Disturbances In Women Research Articles

Evaluation of Sleep Disturbances in Women with Polycystic Ovary Syndrome

Evaluation of Sleep Disturbances in Women with Polycystic Ovary Syndrome

Association of Spexin Hormone Levels with Metabolic Disturbance in Women with Polycystic Ovarian Syndrome

Background: Polycystic ovarian syndrome is affecting around 5–15% of females. Spexin hormone, identified as neuropeptide Q, has been newly recognized by bioinformatics methods. Objective: To evaluate the relationship concerning levels of spexin hormone with metabolic disruption in women with polycystic ovarian syndrome. Patients and Methods: A case-control study carried out in the department of Obstetrics and Gynecology in Al-Imamain Al-Khademain medical city/Baghdad, Iraq, from Jan 1, 2022, to the end of Dec 31, 2022. The study sample comprises, 192 participants aged 18-45 years were joined and allocated into a case group (96 women with PCOS) and a control group (96 women without PCOS). Results: Mean value of spexin hormone was (2.7±0.3 ng/mL) in the PCOS group, while it was (3.5±0.7 ng/mL) in the control group; fasting blood sugar shows significant association with a negative, weak correlation with Spexin in patients (P-value= 0.005), Insulin shows significant association with inverse correlation with Spexin in patients (P-value= 0.04), Homeostasis model valuation of insulin resistance (HOMA-IR) shows significant association with inverse correlation with Spexin in patients (P-value= 0.003). Spexin had a significant inverse correlation with LH, SHBG, testosterone, FAI, and Dehydroepiandrosterone. Conclusion: Serum level of spexin hormone was meaningfully decreased in patients with PCOS than that in healthy women.

Transcutaneous Tibial Nerve Stimulation for Quality-of-Life Improvement and Sleep Deficiency in Women with Primary Dysmenorrhea: A Randomized Clinical Trial.

Background: Primary dysmenorrhea is a leading cause of chronic cyclic pelvic pain, contributing to a reduced quality of life and sleep disturbances in women. The objective of this study was to assess the effectiveness of transcutaneous tibial nerve stimulation (TTNS) in improving the quality of life, sleep, and overall health perceptions of participants compared to a control group of women with dysmenorrhea over short-term, medium-term, and long-term periods. Methods: A single-blind, controlled clinical trial was conducted, with participants randomly assigned to an experimental group (receiving TTNS) or a control group (receiving sham TTNS). Both groups underwent 12, weekly 30 min sessions using the NeuroTrac™ PelviTone electrostimulation device. Outcomes related to quality of life, sleep deficiency, and overall improvement were evaluated at three time points: short-term (post-treatment), medium-term (1-3 months), and long-term (6 months). Results: Of the 61 participants initially randomized (31 in the experimental group and 30 in the control group), 55 completed the study and were included in the final analysis. A statistically significant improvement was observed in the experimental group in both physical and mental health components, as measured by the SF-36v2® questionnaire, following 12 weeks of intervention, compared to the control group, persisting 6 months after the intervention. Additionally, statistically significant differences in overall improvement were noted between the two groups, as measured by the PGIC questionnaire at the end of treatment (p = 0.0103) and 6 months post-treatment (p = 0.0432). Conclusions: TTNS appears to be a safe and effective strategy for enhancing quality of life and overall health in women with PD, potentially reducing the reliance on pharmacological treatments or more invasive methods.

Estradiol and progesterone from pregnancy to postpartum: a longitudinal latent class analysis.

During the peripartum, women undergo significant hormonal changes that are crucial for fetal development and a healthy pregnancy and postpartum period for mother and infant. Although several studies have determined healthy norm ranges of estradiol and progesterone, there are discrepancies among the reports, rendering it unclear which hormone levels are linked to adverse health outcomes. To account for the impact of sex steroid patterns on health outcomes in mothers and children, a longitudinal assessment of different parameters is needed. We longitudinally assessed a cohort of 130 women over five months during pregnancy and postpartum. The women provided saliva samples and completed psychosocial questionnaires. Hormone analyses were conducted using enzyme-linked immunosorbent assay (ELISA). Different parameters of estradiol and progesterone were analyzed and evaluated in relation to psychometric variables. To examine the presence of heterogenous hormonal trajectories in the peripartum, we applied group-based trajectory modelling as a special case of latent-class group analysis. Estradiol and progesterone levels rose towards the end of pregnancy and dropped sharply after birth, with considerable individual variation, particularly during pregnancy. However, their ratio remained stable. We identified three estradiol trajectory subgroups and two progesterone subgroups. Age influenced progesterone levels, with older pregnant women having higher levels than younger women. Anxiety and depressive symptoms had a predictive value for trajectories of specific subgroups of women. The study also revealed two distinct subgroups regarding the course of estradiol and progesterone fluctuations as well as their ratio. This study provides insights into the course and fluctuation of salivary estradiol and progesterone levels among healthy women during the peripartum period, highlighting significant variations in hormone levels but stability in their ratio during this time. The finding of distinct sex steroid courses in the peripartum is new and suggests the need for further research to explore their impact on health outcomes. Our preliminary results suggest that hormonal fluctuations at the end of pregnancy appear to be a normal occurrence and might even be a protective factor for associated psychological symptoms and sleep disturbances in women.

