Sleep, Reproductive Transitions, and Health in Women

描述(由申请人提供)：每年有数百万妇女在绝经早期过渡(EMT)期间经历衰弱的身体和心理症状。自我报告的睡眠障碍在有症状的女性中几乎是无处不在的现象，并导致生产力下降和求医行为增加医疗保健系统负担的经济和社会成本。此前的研究未能找到这种感知到的睡眠障碍的潜在机制。我们假设，在EMT期间出现与生殖激素变化相关的症状的女性已经改变了中枢或自主神经系统(ANS)调节，这可能会扰乱睡眠的恢复功能。我们还假设这些女性在月经周期中对ANS的调节有所不同。我们的目标是在特定的目标1和2中使用脑电(EEG)和睡眠中ANS活动的灵敏测量来测试这些假设。有症状的女性也不断报告更高的压力水平，暴露在这种压力下往往会加剧更年期症状。压力也是睡眠障碍的常见诱因，因为它对ANS有影响。具体目标3将检验这样一种假设，即EMT中有症状的女性在暴露于急性应激源后，在睡眠期间ANS的反应性会发生变化。这些研究为研究绝经期常见的睡眠障碍的机制提供了一种新的方法。这项研究还将提供有关有症状妇女的应激反应的信息，并告知她们观察到的心血管发病率升高风险背后的机制。 与公共卫生有关：在更年期过渡期间出现症状的妇女会出现一系列使人衰弱的症状，这些症状会影响她们的身心健康，并导致生产力下降和卫生保健支出方面的重大社会代价。睡眠障碍是更年期的一种普遍现象，尤其具有破坏性。本研究将评估更年期早期女性自主神经系统紊乱、睡眠障碍和应激反应之间的关系。

DESCRIPTION (provided by applicant): Several million women experience debilitating physical and psychological symptoms during the early menopausal transition (EMT) each year. Self-reported sleep disturbance is an almost ubiquitous phenomenon in symptomatic women, and contributes to the economic and social costs of reduced productivity and increased load to the health care system from treatment seeking behavior. Previous studies have failed to find underlying mechanisms for this perceived sleep disturbance. We hypothesize that women who develop symptoms in association with reproductive hormone changes during the EMT have altered central or autonomic nervous system (ANS) regulation that can disrupt the restorative function of sleep. We also hypothesize that regulation of the ANS in these women varies over the menstrual cycle. We aim to test these hypotheses in Specific Aims 1 and 2 using sensitive measures of electroencephalographic (EEG) and ANS activity during sleep. Symptomatic women also consistently report higher levels of stress, exposure to which will often exacerbate menopausal symptoms. Stress is also a common precipitant of sleep disturbance via its impact on the ANS. Specific Aim 3 will test the hypothesis that symptomatic women in the EMT will show altered reactivity of the ANS during sleep following exposure to an acute stressor. These studies provide a novel approach to investigating the mechanisms underlying sleep disturbance commonly experienced in the menopausal years. The study will also provide information as to stress reactivity in symptomatic women and inform the mechanisms underlying their observed elevated risk of cardiovascular morbidity. PUBLIC HEALTH RELEVANCE: Women who are symptomatic during the menopausal transition suffer from a range of debilitating symptoms that impact their physical and mental health and that lead to major societal costs in lost productivity and health care expenditure. Sleep disturbances are a ubiquitous and particularly disruptive feature of menopause. This study will assess the relationships between autonomic nervous system dsyregulation, sleep disturbance and the response to stress in women in the early menopausal transition.