Sleep after intranasal progesterone vs. zolpidem and placebo in postmenopausal women – A randomized, double-blind cross over study

Schüssler, P.; Kluge, Michael; Adamczyk, Marek; Beitinger, M; Beitinger, P. A.; Bleifuss, Annabell; Cordeiro, Susana Arruda; Mattern, Claudia; Uhr, M.; Wetter, Thomas C.; Yassouridis, Alexander; Rupprecht, Rainer; Frieß, Elisabeth; Steiger, Axel

doi:10.1016/j.psyneuen.2018.04.001

Cited by 23 publications

(12 citation statements)

References 22 publications

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“…These alterations were considerably reduced on progesterone (with the notable exception of REM sleep), suggesting that progesterone may restore normal sleep when sleep is disturbed by environmental conditions, but may have limited or no effect on undisturbed sleep. Indeed, in investigations referred above, [3][4][5] the magnitude of mean WASO responses to progesterone administration appears to be related to corresponding mean WASO levels on placebo, as illustrated in the upper panel of Figure 1: the highest the WASO duration on placebo, the highest the progesterone effect. Moreover, mean WASO levels on progesterone never fell below the levels recorded in the 'undisturbed' arm (no catheter) of our study.…”

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confidence: 83%

“…Moreover, mean WASO levels on progesterone never fell below the levels recorded in the 'undisturbed' arm (no catheter) of our study. 5 These fi ndings suggest that in some of these experiments, 3,4 sleep on placebo was slightly disturbed, presumably because selection procedure and sleep-wake schedule requirements during the days preceding the admission to the sleep laboratory were not stringent enough.…”

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confidence: 94%

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Progesterone and estradiol may be active components of the sleep‐wake regulatory mechanisms: An evidence‐based hypothesis

Copinschi

Caufriez

2021

Clinical Endocrinology

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While multiple effects of progesterone in the brain are well documented, 1 very few randomized placebo-controlled studies have investigated its effects on sleep architecture. In healthy young men 2 and in healthy postmenopausal women, 3 acute administration of a single dose of progesterone resulted in a signifi cant increase in the duration of light non-REM (rapid eye movement) sleep and a decrease in wake after sleep onset (WASO) duration. In a third study, daily evening oral administration of 300 mg of micronized progesterone for three weeks was associated with a decrease in WASO duration, without any other signifi cant effect on overnight sleep architecture. 4

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confidence: 83%

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confidence: 94%

Progesterone and estradiol may be active components of the sleep‐wake regulatory mechanisms: An evidence‐based hypothesis

Copinschi

Caufriez

2021

Clinical Endocrinology

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“…In women with PCOS, low levels of progesterone are associated with increased sleep-disordered breathing [ 67 ], whereas high levels of progesterone are associated with lower rates of obstructive sleep apnea (OSA) and obesity-related hypoventilation [ 65 ]. Moreover, the loss of progesterone during menopause is linked to sleep complaints [ 64 ]; and administration of intranasal progesterone in postmenopausal women has sleep promoting effects [ 68 ].…”

Section: Methodsmentioning

confidence: 99%

Impact of sleep patterns upon female neuroendocrinology and reproductive outcomes: a comprehensive review

Beroukhim

Esencan

Seifer

2022

Reprod Biol Endocrinol

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Sleep is vital to human bodily function. Growing evidence indicates that sleep deprivation, disruption, dysrhythmia, and disorders are associated with impaired reproductive function and poor clinical outcomes in women. These associations are largely mediated by molecular-genetic and hormonal pathways, which are crucial for the complex and time sensitive processes of hormone synthesis/secretion, folliculogenesis, ovulation, fertilization, implantation, and menstruation. Pathologic sleep patterns are closely linked to menstrual irregularity, polycystic ovarian syndrome, premature ovarian insufficiency, sub/infertility, and early pregnancy loss. Measures of success with assisted reproductive technology are also lower among women who engage in shift work, or experience sleep disruption or short sleep duration. Extremes of sleep duration, poor sleep quality, sleep disordered breathing, and shift work are also associated with several harmful conditions in pregnancy, including gestational diabetes and hypertensive disorders. While accumulating evidence implicates pathologic sleep patterns in impaired reproductive function and poor reproductive outcomes, additional research is needed to determine causality and propose therapeutic interventions.

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“…Accordingly, the hypnotic properties of progesterone are dampened by 5α‐reductase inhibitors, which block the conversion of progesterone to AP . However, it is worth noting that, at least in postmenopausal women, some of the sleep‐inducing effects of intranasal progesterone may not reflect GABA A receptor activation …”

Section: Neurosteroids Are Involved In the Neurobehavioural Effects Omentioning

confidence: 99%

Neurobehavioural complications of sleep deprivation: Shedding light on the emerging role of neuroactive steroids

Frau

Traccis

Bortolato

2019

J Neuroendocrinology

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Sleep deprivation (SD) is associated with a broad spectrum of cognitive and behavioural complications, including emotional lability and enhanced stress reactivity, as well as deficits in executive functions, decision making and impulse control. These impairments, which have profound negative consequences on the health and productivity of many individuals, reflect alterations of the prefrontal cortex (PFC) and its connectivity with subcortical regions. However, the molecular underpinnings of these alterations remain elusive. Our group and others have begun examining how the neurobehavioural outcomes of SD may be influenced by neuroactive steroids, a family of molecules deeply implicated in sleep regulation and the stress response. These studies have revealed that, similar to other stressors, acute SD leads to increased synthesis of the neurosteroid allopregnanolone in the PFC. Whereas this up‐regulation is likely aimed at counterbalancing the detrimental impact of oxidative stress induced by SD, the increase in prefrontal allopregnanolone levels contributes to deficits in sensorimotor gating and impulse control, signalling a functional impairment of PFC. This scenario suggests that the synthesis of neuroactive steroids during acute SD may be enacted as a neuroprotective response in the PFC; however, such compensation may in turn set off neurobehavioural complications by interfering with the corticolimbic connections responsible for executive functions and emotional regulation.

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Sleep after intranasal progesterone vs. zolpidem and placebo in postmenopausal women – A randomized, double-blind cross over study

Cited by 23 publications

References 22 publications

Progesterone and estradiol may be active components of the sleep‐wake regulatory mechanisms: An evidence‐based hypothesis

Progesterone and estradiol may be active components of the sleep‐wake regulatory mechanisms: An evidence‐based hypothesis

Impact of sleep patterns upon female neuroendocrinology and reproductive outcomes: a comprehensive review

Neurobehavioural complications of sleep deprivation: Shedding light on the emerging role of neuroactive steroids

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Sleep after intranasal progesterone vs. zolpidem and placebo in postmenopausal women – A randomized, double-blind cross over study

Cited by 23 publications

References 22 publications

Progesterone and estradiol may be active components of the sleep‐wake regulatory mechanisms: An evidence‐based hypothesis

Progesterone and estradiol may be active components of the sleep‐wake regulatory mechanisms: An evidence‐based hypothesis

Impact of sleep patterns upon female neuroendocrinology and reproductive outcomes: a comprehensive review

Neurobehavioural complications of sleep deprivation: Shedding light on the emerging role of neuroactive steroids

Contact Info

Product

Resources

About

Impact of sleep patterns upon female neuroendocrinology and reproductive outcomes: a comprehensive review