Micronutrient homeostasis disturbances in women with gestational diabetes mellitus and subclinical hypothyroidism: effects on pregnancy and outcomes

Aim. To characterize micronutrient homeostasis in women with a combination of gestational diabetes mellitus (GDM) and subclinical hypothyroidism (SCH), and to determine the significance of micronutrient imbalance in complicated pregnancies.Material and Methods. The study analyzed 439 birth histories of patients with GDM and SCH, who underwent plasma micronutrient analysis at 12−13 weeks of gestation. The study examined the patients' anthropometric and medical history data, complications during the current pregnancy, the timing and method of delivery, and newborn conditions. Some of these indicators were compared with previously obtained plasma micronutrient levels (Al, Co, Cu, Fe and others) measured at 12−13 weeks of gestation.Results. The analysis of micronutrient concentrations in plasma at 12−13 weeks of gestation revealed iron deficiency in 250 patients (57%), iodine deficiency in 231 patients (52.6%), cobalt deficiency in 229 patients (52.2%), vitamin B12 deficiency in 285 patients (64.9%), and vitamin D deficiency in 280 patients (63.6%). Iron deficiency was significantly more common in pregnant women with overweight and obesity than in those with normal body weight (χ2 =.14 and 5.32, respectively). The risk of developing iron deficiency also increased with higher body weight (1.81-fold for overweight (95% CI 1.2–2.73) and 2.07-fold for obesity (95% CI 1.11–3.86). Around 50% of patients with threatened preterm birth had cobalt deficiency and 59% of patients with anemia had iron deficiency. Selenium, calcium, and vitamin B12 deficiencies were observed in 55%, 70%, and 73% of patients with preeclampsia (PE), respectively.Conclusion. The observed deficiency of certain micronutrients in specific pregnancy complications suggests that correcting micronutrient levels during pre-conception or early gestation may improve pregnancy outcomes.

Sleep Disorders in Women: What Should a Gynecologist Know?

Women often face sleep disturbances during key life stages such as adolescence, pregnancy, postpartum period, and perimenopause, influenced by hormonal fluctuations and conditions like polycystic ovary syndrome (PCOS) and premenstrual syndrome (PMS). The goal is to explore women's sleep disorders as classified in the International Classification of Sleep Disorders-3 (ICSD-3). Through a literature review, this study assesses the management of sleep disorders in women, particularly focusing on the link between gynecological disease and sleep disorders. It scrutinizes landmark research in diagnosing and treating women's sleep disorders. Observations indicate that physiological changes during adolescence, pregnancy, postpartum, and perimenopause can cause sleep issues, commonly addressed by gynecologists. Conditions like PCOS and PMS are notably linked to increased sleep disorder occurrences. The conclusion underscores the importance of gynecologists' awareness of the heightened risk of sleep disturbances in women, who often present these issues during consultations.

The effect of an odd-one-out visual search task on attentional bias, body size adaptation, and body dissatisfaction.

Body image disturbance is a both a risk factor for, and a symptom of, many eating disorders and refers to the misperception of and dissatisfaction with one's own body. Women with high body dissatisfaction have been shown to direct more attention to low body mass index (BMI) bodies, which results in the overestimation of body size via body size adaptation. Therefore, attention may have a causal role in body image disturbance. We conducted a novel training visual search task with 142 young adult women who we trained to attend to either high or low BMI bodies. We assessed the effects of this training on attention to bodies of different sizes, body size adaptation, and body dissatisfaction. Women trained to attend to low BMI bodies decreased their perceptions of a 'normal' body size via adaptation from pre- to post-training (p < 0.001); however, women trained to attend to high BMI bodies showed no change in their perception of a 'normal' body size. We found no lasting effects of the training on attention to body size or body dissatisfaction; however, our visual search task showed poor internal consistency as a measure of attention. These findings indicate that attention to low BMI bodies may exacerbate body image disturbance in women. However, more reliable measures of attentional are required to confirm this finding.

