Effects of exogenous melatonin on sleep and circadian rhythms in women with premenstrual dysphoric disorder

Association between sleep quality and premenstrual syndrome in young women in a cross-sectional study

Sleep disorders are recognized as one of the significant risk factors for premenstrual syndrome (PMS). Therefore, this study aimed to identify the relationship between sleep quality and PMS symptoms among young women. In this cross-sectional study, 252 women from health centers of Qazvin province participated according to the inclusion criteria. The data of premenstrual symptoms and sleep quality was received through online premenstrual symptoms screening (PSST) and the Pittsburgh Sleep Quality Index (PSQI) questionnaires. For analyzing data, ANOVA and chi-square tests were used to evaluate quantitative and qualitative variables. Sampling adequacy was assessed using the Kaiser-Meyer-Olkin (KMO) test. According to the PSST, 28.7% of individuals experienced mild severity, 21.9% experienced moderate severity, and 49.4% experienced severe severity. The correlation between PSQI and PSST showed a significant relationship (p < 0.05) with anger/temper, anxiety/tension, crying/sensitivity to negative responses, depressed mood/disappointment, and fatigue/lack of energy. Based on the results, it has been established that there is a notable correlation between the quality of sleep and the severity of PMS symptoms. This underscores the crucial role of sleep in the management of PMS.

Impact of nocturnal road traffic noise and annoyance on self-reported insomnia symptoms: policy intervention in noise-polluted environments

Chronic exposure to traffic noise is associated with increased stress and sleep disruptions. Research on the health consequences of environmental noise, specifically traffic noise, has primarily been conducted in high-income countries (HICs), which have guided the development of noise regulations. The relevance of these findings to policy frameworks in low- and middle-income countries (LMICs) remains uncertain. To investigate the relationship between road traffic noise exposure and annoyance on insomnia symptoms, a questionnaire survey was administered to 5408 randomly selected participants residing in Srinagar, India. Sleep quality was assessed using a standardized sleep disturbance score, along with self-reported annoyance levels related to road traffic noise at the participants' residences. Nighttime road traffic noise was modeled using Sound PLAN 8.2 software to generate noise contour maps, enabling the spatial evaluation of noise levels along roadways near residential areas. A total of 79.3% of the 5408 respondents were exposed to noise levels exceeding 45 Lnight dB(A). Statistically significant associations were observed between traffic noise exposure and all insomnia symptoms, with difficulty falling asleep showing the strongest association (OR = 1.53; 95% CI = 1.12-2.09) within the study sample. Compared to males, females exhibited higher insomnia symptoms (OR = 1.68; 95% CI = 1.35-2.08). The results indicated that insomnia was strongly correlated with an increased odds of traffic noise annoyance (OR = 2.39; 95% CI = 1.73-3.76) (p = 0.029). Finally, this study advocates for a robust regulatory framework to incorporate noise pollution mitigation strategies into the public health action plans of developing nations.

Efficacy of melatonin for prolonged disorders of consciousness: a double-blind, randomized clinical trial

BACKGROUND

Sleep is essential for the recovery of patients with disorders of consciousness (DoC). However, few approaches targeting sleep were applied. Melatonin has been shown to enhance sleep efficiency with virtually no side effects. This study explored melatonin's benefits for patients with prolonged DoC, as well as the underlying mechanisms involved.

METHODS

A cohort of 46 patients with prolonged DoC were randomly assigned to either the melatonin treatment group or the placebo group. Assessments were conducted using the Coma Recovery Scale-Revised (CRS-R), electroencephalography (EEG), and polysomnography (PSG) before and after the intervention, with follow-up CRS-R evaluations performed 6 months post-treatment.

RESULTS

Compared to the placebo, melatonin demonstrated a significant improvement in CRS-R scores after a 2-week period in patients with unresponsive wakefulness syndrome (UWS) (Fgroup*time = 6.86, P = 0.032; Fgroup = 4.03, P = 0.045) and this improvement was particularly pronounced in visual scores (Fgroup*time = 7.03, P = 0.030; Fgroup = 4.90, P = 0.027). Moreover, patients with UWS who received melatonin exhibited a higher relative spectral density of the alpha band in the frontal lobe compared to those who received placebo (Ftime-mel = 4.55, P = 0.033) and benefited for their prognosis after 6 months (Pseudo R2 = 0.370, F = 12.03, P = 0.034).

