Adverse effects of induced hot flashes on objectively recorded and subjectively reported sleep: results of a gonadotropin-releasing hormone agonist experimental protocol.
Adverse effects of induced hot flashes on objectively recorded and subjectively reported sleep: results of a gonadotropin-releasing hormone agonist experimental protocol.
复制标题
诱导热闪光对客观记录和主观报道的睡眠的不利影响：促性腺激素释放激素激动剂实验方案的结果。
DOI：
10.1097/gme.0b013e31828292d1
复制
发表时间：
2013-09
期刊：
影响因子：
--
通讯作者：
Hall JE
中科院分区：
文献类型：
--
作者：
Joffe H;White DP;Crawford SL;McCurnin KE;Economou N;Connors S;Hall JE
潮热对睡眠的影响是临床上非常感兴趣的，但结果并不一致，特别是当潮热和睡眠都是客观测量的时候。使用客观和主观测量方法，我们通过使用促性腺激素释放激素激动剂(GnRHa)诱发潮热来检查潮热对睡眠的影响。20名健康的绝经前志愿者服用了GnRHa亮丙瑞林，这些志愿者没有潮热或睡眠障碍。在1个月的随访中，客观(皮肤电导监测)和主观(每日日记)评估诱发性潮热。在有和没有出现客观潮热的女性之间，比较了客观(动作图)和主观睡眠质量(匹兹堡睡眠质量指数[PSQI])基线的变化，同时进行了主观潮热的分析。有14例(70%)记录到新发潮热，14例(70%)妇女报告有新发潮热(80%符合)。雌二醇被普遍抑制。有客观潮热的女性客观睡眠效率下降，而没有客观潮热的女性睡眠效率提高(中位数减少2.6%，增加4.2%，p=0.005)。有主观潮热者的主观睡眠质量比没有主观潮热者更差(PSQI中位数增加2.5对1.0，p=0.03)。客观潮热与主观睡眠质量无关，主观症状也与客观睡眠指标无关。这个诱导潮热的实验模型证明了潮热和睡眠质量差之间的因果关系。客观潮热会导致客观睡眠效率下降，而主观潮热会使人感觉到的睡眠质量下降。
The impact of hot flashes on sleep is of great clinical interest, but results are inconsistent, especially when both hot flashes and sleep are measured objectively. Using objective and subjective measurements, we examined the impact of hot flashes on sleep by inducing hot flashes with a gonadotropin-releasing hormone agonist (GnRHa). The GnRHa leuprolide was administered to 20 healthy premenopausal volunteers without hot flashes or sleep disturbances. Induced hot flashes were assessed objectively (skin-conductance monitor) and subjectively (daily diary) during one-month follow-up. Changes from baseline in objective (actigraphy) and subjective sleep quality (Pittsburgh Sleep Quality Index [PSQI]) were compared between women who did and did not develop objective hot flashes, and, in parallel analyses, subjective hot flashes. New-onset hot flashes were recorded in 14 (70%) and reported by 14 (70%) women (80% concordance). Estradiol was universally suppressed. Objective sleep efficiency worsened in women with objective hot flashes and improved in women without objective hot flashes (median decrease 2.6%, increase 4.2%, p=0.005). Subjective sleep quality worsened more in those with than without subjective hot flashes (median increase PSQI 2.5 vs. 1.0, p=0.03). Objective hot flashes were not associated with subjective sleep quality, nor were subjective symptoms linked to objective sleep measures. This experimental model of induced hot flashes demonstrates a causal relationship between hot flashes and poor sleep quality. Objective hot flashes result in worse objective sleep efficiency, while subjective hot flashes worsen perceived sleep quality.