Italian Association of Sleep Medicine (AIMS) position statement and guideline on the treatment of menopausal sleep disorders

Silvestri, Rosalia; Aricò, Irene; Bonanni, Enrica; Bonsignore, Maria R.; Caretto, Marta; Caruso, Danila; Perri, Maria Caterina Di; Galletta, Santi; Lecca, Rosamaria; Lombardi, Carolina; Maestri, Michelangelo; Miccoli, Mario; Palagini, Laura; Provini, Federica; Puligheddu, Monica; Savarese, Mariantonietta; Spaggiari, Maria Cristina; Simoncini, Tommaso

doi:10.1016/j.maturitas.2019.08.006

Cited by 21 publications

(19 citation statements)

References 67 publications

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“…It has also been reported that central serotonin plays an important role in the regulation of circadian rhythm by modulating the activity of SCN neurons [25], and estrogen enhances the dorsal raphe serotonin system response to environmental light exposure [26]. Furthermore, SSRIs reportedly improve sleep disorder in postmenopausal women, suggesting that the serotonergic system is possibly involved in the circadian rhythm regulation by estrogen [5].…”

Section: Introductionmentioning

confidence: 98%

“…Estrogen plays an important role in the regulation of energy homeostasis in women [1]. The marked decrease in systemic estrogen levels after menopause often causes weight gain, obesity, or sleep disorder, which are serious public health concerns in modern society [2][3][4][5]. A large number of studies have demonstrated that estrogen reduces energy intake by affecting the activity of hypothalamic neurons that regulate food intake [1,6,7], however the mechanism has not been fully elucidated.…”

Section: Introductionmentioning

confidence: 99%

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Fluoxetine Mimics the Anorectic Action of Estrogen and Its Regulation of Circadian Feeding in Ovariectomized Female Rats

et al. 2020

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Our previous study demonstrated that chronic estrogen replacement in ovariectomized rats reduces food intake and augments c-Fos expression in the suprachiasmatic nucleus (SCN), specifically during the light phase. Here, we hypothesized that serotonergic neurons in the central nervous system (CNS), which have anorectic action and play a role in regulating circadian rhythm, mediate the light phase-specific anorectic action of estrogen, and that selective serotonin reuptake inhibitors (SSRIs) mimic the hypophagic action of estrogen. Female Wistar rats were ovariectomized and treated with estradiol (E2) or cholesterol by subcutaneously implanting a silicon capsule containing E2 or cholesterol. Then, half of the cholesterol-treated rats were injected with the SSRI fluoxetine (5 mg/kg) (FLX group), while the remaining rats in the cholesterol-treated group (CON group) and all those in the E2 group were injected with saline subcutaneously twice daily at the onsets of the light and dark phases. Both E2 and FLX reduced food intake during the light phase but not the dark phase, and reduced body weight gain. In addition, both E2 and FLX augmented the c-Fos expression in the SCN, specifically during the light phase. These data indicate that FLX exerts estrogen-like antiobesity and hypophagic actions by modifying circadian feeding patterns, and suggest that estrogen regulates circadian feeding rhythm via serotonergic neurons in the CNS.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Fluoxetine Mimics the Anorectic Action of Estrogen and Its Regulation of Circadian Feeding in Ovariectomized Female Rats

et al. 2020

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“…Isso porque atividades físicas regulares aumentam a densidade mineral óssea, o VO 2 máximo, a força muscular e o equilíbrio, repercutindo positivamente na composição corporal (CAPUTO;SEIDELEN et al, 2017). Quanto aos fatores clínicos, melhora o sistema imunológico, promove efeitos anti-inflamatórios (ZBINDEN-FONCEA et al, 2020), reduz o risco de resistência à insulina, diabetes tipo 2, síndrome metabólica e risco de doenças cardiovasculares (STERNFELD; DUGAN, 2011;COLBERG et al, 2016;BIRD;HAWLEY, 2017;SYLOW;RITCHER, 2019), além de reduzir os sintomas vasomotores (SILVESTRI et al, 2019) e sintomas psicológicos (SILVESTRI et al, 2019;SPÖRNDLY-NEES et al, 2017;MORARDPOUR et al, 2020), sintomas recorrentes nesse período (MOILANEN et al, 2012).…”

Section: Climatériounclassified

As Interfaces Produzidas Pela Ambiência Em Uma Unidade Básica De Saúde Em Cidade De Médio Porte No Interior De Minas Gerais