CONCLUSIONS

Overall, melatonin intervention seems to have a better response in UWS patients with preserved sleep cycles. These positive effects may not be solely attributed to improvements in the patients' sleep quality.

TRAIL REGISTRATION

ClinicalTrials.gov: NCT05285124.

Premenstrual Symptoms Risk Factors Among Newly Graduated Nurses in Shift Work: A Prospective Longitudinal Study

PURPOSE

The premenstrual symptoms (PMSs) are a common health issue affecting women of reproductive age and are associated with various physiological, psychological, and situational factors. Newly graduated nurses, when suddenly exposed to excessive workloads and shift work, may experience disturbances such as sleep disorders, fatigue, depression, and stress. These factors are related to PMS, and their occurrence varies. Therefore, this study aimed to understand the changes in PMS and its risk factors among newly graduated nurses across shift work periods, and investigate the longitudinal relationships between PMS and its risk factors based on the theory of unpleasant symptoms.

METHODS

This study constituted a secondary data analysis and employed a prospective longitudinal design. Newly graduated nurses were assessed three times: before starting shift work, six months after initiating shift work, and 18 months thereafter. Physiological (age, body mass index, alcohol consumption, dietary behavior), psychological (sleep quality, fatigue, depression, stress, life satisfaction), and situational (social support) factors were included as PMS-related factors.

RESULTS

PMS worsened six months after the initiation of shift work compared with those before, and this aggravation persisted even after 18 months of shift work (p < .001). Age (p = .043), sleep quality (p = .004), and fatigue (p < .001) were associated with PMS. An interaction between time and depression that affected PMS was observed (p = .021).

CONCLUSION

Newly graduated nurses need to pay attention to the exacerbation of PMS after initiating shift work. Interventions to improve sleep quality and reduce fatigue are crucial for novice nurses, irrespective of shiftwork duration. Additionally, it is important to assess depressive symptoms before starting shift work and implement early interventions. Furthermore, the need for interventions addressing depression escalates with the increase in shiftwork duration.

Overexpression of oHIOMT results in various morphological, anatomical, physiological and molecular changes in switchgrass

Introduction

Melatonin (N-acetyl-5-methoxytryptamine) is a molecule implicated in multiple biological functions, but exerts contrasting effects on plants owing to concentration differences. Hydroxyindole O-methyltransferase (HIOMT), which catalyzes the last step of melatonin synthesis, plays a crucial role in this context.

Methods

Transgenic switchgrass overexpressing oHIOMT with different melatonin levels displayed distinct morphological changes in a concentration-dependent manner. In this study, we divided the transgenic switchgrass into two groups: melatonin-moderate transgenic (MMT) plants and melatonin-rich transgenic (MRT) plants. To determine the concentration-dependent effect of melatonin on switchgrass growth and stress resistance, we conducted comparative morphological, physiological, omics and molecular analyses between MMT, MRT and wild-type (WT) plants.

Results

We found that oHIOMT overexpression, with moderate melatonin levels, was crucial in regulating switchgrass growth through changes in cell size rather than cell number. Moderate levels of melatonin were vital in regulating carbon fixation, stomatal development and chlorophyll metabolism. Regarding salt tolerance, melatonin with moderate levels activated numerous defense (e.g. morphological characteristics, anatomical structure, antioxidant enzymatic properties, non-enzymatic capacity and Na+/K+ homeostasis). Additionally, moderate levels of oHIOMT overexpression were sufficient to increase lignin content and alter monolignol compositions with an increase in the S/G lignin ratio.

Discussion

Taken together, oHIOMT overexpression in switchgrass with different melatonin levels resulted in morphological, anatomical, physiological and molecular changes in a concentration-dependent manner, which characterized by stimulation at low doses and inhibition at high doses. Our study presents new ideas and clues for further research on the mechanisms of the concentration-dependent effect of melatonin.

The Menstrual Cycle and Sleep

Aspects of sleep change across the menstrual cycle in some women. Poorer sleep quality in the premenstrual phase and menstruation is common in women with premenstrual symptoms or painful menstrual cramps. Although objective sleep continuity remains unchanged across the regular, asymptomatic menstrual cycle, activity in the sleep electroencephalogram varies, with a prominent increase in sleep spindle activity in the postovulatory luteal phase, when progesterone is present, relative to the follicular phase. Menstrual cycle phase, reproductive stage, and menstrual-related disorders should be considered when assessing women's sleep complaints.

