordered breathing in clinical samples of women with PCOS, after accounting for their profile of body weight. Poor sleep patterns increase insulin resistance and thus may exacerbate PCOS symptoms and longer-term risk of metabolic disease. STUDY DESIGN, SIZE, DURATION A cross-sectional study of 724 women, comprising 74% of a cohort study established retrospectively when women were around age 30 years. PARTICIPANTS/MATERIALS, SETTING, METHODS Comparisons were made between 87 women with PCOS, diagnosed using the Rotterdam criteria, and 637 women without this diagnosis in Adelaide, South Australia. Differences in sleep disturbances, assessed using a modified version of the Jenkins questionnaire, were investigated using ordered logistic regression. MAIN RESULTS AND THE ROLE OF CHANCE Sleep disturbances were twice as common in women with PCOS compared with those without. Specifically, PCOS was associated with increasing occurrence of difficulty falling asleep (odds ratio (OR) 1.94, 95% confidence interval (CI) 1.28-2.95); this association was attenuated but still statistically significant after accounting for BMI and depressive symptoms. Increasing occurrence of difficulty maintaining sleep (OR 1.92 95% CI 1.12-3.31) was mediated by obesity and depressive symptoms, together. Other factors did not change these findings. LIMITATIONS, REASONS FOR CAUTION The cross-sectional nature of the study means that the direction of associations between PCOS and sleep disturbances is unclear, although bi-directionality for the mediators is likely based on data in the wider literature. WIDER IMPLICATIONS OF THE FINDINGS Our results indicate that assessment and management of both sleep and mental health problems in women with PCOS should be undertaken. Longitudinal data would be valuable to see how poor sleep affects longer-term health profiles.
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Affiliation(s)
- L J Moran
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia
| | - W A March
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia
| | - M J Whitrow
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia School of Population Health, University of Adelaide, Adelaide, Australia
| | - L C Giles
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia School of Population Health, University of Adelaide, Adelaide, Australia
| | - M J Davies
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia
| | - V M Moore
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia School of Population Health, University of Adelaide, Adelaide, Australia The Fay Gale Centre for Research on Gender, University of Adelaide, Adelaide, Australia
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Hachul H, Monson C, Kozasa EH, Oliveira DS, Goto V, Afonso R, Llanas AC, Tufik S. Complementary and alternative therapies for treatment of insomnia in women in postmenopause. Climacteric 2014; 17:645-53. [DOI: 10.3109/13697137.2014.926321] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Green MJ, Espie CA, Benzeval M. Social class and gender patterning of insomnia symptoms and psychiatric distress: a 20-year prospective cohort study. BMC Psychiatry 2014; 14:152. [PMID: 24884517 PMCID: PMC4041899 DOI: 10.1186/1471-244x-14-152] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 05/20/2014] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Psychiatric distress and insomnia symptoms exhibit similar patterning by gender and socioeconomic position. Prospective evidence indicates a bi-directional relationship between psychiatric distress and insomnia symptoms so similarities in social patterning may not be coincidental. Treatment for insomnia can also improve distress outcomes. We investigate the extent to which the prospective patterning of distress over 20 years is associated with insomnia symptoms over that period. METHODS 999 respondents to the Twenty-07 Study had been followed for 20 years from approximately ages 36-57 (73.2% of the living baseline sample). Psychiatric distress was measured using the GHQ-12 at baseline and at 20-year follow-up. Gender and social class were ascertained at baseline. Insomnia symptoms were self-reported approximately every five years. Latent class analysis was used to classify patterns of insomnia symptoms over the 20 years. Structural Equation Models were used to assess how much of the social patterning of distress was associated with insomnia symptoms. Missing data was addressed with a combination of multiple-imputation and weighting. RESULTS Patterns of insomnia symptoms over 20 years were classified as either healthy, episodic, developing or chronic. Respondents from a manual social class were more likely to experience episodic, developing or chronic patterns than those from non-manual occupations but this was mostly explained by baseline psychiatric distress. People in manual occupations experiencing psychiatric distress however were particularly likely to experience chronic patterns of insomnia symptoms. Women were more likely to experience a developing pattern than men, independent of baseline distress. Psychiatric distress was more persistent over the 20 years for those in manual social classes and this effect disappeared when adjusting for insomnia symptoms. Irrespective of baseline symptoms, women, and especially those in a manual social class, were more likely than men to experience distress at age 57. This overall association for gender, but not the interaction with social class, was explained after adjusting for insomnia symptoms. Sensitivity analyses supported these findings. CONCLUSIONS Gender and socioeconomic inequalities in psychiatric distress are strongly associated with inequalities in insomnia symptoms. Treatment of insomnia or measures to promote healthier sleeping may therefore help alleviate inequalities in psychiatric distress.
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Affiliation(s)
- Michael J Green
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 4 Lilybank Gardens, Glasgow, G12 8RZ, UK.
| | - Colin A Espie
- Nuffield Department of Clinical Neurosciences/Sleep & Circadian Neuroscience Institute, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Michael Benzeval
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 4 Lilybank Gardens, Glasgow, G12 8RZ, UK,Institute of Social and Economic Research, University of Essex, Colchester, CO4 3SQ, UK
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Ornat L, Martínez-Dearth R, Chedraui P, Pérez-López FR. Assessment of subjective sleep disturbance and related factors during female mid-life with the Jenkins Sleep Scale. Maturitas 2014; 77:344-50. [DOI: 10.1016/j.maturitas.2014.01.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 01/15/2014] [Indexed: 10/25/2022]
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