Role of Ovarian Hormones in the Modulation of Sleep in Females Across the Adult Lifespan

Abstract

Ovarian hormones, including 17β-estradiol, are implicated in numerous physiological processes, including sleep. Beginning at puberty, girls report more sleep complaints than boys, which is maintained throughout the reproductive life stage. Sleep problems are exacerbated during the menopausal transition, evidenced by greater risk for sleep disorders. There is emerging evidence that menopause-associated hormone loss contributes to this elevated risk, but age is also an important factor. The extent to which menopause-associated sleep disturbance persists into postmenopause above and beyond the effects of age remains unknown. Untreated sleep disturbances have important implications for cognitive health, as they are emerging as risk factors for dementia. Given that sleep loss impairs memory, an important knowledge gap concerns the role played by menopause-associated hormone loss in exacerbating sleep disturbance and ultimately, cognitive function in aging women. In this review, we take a translational approach to illustrate the contribution of ovarian hormones in maintaining the sleep-wake cycle in younger and middle-aged females, with evidence implicating 17β-estradiol in supporting the memory-promoting effects of sleep. Sleep physiology is briefly reviewed before turning to behavioural and neural evidence from young females linking 17β-estradiol to sleep-wake cycle maintenance. Implications of menopause-associated 17β-estradiol loss is also reviewed before discussing how ovarian hormones may support the memory-promoting effects of sleep, and why menopause may exacerbate pathological aging via effects on sleep. While still in its infancy, this research area offers a new sex-based perspective on aging research, with a focus on a modifiable risk factor for pathological aging.

Age and gender differences in objective sleep properties using large-scale body acceleration data in a Japanese population

“…In addition to the contributions of biological aging, menopause-related insomnia, persisting in postmenopausal states, might partly account for the remarkable decline of sleep quality in females. There is some evidence 54 – 56 that menopausal and postmenopausal women frequently report sleep complaints, including nighttime awakening with difficulty falling back asleep, possibly linked with characteristic concomitant menopause symptoms (e.g., vasomotor symptoms such as hot flashes and night sweats, or mood swings) mediated by rapid changes in the ovarian hormonal milieu. This is apparently related with the higher prevalence of insomnia during menopause and postmenopause 56 – 58 .…”

Bidirectional relationship between sleep and sedentary behavior in adults with overweight or obesity: A secondary analysis

“…The associations between that day’s sedentary time and that night’s WASO and awakenings were only found in the analyses that included all the participants. Peri- and post-menopausal status are associated with a higher prevalence of sleep disorders, sleep fragmentation, and hot flashes resulting in a greater number of awakenings [ 29 ]. These changes may account for the different findings in the analyses conducted in the full versus female-specific sample.…”

Altered Spontaneous Brain Activity in Women During Menopause Transition and Its Association With Cognitive Function and Serum Estradiol Level

“…E2 is a form of estrogens which is implicated in numerous physiological processes ( 39 ). Studies have reported that E2 is implicated in cognitive function, mood regulation, learning, memory, etc.…”

“…Studies have reported that E2 is implicated in cognitive function, mood regulation, learning, memory, etc. ( 39 , 40 ). In addition, E2 plays a critical role in neurodegenerative diseases including Alzheimer’s disease, dementia and stroke ( 41 ).…”