The effect of menopause on objective sleep parameters: Data from an epidemiologic study in São Paulo, Brazil

Hachul, Helena; Frange, Cristina; Bezerra, Andréia Gomes; Hirotsu, Camila; Pires, Gabriel Natan; Andersen, Mônica Levy; Bittencourt, Lia; Tufik, Sérgio

doi:10.1016/j.maturitas.2014.11.002

Cited by 52 publications

(24 citation statements)

References 36 publications

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“…Peri/postmenopause is associated with increased prevalence of insomnia (characterized by difficulty falling and/or staying asleep), restless leg syndrome (characterized by uncontrollable leg movement), and sleep apnea (characterized by interrupted breathing) ( 50-56 ). While age itself is a risk factor for sleep apnea ( 57 ), higher apnea–hypopnea index (number of apneas or hypopneas/hour) and lower arterial oxygen saturation are observed in postmenopausal than in premenopausal women even after controlling for age ( 53 ), indicating that hormone loss also contributes. Daytime sleepiness, which is a symptom of sleep disorders, is also higher among postmenopausal women ( 58 ).…”

Section: Contributions Of Menopause-associated Hormone Changes To Slementioning

confidence: 99%

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

Brown

Gervais

2020

Endocrinology

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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.

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Section: Contributions Of Menopause-associated Hormone Changes To Slementioning

confidence: 99%

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

Brown

Gervais

2020

Endocrinology

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“…These differences have been attributed to sex differences in airway collapsibility, related to both differences in anatomy and respiratory chemosensitivity (11). An increase in OSA severity in women after menopause also suggests a role for sex hormones in influencing this disorder (12).…”

Section: Clinical Relevancementioning

confidence: 99%

Multiethnic Meta-Analysis Identifies RAI1 as a Possible Obstructive Sleep Apnea–related Quantitative Trait Locus in Men

Chen

Cade

Gleason

et al. 2018

Am J Respir Cell Mol Biol

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Obstructive sleep apnea (OSA) is a common heritable disorder displaying marked sexual dimorphism in disease prevalence and progression. Previous genetic association studies have identified a few genetic loci associated with OSA and related quantitative traits, but they have only focused on single ethnic groups, and a large proportion of the heritability remains unexplained. The apnea-hypopnea index (AHI) is a commonly used quantitative measure characterizing OSA severity. Because OSA differs by sex, and the pathophysiology of obstructive events differ in rapid eye movement (REM) and non-REM (NREM) sleep, we hypothesized that additional genetic association signals would be identified by analyzing the NREM/REM-specific AHI and by conducting sex-specific analyses in multiethnic samples. We performed genome-wide association tests for up to 19,733 participants of African, Asian, European, and Hispanic/Latino American ancestry in 7 studies. We identified rs12936587 on chromosome 17 as a possible quantitative trait locus for NREM AHI in men (N = 6,737; P = 1.7 × 10) but not in women (P = 0.77). The association with NREM AHI was replicated in a physiological research study (N = 67; P = 0.047). This locus overlapping the RAI1 gene and encompassing genes PEMT1, SREBF1, and RASD1 was previously reported to be associated with coronary artery disease, lipid metabolism, and implicated in Potocki-Lupski syndrome and Smith-Magenis syndrome, which are characterized by abnormal sleep phenotypes. We also identified gene-by-sex interactions in suggestive association regions, suggesting that genetic variants for AHI appear to vary by sex, consistent with the clinical observations of strong sexual dimorphism.

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“…In our study, sleep in young women was deeper and more consolidated than in other groups, but in the peri-and postmenopausal women it was quite similar. At least three large population-based studies have addressed the effects of midlife reproductive state on objective sleep quality (Hachul et al, 2010;Hachul et al, 2015;Young et al, 2003), showing that periand postmenopausal women have more SWS and less REM sleep than premenopausal women, even when adjusting for age. Sleep in postmenopausal HT users is less fragmented and less prone to external disturbance than sleep in non-users (Hachul et al, 2010;Moe et al, 2001;Young et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

First-Night Effect on Sleep in Different Female Reproductive States

Virtanen

Kalleinen

Urrila

et al. 2016

Behavioral Sleep Medicine

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The effect of menopause on objective sleep parameters: Data from an epidemiologic study in São Paulo, Brazil

Cited by 52 publications

References 36 publications

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

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

Multiethnic Meta-Analysis Identifies RAI1 as a Possible Obstructive Sleep Apnea–related Quantitative Trait Locus in Men

First-Night Effect on Sleep in Different Female Reproductive States

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