SLEEP IN OLDER WOMEN--EFFECTS OF ESTROGEN

描述（改编自研究者的摘要）：睡眠投诉 男性和女性都随着年龄的增长而显着增加，但增加幅度是 在女性身上尤其引人注目。 老年女性经历更多的夜间时光 觉醒、较长的入睡潜伏期和“较浅”的睡眠。 失眠， 睡眠中断以及随之而来的白天嗜睡与 事故风险增加，医疗保健利用率提高， 镇静催眠药物，以及生活质量下降。 老年妇女 收到过多的镇静催眠药处方， 这会加剧睡眠呼吸暂停并导致白天的残留效应，例如 如镇静、跌倒和随后的骨折以及认知障碍。 一个 更好地了解老年女性经历的睡眠变化 迫切需要。 一个促成因素可能是性类固醇的年龄相关变化，例如 雌激素。 绝经后雌激素水平极低， 广泛的慢性影响，从增加心血管危险因素到 对记忆可能产生的影响。 老年女性的睡眠变化也可能 与荷尔蒙环境的这种巨大变化有关。 多项研究已 研究表明，ERT 可以改善围绝经期女性的睡眠，我们的 初步数据显示，使用 ERT 与改善睡眠有关 老年绝经后妇女。 雌激素作用于多个大脑区域 对于睡眠和昼夜节律很重要（例如，视交叉上 核、下丘脑视前区和松果体）。 先前关于 ERT 对睡眠影响的研究是基于围绝经期女性 正在经历潮热和/或其他更年期症状的人，包括 抑郁症。 除少数研究外，所有这些研究都是基于简短的主观研究 睡眠评级。 尚未发表的研究探讨 ERT 对 绝经后妇女的睡眠，即几年前的妇女 更年期、更年期症状以及与更年期相关的激素波动。 拟议的研究将采用基于实验室的多导睡眠图和 随机、安慰剂对照的受试者内设计来评估效果 六个月 ERT 或安慰剂对睡眠和昼夜节律的影响 绝经后妇女。 结果将有助于确定 与年龄相关的雌激素下降导致老年女性睡眠质量下降。 这项研究是一项研究计划的第一步，旨在调查 性类固醇与老年人睡眠之间的关系。

DESCRIPTION (adapted from investigator's abstract): Sleep complaints increase significantly with age in both men and women, but the increase is especially striking in women. Older women experience more nighttime awakenings, longer sleep onset latencies, and "lighter" sleep. Insomnia, disrupted sleep, and consequent daytime drowsiness are associated with an increased risk of accidents, increased utilization of health care and sedative-hypnotic medications, and a reduced quality of life. Older women receive a disproportionate number of prescriptions for sedative-hypnotics, which can exacerbate sleep apnea and lead to daytime carryover effects such as sedation, falls and subsequent fractures, and cognitive impairment. A better understanding of the sleep changes experienced by older women is sorely needed. One contributing factor may be age-related changes in sex steroids such as estrogen. The very low levels of estrogen that occur post-menopause have wide-ranging chronic effects, from increased cardiovascular risk factors to possible effects on memory. Sleep changes in older women may also be related to this dramatic change in hormonal milieu. Several studies have shown that ERT can improve the sleep of peri-menopausal women, and our preliminary data shows that the use of ERT is associated with better sleep in older post-menopausal women. Estrogen acts on several brain areas important for sleep and circadian rhythms (e.g., the suprachiasmatic nucleus, the hypothalamic pre-optic area, and the pineal gland). Previous studies of ERT effects on sleep were based on peri-menopausal women who were experiencing hot flashes and/or other menopausal symptoms including depression. All but a few of these studies were based on brief subjective sleep ratings. No published studies have examined the effect of ERT on the sleep of post-menopausal women., i.e., women who are several years past menopause, menopausal symptoms, and menopause-related hormone fluctuations. The proposed study will employ laboratory-based polysomnography and a randomized, placebo-controlled within-subjects design to assess the effect of six months ERT or placebo on the sleep and circadian rhythms of post-menopausal women. The results will help determine the role of age-related estrogen decline in the decreased sleep quality of older women. This study is the first step in a research program investigating the relationship between sex steroids and sleep in older individuals.