Postmenopausal hormones and sleep quality in the elderly: a population based study

BMC Women's Health

Research Article

Gregory J Tranah¹  Terri Blackwell¹  Steven R Cummings¹  Neeta Parimi¹  Katie L Stone¹  Jane A Cauley²  Susan Redline³  Nancy Lane⁴  Sonia Ancoli-Israel⁵  Kristine Yaffe⁶  Misti L Paudel⁷  Kristine E Ensrud⁸  Teresa A Hillier⁹ 

[1] CPMC Research Institute, San Francisco, CA, USA;Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA;Department of Medicine and Center for Clinical Investigation, Case Western Reserve University, Cleveland, OH, USA;Department of Medicine, University of California Davis Medical School, Sacramento, CA, USA;Department of Psychiatry, University of California San Diego, San Diego, CA, USA;Departments of Psychiatry, Neurology, and Epidemiology, University of California, San Francisco and the San Francisco VA Medical Center, San Francisco, CA, USA;Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA;Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA;Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN, USA;Department of Medicine, University of Minnesota, Minneapolis, MN, USA;Kaiser Permanente Center for Health Research Northwest/Hawaii, Portland, OR, USA;

关键词: Postmenopausal Woman;    Hormone Therapy;    Sleep Latency;    Total Sleep Time;    Sleep Efficiency;   

DOI  :  10.1186/1472-6874-10-15

 received in 2009-07-28, accepted in 2010-05-04,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundSleep disturbance and insomnia are commonly reported by postmenopausal women. However, the relationship between hormone therapy (HT) and sleep disturbances in postmenopausal community-dwelling adults is understudied. Using data from the multicenter Study of Osteoporotic Fractures (SOF), we tested the relationship between HT and sleep-wake estimated from actigraphy.MethodsSleep-wake was ascertained by wrist actigraphy in 3,123 women aged 84 ± 4 years (range 77-99) from the Study of Osteoporotic Fractures (SOF). This sample represents 30% of the original SOF study and 64% of participants seen at this visit. Data were collected for a mean of 4 consecutive 24-hour periods. Sleep parameters measured objectively included total sleep time, sleep efficiency (SE), sleep latency, wake after sleep onset (WASO), and nap time. All analyses were adjusted for potential confounders (age, clinic site, race, BMI, cognitive function, physical activity, depression, anxiety, education, marital status, age at menopause, alcohol use, prior hysterectomy, and medical conditions).ResultsActigraphy measurements were available for 424 current, 1,289 past, and 1,410 never users of HT. Women currently using HT had a shorter WASO time (76 vs. 82 minutes, P = 0.03) and fewer long-wake (≥ 5 minutes) episodes (6.5 vs. 7.1, P = 0.004) than never users. Past HT users had longer total sleep time than never users (413 vs. 403 minutes, P = 0.002). Women who never used HT had elevated odds of SE <70% (OR,1.37;95%CI,0.98-1.92) and significantly higher odds of WASO ≥ 90 minutes (OR,1.37;95%CI,1.02-1.83) and ≥ 8 long-wake episodes (OR,1.58;95%CI,1.18-2.12) when compared to current HT users.ConclusionsPostmenopausal women currently using HT had improved sleep quality for two out of five objective measures: shorter WASO and fewer long-wake episodes. The mechanism behind these associations is not clear. For postmenopausal women, starting HT use should be considered carefully in balance with other risks since the vascular side-effects of hormone replacement may exceed its beneficial effects on sleep.

【 授权许可】

CC BY   
© Tranah et al; licensee BioMed Central Ltd. 2010