SLEEP IN OLDER WOMEN--EFFECTS OF ESTROGEN

描述（改编自研究者摘要）：睡眠主诉 随着年龄的增长，男性和女性都有显着增加，但 尤其是女性。 老年女性在夜间 觉醒，更长的睡眠开始时间，以及“更轻”的睡眠。 不好意思， 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， 镇静催眠药物和生活质量下降。 老年妇女 接受了不成比例的镇静催眠药处方， 这会加重睡眠呼吸暂停并导致日间遗留效应， 如镇静、福尔斯和随后的骨折以及认知障碍。 一 更好地了解老年妇女的睡眠变化， 非常需要。 一个影响因素可能是性类固醇的年龄相关变化，如 雌激素. 绝经后雌激素水平很低， 广泛的慢性影响，从增加心血管风险因素， 可能对记忆力有影响。 老年妇女的睡眠变化也可能是 与荷尔蒙环境的巨大变化有关。 几项研究 表明ERT可以改善围绝经期妇女的睡眠，我们的研究表明， 初步数据显示，ERT的使用与更好的睡眠有关， 绝经后的老年妇女。 雌激素作用于几个大脑区域 对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）。 以前关于ERT对睡眠影响的研究是基于围绝经期妇女 正在经历潮热和/或其他更年期症状，包括 萧条 除了少数几项研究外，所有这些研究都是基于简短的主观 睡眠评分 没有发表的研究检查了ERT对 绝经后妇女睡眠，也就是说，几年前的女人 绝经、绝经症状和绝经相关激素波动。 这项拟议的研究将采用实验室为基础的多导睡眠图和 随机化、安慰剂对照受试者内设计，以评估效果 六个月的ERT或安慰剂对睡眠和昼夜节律的影响 绝经后妇女。 研究结果将有助于确定 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， 性类固醇和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.