PROGESTERONE AND SLEEP IN OLDER WOMEN

黄体酮与老年女性的睡眠

• 批准号: 6693035
• 负责人: MICHAEL V. VITIELLO
• 金额: $ 28.41万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-02-01 至 2005-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6693035
• 关键词: cognition; electroencephalography; estrogens; female; hormone regulation /control mechanism; hormone therapy; human middle age (35-64); human old age (65+); human subject; human therapy evaluation; memory; menopause; patient oriented research; polysomnography; progesterone; quality of life; sedative /hypnotic; sleep; sleep apnea; sleep disorders; wakefulness; women' s health

Sleep complaints increase significantly with age in women. Many older women experience difficulty falling asleep, more night-time awakenings, and less restful sleep. Sleep studies verify that disturbed sleep patterns are observed even in healthy older women. Sleep disturbances are associated with increased daytime drowsiness, increased accident risk, increased use of health care, and reduced quality of life. Older women receive a disproportionate number of sedative-hypnotic medications, which can exacerbate sleep apnea and have 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 menopause-related changes in sex steroids such as estrogen and progesterone. Research attention has focused on estrogen. However, progesterone may also participate in the control of sleep. Clinical reports indicate that women often feel drowsy after they take oral progesterone - an effect which is undesirable during the day, but may be positive at night. To date there are no published studies of progesterone's effect on the objectively-measured sleep and daytime drowsiness of older women. The proposed study will take a systematic, multi-dimensional approach to determining the effect of progesterone on the sleep and drowsiness of older women. Objective techniques (polysomnography, Multiple Sleep Latency Test) will be used to measure sleep and daytime drowsiness following evening or morning administration of 300 mg micronized progesterone, in 40 postmenopausal women who are at least 5 years past menopause and who are not experiencing hot flashes. Attention, memory, subjective sleepiness, and blood levels of progesterone and its metabolite (allopregnanolone) will also be measured. This study is part of a long-term research plan to assess (1) how the very low postmenopausal levels of estrogen and progesterone contribute to sleep difficulties of older women, and (2) how hormone replacement therapy affects the sleep of women. An ongoing placebo-controlled study is investigating the effects of estrogen on the sleep of older women. The proposed study will complement the estrogen study. It will enhance our limited understanding of the relationship between sex steroids and sleep, and the factors that contribute to sleep problems in older women.

女性的睡眠问题随着年龄的增长而显着增加。 许多老年女性都经历入睡困难、夜间醒来次数增多以及睡眠质量较差等问题。 睡眠研究证实，即使在健康的老年女性中也会观察到睡眠模式紊乱。 睡眠障碍与白天困倦增加、事故风险增加、医疗保健使用增加以及生活质量下降有关。 老年女性接受过多的镇静催眠药物，这些药物会加剧睡眠呼吸暂停，并产生日间残留效应，如镇静、跌倒和随后的骨折以及认知障碍。 迫切需要更好地了解老年女性所经历的睡眠变化。影响因素之一可能是与更年期相关的性类固醇（例如雌激素和黄体酮）的变化。 研究注意力集中在雌激素上。 然而，黄体酮也可能参与睡眠的控制。 临床报告表明，女性在服用口服黄体酮后经常会感到昏昏欲睡，这种效果在白天是不受欢迎的，但在晚上可能会产生积极的效果。 迄今为止，还没有发表关于黄体酮对老年女性客观测量的睡眠和白天睡意的影响的研究。拟议的研究将采用系统的、多维的方法来确定黄体酮对老年女性睡眠和困倦的影响。 客观技术（多导睡眠图、多次睡眠潜伏期测试）将用于测量 40 名绝经后至少 5 年且未出现潮热的绝经后妇女晚上或早上服用 300 毫克微粉化黄体酮后的睡眠和白天困倦情况。 注意力、记忆力、主观困倦以及黄体酮及其代谢物（别孕酮）的血液水平也将被测量。这项研究是长期研究计划的一部分，旨在评估（1）绝经后雌激素和黄体酮水平极低如何导致老年女性睡眠困难，以及（2）激素替代疗法如何影响女性睡眠。 一项正在进行的安慰剂对照研究正在调查雌激素对老年女性睡眠的影响。 拟议的研究将补充雌激素研究。 它将增强我们对性类固醇与睡眠之间的关系以及导致老年女性睡眠问题的因素的有限了解。