Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women.
Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women.
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DOI：
10.5665/sleep/31.7.979
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发表时间：
2008-07
期刊：
影响因子：
5.6
通讯作者：
H. Kravitz;Xinhua Zhao;J. Bromberger;E. Gold;M. Hall;K. Matthews;M. Sowers
中科院分区：
文献类型：
--
作者：
H. Kravitz;Xinhua Zhao;J. Bromberger;E. Gold;M. Hall;K. Matthews;M. Sowers
检查中年妇女自我报告的入睡和保持睡眠困难以及清晨醒来的年龄调整的几率和种族/民族差异，以确定睡眠困难是否随着绝经过渡期的进展而增加。设计纵向分析。以社区为基础。参与者：3,045名白人、非裔美国人、中国人、日本人和西班牙裔妇女，年龄42-52岁，基线时处于绝经前或早期围绝经期，参加全国妇女健康研究（SWAN）。干预措施测量和结果在基线和7年的年度评估中获得了前2周内自我报告的入睡困难、保持睡眠和清晨醒来的夜晚数。采用随机效应逻辑回归模型分析3种睡眠指标与绝经过渡期之间的相关性，绝经过渡期由出血模式、血管痉挛症状（VMS）、雌二醇（E2）和促卵泡激素（FSH）血清水平定义。调整后的比值比（OR）入睡困难和保持睡眠增加，通过绝经过渡期，但降低了清晨醒来从围绝经期后期到绝经后。自然绝经和手术绝经后妇女使用激素，与那些谁没有，一般有较低的OR睡眠障碍。更频繁的VMS与每种睡眠困难的较高OR相关。E2水平降低与入睡困难和保持睡眠的OR较高相关，FSH水平升高与保持睡眠困难的OR较高相关。在保持睡眠和清晨醒来方面发现了种族/民族差异。结论：绝经过渡期的进展与自我报告的睡眠障碍有关，这3个绝经特征是症状、出血定义阶段和内源性激素水平。
STUDY OBJECTIVES Examine age-adjusted odds and racial/ethnic differences in self-reported difficulties falling and staying asleep and early morning awakening in midlife women to determine whether difficulty sleeping increased with progression through the menopausal transition. DESIGN Longitudinal analysis. SETTING Community-based. PARTICIPANTS 3,045 Caucasian, African American, Chinese, Japanese, and Hispanic women, aged 42-52 years and pre- or early peri-menopausal at baseline, participating in the Study of Women's Health Across the Nation (SWAN). INTERVENTIONS None. MEASUREMENTS AND RESULTS Self-reported number of nights of difficulty falling asleep, staying asleep, and early morning awakening during the previous 2 weeks were obtained at baseline and 7 annual assessments. Random effects logistic regression was used to model associations between each of the 3 sleep measures and the menopausal transition, defined by bleeding patterns, vasomotor symptoms (VMS), and estradiol (E2) and follicle stimulating hormone (FSH) serum levels. Adjusted odds ratios (ORs) for difficulty falling asleep and staying asleep increased through the menopausal transition, but decreased for early morning awakening from late perimenopause to postmenopause. Naturally and surgically postmenopausal women using hormones, compared with those who were not, generally had lower ORs for disturbed sleep. More frequent VMS were associated with higher ORs of each sleep difficulty. Decreasing E2 levels were associated with higher ORs of trouble falling and staying asleep, and increasing FSH levels were associated with higher ORs of trouble staying asleep. Racial/ethnic differences were found for staying asleep and early morning awakening. CONCLUSIONS Progression through the menopausal transition as indicated by 3 menopausal characteristics--symptoms, bleeding-defined stages, and endogenous hormone levels--is associated with self-reported sleep disturbances.