Neiva¹,

Delboni²,

Roque³

et al. 2021

A Medicina Imersa Em Um Mundo Globalizado Em Rápida Evolução 2

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Direitos para esta edição cedidos à Atena Editora pelos autores.Todo o conteúdo deste livro está licenciado sob uma Licença de Atribuição Creative Commons.Atribuição-Não-Comercial-NãoDerivativos 4.0 Internacional (CC BY-NC-ND 4.0). O conteúdo dos artigos e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores, inclusive não representam necessariamente a posição oficial da Atena Editora. Permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores, mas sem a possibilidade de alterá-la de nenhuma forma ou utilizá-la para fins comerciais. Todos os manuscritos foram previamente submetidos à avaliação cega pelos pares, membros do Conselho Editorial desta Editora, tendo sido aprovados para a publicação com base em critérios de neutralidade e imparcialidade acadêmica.A Atena Editora é comprometida em garantir a integridade editorial em todas as etapas do processo de publicação, evitando plágio, dados ou resultados fraudulentos e impedindo que interesses financeiros comprometam os padrões éticos da publicação. Situações suspeitas de má conduta científica serão investigadas sob o mais alto padrão de rigor acadêmico e ético.

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“…The Italian Association of Sleep Medicine (2019) carried out a systematic review of evidence informing a position statement on the management of postmenopausal sleep disorders. 25 This emphasises the co-occurrence of insomnia, vasomotor symptoms and depression. It states that overall hormone replacement therapy (HRT) improves vasomotor symptoms, insomnia and mood, and that postmenopausal insomnia is best managed with HRT and CBT-I.…”

Section: Introductionmentioning

confidence: 99%

“…The BAP advises antidepressants should be considered when there is a co-existent mood disorder. 25 However, the side effect profile of commonly used SSRIs can lead to counter-productive sleep disruption and sexual dysfunction. 42 Sedating drugs (trazodone or mirtazapine) have been shown to reduce insomnia in people with depression.…”

Section: Introductionmentioning

confidence: 99%

Management of sleep disorders in the menopausal transition

Schaedel¹,

Holloway

Bruce

et al. 2021

Post Reprod Health

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The menopausal transition is associated with increasing sleep disorders including sleep apnoea and restless leg syndrome. Insomnia is the most common and is recognised as a core symptom of the menopause. Guidelines to support decision making for women with sleep problems during the menopausal transition are lacking. Sleep problems are associated with negative impacts on healthcare utilisation, quality of life and work productivity. Sleep deprivation is a risk factor for cardiovascular disease, diabetes, obesity and neurobehavioral dysfunction. Declining oestrogen is implicated as a cause of menopausal sleep disruption. Vasomotor symptoms (VMS) and menopausal mood disturbance are also factors in the complex aetiology. VMS commonly precipitate insomnia and, due to their prolonged duration, they often perpetuate the condition. Insomnia in the general population is most effectively treated with cognitive behavioural therapy (CBT) (also effective in the menopausal transition.) The associations of menopausal sleep disturbance with VMS and depression mean that other treatment options must be considered. Existing guidelines outline effectiveness of hormone replacement therapy (HRT), CBT and antidepressants. HRT may indirectly help with sleep disturbance by treating VMS and also via beneficial effect on mood symptoms. The evidence base underpinning menopausal insomnia often references risks associated with HRT that are not in line with current international menopause guidelines. This may influence clinicians managing sleep disorders, leading to hesitation in offering HRT, despite evidence of effectiveness. Viewing sleep symptoms on an axis of menopausal symptoms – towards vasomotor symptoms or towards mood symptoms may help tailor treatment options towards the symptom profile.

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Italian Association of Sleep Medicine (AIMS) position statement and guideline on the treatment of menopausal sleep disorders

Cited by 21 publications

References 67 publications

Fluoxetine Mimics the Anorectic Action of Estrogen and Its Regulation of Circadian Feeding in Ovariectomized Female Rats

Fluoxetine Mimics the Anorectic Action of Estrogen and Its Regulation of Circadian Feeding in Ovariectomized Female Rats

As Interfaces Produzidas Pela Ambiência Em Uma Unidade Básica De Saúde Em Cidade De Médio Porte No Interior De Minas Gerais

Management of sleep disorders in the menopausal transition

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