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期（EMT）经历使人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一种普遍存在的现象，并且导致了生产力降低的经济和社会成本以及寻求治疗行为对医疗保健系统的负担增加。以前的研究未能找到这种感知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，这可能会破坏睡眠的恢复功能。我们还假设，这些妇女的ANS调节随月经周期而变化。我们的目标是测试这些假设在特定目标1和2使用敏感的措施脑电图（EEG）和ANS活动在睡眠中。有症状的妇女也一贯报告更高水平的压力，暴露于这往往会加剧更年期症状。压力也是睡眠障碍的常见诱因，通过其对ANS的影响。具体目标3将测试的假设，有症状的妇女在EMT将显示改变反应的ANS在睡眠期间暴露于急性应激源。这些研究提供了一种新的方法来调查绝经期常见的睡眠障碍的机制。该研究还将提供有关有症状女性的应激反应的信息，并告知其观察到的心血管发病率升高风险的机制。

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.