Sleep, Reproductive Transitions, and Health in Women

描述（由申请人提供）：每年有数百万妇女在早期绝经过渡（EMT）期间经历身体和心理上的衰弱症状。在有症状的女性中，自我报告的睡眠障碍几乎是一种普遍现象，并导致生产力下降的经济和社会成本，以及寻求治疗行为给卫生保健系统带来的负担增加。之前的研究未能找到这种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改变了中枢或自主神经系统（ANS）的调节，从而破坏了睡眠的恢复功能。我们还假设，这些女性对ANS的调节在月经周期中有所不同。我们的目标是在特定目标1和2中使用睡眠期间脑电图（EEG）和ANS活动的敏感测量来测试这些假设。有症状的女性也一直报告压力水平较高，暴露在压力下往往会加剧更年期症状。压力也是睡眠障碍的一个常见诱因，因为它会影响到ANS。具体目标3将测试一个假设，即EMT中有症状的女性在暴露于急性压力源后，会在睡眠中显示出ANS的反应性改变。这些研究为研究绝经期睡眠障碍的机制提供了一种新的途径。该研究还将提供有关有症状妇女的应激反应性的信息，并告知其观察到的心血管发病率升高的机制。

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.