SLEEP IN OLDER WOMEN--EFFECTS OF ESTROGEN

描述(改编自调查员摘要)：睡眠主诉 男性和女性都随着年龄的增长而显著增加，但这种增加是 尤其是在女性身上。年龄较大的女性夜间体验更多 觉醒，入睡潜伏期更长，睡眠更“清淡”。失眠, 睡眠中断，以及随之而来的白天嗜睡与 事故风险增加，卫生保健利用率提高，以及 镇静剂-催眠药，以及降低的生活质量。年龄较大的女性 接受不成比例的镇静催眠药处方， 它会加重睡眠呼吸暂停，并导致白天的遗留效应，如 如镇静、跌倒和随后的骨折，以及认知障碍。一个 更好地理解老年女性经历的睡眠变化 这是非常需要的。 一个促成因素可能是与年龄相关的性激素变化，如 雌激素。绝经后出现的极低水平的雌激素 广泛的慢性影响，从增加心血管风险因素到 可能会对记忆造成影响。老年女性的睡眠变化也可能是 与荷尔蒙环境的这种戏剧性变化有关。几项研究已经 显示ERT可以改善围绝经期妇女的睡眠，我们的 初步数据显示，ERT的使用与更好的睡眠有关 在绝经后的老年妇女中。雌激素作用于大脑的多个区域 对睡眠和昼夜节律很重要(例如，视交叉上 核团、下丘脑视前区和松果体)。 以前关于ERT对睡眠影响的研究是基于围绝经期妇女的 有潮热和/或其他更年期症状的患者，包括 抑郁症。除了少数研究外，所有这些研究都是基于简短的主观 睡眠评级。目前还没有公开发表的研究研究ERT对 绝经后妇女的睡眠，即已经过了几年的妇女 更年期、更年期症状和与更年期相关的激素波动。 这项拟议的研究将使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以评估疗效 6个月的ERT或安慰剂对睡眠和昼夜节律的影响 绝经后的女性。这一结果将有助于确定 老年女性睡眠质量下降时，与年龄相关的雌激素水平下降。 这项研究是研究计划的第一步，该计划旨在调查 老年人性激素与睡眠的关系。

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.