SWAN Sleep Study II - Michigan Center

描述(申请人提供)：女性在中年期间睡眠中断增加，部分原因是年龄本身的影响，但也可能部分是由于绝经过渡，即在绝经过渡期间发生的激素、症状和出血的变化。目前的修订提案(睡眠II)将纵向扩展目前资助的关于中年女性睡眠的多地点、多种族横断面研究(睡眠I)。在《睡眠I》中，来自全国妇女健康研究(SWAN，一项关于更年期和衰老的纵向研究)的七个研究地点中的四个，对370名绝经前、围绝经期和绝经后的高加索人、非裔美国人和中国妇女进行了现场检查，使用了家庭多导睡眠图、每日日记和活动记录仪，以及自我报告睡眠问卷。在“睡眠二期”项目中，利用协调的R01机制，将对同一样本妇女(年龄为51-62岁)进行第二次实地检查，采用相同的程序。一个被广泛引用的睡眠障碍病理生理学的启发式模型将被应用于这些纵向数据，以评估这一多种族女性样本中与更年期相关的睡眠障碍的发展。该模型将急性睡眠障碍归因于诱因和诱发因素的综合作用，并将慢性睡眠障碍的持续性归因于急性压力源以外的永久性因素。 对绝经期过渡期间的睡眠进行纵向评估的具体目的是确定潜在的：1)易感因素(种族、低社会经济地位、低体力活动水平、高体重指数、吸烟、睡眠问题史、健康状况不佳)；2)过渡期间急性睡眠障碍的诱发因素(血管运动症状、新的不良生活事件、卵泡刺激素快速增加)；3)过渡期间慢性睡眠障碍的永久性因素(糟糕的睡眠卫生、对睡眠的功能失调的态度和信念、夜间认知和生理唤醒增强、种族)；4)睡眠障碍对绝经后早期健康状况的不利影响(代谢状况和生活质量恶化，高血压增加，身体限制)。 这项研究的公共卫生相关性是为了更好地了解不同种族和社会经济背景的女性睡眠的变化，并确定睡眠问题的危险因素。这一结果可以为初级预防提供信息，以了解更年期相关睡眠障碍造成的不良健康后果。

DESCRIPTION (provided by applicant): Sleep disruptions increase during mid-life in women, due in part to the effects of age itself, but also possibly due in part to the menopausal transition, i.e. changes in hormones, symptoms, and bleeding that occur during the menopausal transition. The current, revised proposal (Sleep II) will extend longitudinally the currently funded, multi-site, multi-ethnic cross-sectional study of sleep in midlife women (Sleep I). In Sleep I, field-based examinations were conducted with 370 midlife pre-, peri- and postmenopausal Caucasian, African-American, and Chinese women from four of seven study sites from the Study of Women's Health Across the Nation (SWAN, a longitudinal study of menopause and aging), using in-home polysomnography, daily diaries and actigraphs, and self-report sleep questionnaires. In Sleep II, using a Coordinated R01 mechanism, a second field-based examination will be conducted on the same sample of women (who will be aged 51-62 years), incorporating the same procedures. A widely-cited heuristic model of the pathophysiology of sleep disturbances will be applied to these longitudinal data to evaluate the development of menopause-related sleep disturbances in this multi-ethnic sample of women. This model attributes acute sleep disturbances to the combined effects of predisposing and precipitating factors, and persistence of chronic sleep disturbances beyond the acute stressor to perpetuating factors. The specific aims for this longitudinal assessment of sleep through the menopausal transition are to identify potential: 1) predisposing factors (race, low socioeconomic status, low levels of physical activity, high body mass index, smoking, history of sleep problems, poor health status); 2) precipitating factors (vasomotor symptoms, new adverse life events, rapid increases in follicle stimulating hormone) for acute sleep disturbances during the transition; 3) perpetuating factors (poor sleep hygiene, dysfunctional attitudes and beliefs about sleep, heightened cognitive and physiologic arousal at night, race) for chronic sleep disturbances during the transition; and 4) adverse effects of sleep disturbances on subsequent health status during the early postmenopause (worsening metabolic profile and quality of life, increased hypertension, physical limitations). The public health relevance of this research is to understand better the changes in the sleep of women from different racial and socioeconomic backgrounds and identify risk factors for sleep problems. The results can inform primary prevention of adverse health outcomes due to the menopause-related sleep disturbances.