Recent Progress in Long-Term Sleep Monitoring Technology

Sleep is an essential physiological activity, accounting for about one-third of our lives, which significantly impacts our memory, mood, health, and children's growth. Especially after the COVID-19 epidemic, sleep health issues have attracted more attention. In recent years, with the development of wearable electronic devices, there have been more and more studies, products, or solutions related to sleep monitoring. Many mature technologies, such as polysomnography, have been applied to clinical practice. However, it is urgent to develop wearable or non-contacting electronic devices suitable for household continuous sleep monitoring. This paper first introduces the basic knowledge of sleep and the significance of sleep monitoring. Then, according to the types of physiological signals monitored, this paper describes the research progress of bioelectrical signals, biomechanical signals, and biochemical signals used for sleep monitoring. However, it is not ideal to monitor the sleep quality for the whole night based on only one signal. Therefore, this paper reviews the research on multi-signal monitoring and introduces systematic sleep monitoring schemes. Finally, a conclusion and discussion of sleep monitoring are presented to propose potential future directions and prospects for sleep monitoring.

The Effect of Zinc Supplementation on the Improvement of Premenstrual Symptoms in Female University Students: a Randomized Clinical Trial Study

Zinc is an essential microelement that plays many important functions in the body. It is crucial for the regulation of cell growth, hormone release, immunological response, and reproduction. Thus, this trial aimed to evaluate the effects of zinc supplementation in comparison with placebo on the improvement of premenstrual symptoms in female university students. This triple-masked, randomized, placebo-controlled, parallel trial was conducted among 69 female students aged 18-35 with premenstrual syndrome that living in dormitories of Hamadan University of Medical Sciences, in west of Iran. Participants were randomly assigned to two groups of equal number; one group received 220 mg of elemental zinc (n = 33) and the other group received placebo (n = 36) on a regular daily for 24 weeks. The premenstrual syndrome was assessed by Premenstrual Symptoms Screening Tool-Adolescent (PSST-A) questionnaire for all participants. Chi-square and t-student tests were used to compare the percentage or mean of parameters between two groups. All statistical analysis conducted by SPSS version 16. The mean age in the intervention group was 25.64 [Formula: see text] 0.53 years, and in the control group was 24.38 [Formula: see text] 0.51 years (P = 0.087). After 24 weeks of intervention, PMS physical and psychological symptoms such as anger, anxiety, depressed mood, overeating, breast tenderness, headaches, muscle pain, bloating, and weight gain significantly decreased in zinc group compared to placebo group (P < 0.001). We observed a significant increase in relationship with friends, classmates, and coworkers (p = 0.003) after 24 weeks of intervention with zinc compared to placebo. In conclusion, zinc, as a simple and inexpensive treatment, was associated with improvement of PMS symptoms. Given that this is among the first studies to evaluate the effect of zinc supplementation on PMS, additional studies are warranted to confirm these findings.

Melatonin for premenstrual syndrome: A potential remedy but not ready

Premenstrual syndrome (PMS), a recurrent and moderate disorder that occurs during the luteal phase of the menstrual cycle and quickly resolves after menstruation, is characterized by somatic and emotional discomfort that can be severe enough to impair daily activities. Current therapeutic drugs for PMS such as selective serotonin reuptake inhibitors are not very satisfying. As a critical pineal hormone, melatonin has increasingly been suggested to modulate PMS symptoms. In this review, we update the latest progress on PMS-induced sleep disturbance, mood changes, and cognitive impairment and provide possible pathways by which melatonin attenuates these symptoms. Moreover, we focus on the role of melatonin in PMS molecular mechanisms. Herein, we show that melatonin can regulate ovarian estrogen and progesterone, of which cyclic fluctuations contribute to PMS pathogenesis. Melatonin also modulates gamma-aminobutyric acid and the brain-derived neurotrophic factor system in PMS. Interpreting the role of melatonin in PMS is not only informative to clarify PMS etiology but also instructive to melatonin and its receptor agonist application to promote female health. As a safe interaction, melatonin treatment can be effective in alleviating symptoms of PMS. However, symptoms such as sleep disturbance, depressive mood, cognitive impairment are not specific and can be easily misdiagnosed. Connections between melatonin receptor, ovarian steroid dysfunction, and PMS are not consistent among past studies. Before final conclusions are drawn, more well-organized and rigorous studies are recommended.