The Impact of Hegu Point (LI4) Acupressure Therapy and Warm Compress on Menstrual Pain (Dysmenorrhea) in Middle School Students

Introduction: Menstruation often leads to disturbances in women, with menstrual pain, or dysmenorrhea, being a common issue that affects daily activities. Non-pharmacological therapies like acupressure and warm compresses are considered safe and effective in managing dysmenorrhea. This study examines the effect of Hegu Point (LI4) acupressure therapy combined with warm compresses on menstrual pain in students at SMP Wisata Denpasar. Methods: This quantitative study employed a pre-experimental, one-group pre-test, and post-test design. The sample size was 52 students, selected through purposive sampling. The intervention involved applying a warm compress and acupressure at the Hegu point (LI4). Pain levels were measured using an observation sheet for pain scales, and the data were analyzed using the Wilcoxon rank test. Results: After the intervention, menstrual pain significantly decreased. Before the intervention, 57.7% of the students experienced moderate pain. After the intervention, 53.8% reported mild pain. The Wilcoxon test yielded a p-value of 0.000, indicating a significant effect. Conclusion: In students, Hegu Point (LI4) acupressure therapy combined with a warm compress significantly reduces menstrual pain. Healthcare providers should educate students about these non-pharmacological therapies for managing dysmenorrhea.

Telehealth cognitive behaviour therapy for the management of sleep disturbance in women with early breast cancer receiving chemotherapy: a feasibility study

PurposeSleep quality commonly deteriorates in people receiving chemotherapy for breast cancer (BC). We aimed to determine feasibility and acceptability of telehealth-delivered cognitive behaviour therapy for insomnia (CBT-I) in people with early BC receiving (neo)adjuvant chemotherapy.MethodsMulti-centre, single arm, phase 2 feasibility trial. People with stage I-III BC received 4 sessions of telehealth CBT-I over 8 weeks, during chemotherapy. Participants completed Pittsburgh Sleep Quality Index (PSQI) and other Patient Reported Outcome Measures (PROMs) at baseline, post-program (week 9) and post-chemotherapy (week 24); and an Acceptability Questionnaire at week 9. Primary endpoint was proportion completing 4 sessions of telehealth CBT-I.ResultsIn total, 41 participants were recruited: mean age 51 years (range 31–73). All 4 CBT-I sessions were completed by 35 (85%) participants. Acceptability of the program was high and 71% reported ‘the program was useful’. There was no significant difference in the number of poor sleepers (PSQI score ≥ 5) at baseline 29/40 (73%) and week 24 17/25 (68%); or in the mean PSQI score at baseline (7.43, SD 4.06) and week 24 (7.48, SD 4.41). From baseline to week 24, 7/25 (28%) participants had a ≥ 3 point improvement in sleep quality on PSQI, and 5/25 (20%) had a ≥ 3 point deterioration. There was no significant difference in mean PROM scores.ConclusionIt is feasible to deliver telehealth CBT-I to people with early BC receiving chemotherapy. Contrary to literature predictions, sleep quality did not deteriorate. Telehealth CBT-I has a potential role in preventing and managing sleep disturbance during chemotherapy.Australian New Zealand Clinical Trials Registry (ANZCTR) registration number: ACTRN12620001379909 and date 22/12/2020.

Objective and subjective sleep patterns and biomarkers of stress among women with a history of sexual abuse in childhood.

Childhood sexual abuse (CSA) is associated with posttraumatic stress symptoms (PTSSs) and sleep disturbance into adulthood. The latter is thought to emerge from dysregulation in biobehavioral systems, including nighttime hyperarousal; however, studies investigating specific mechanisms to explain these long-term sleep problems are limited. The present study examined presleep arousal, fear of sleep, and the cortisol awakening response (CAR) as putative mediators between PTSS and sleep disturbance in women with a history of CSA. N = 64 cis-gendered women with a self-reported history of CSA completed a baseline diagnostic interview, self-reported mental health and sleep measures, 7 days of actigraphy monitoring with concurrent sleep diary, and 2 days of saliva sampling. PTSSs were not significantly associated with actigraphy-estimated sleep variables but were positively associated with self-reported sleep onset latency (SOL) and negatively associated with self-reported sleep quality. Similarly, PTSSs were not significantly associated with CAR but were associated with higher presleep arousal and fear of sleep ratings. Mediational models identified greater presleep cognitive arousal to partially explain the PTSS-SOL relationship. Specific features of CSA (i.e., age at time of abuse, location of abuse, relationship to the perpetrator) did not moderate this association. Findings suggest that targeting maladaptive cognitions (e.g., worries, rumination) that occur during the presleep period may be a potential intervention target in mitigating sleep disturbance and PTSSs in this population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Attachment disturbance in women with depressive spectrum disorder, its connection with hostility

IntroductionThe results of the study of psychological factors of hostility in depression are presented. The topicality of the study is due to hostility considered, on the one hand, as a property of depression, and on the other hand, as a risk factor, associated with the likelihood of auto-aggressive behavior.ObjectivesThe aim of the study was to analyze the relationship between hostility and attachment disorders in endogenous depression.MethodsThe study involved 49 patients with depressive disorder (mean age 19,8±4,5). All patients were assessed using the Hamilton Depression Rating Scale (HDRS-17 mean 21,03±6,02). All completed the following methods: Revised Experiences in Close Relationships (ECR-R); Symptom Check List-90-Revised (SCL-90R); Aggression Questionnaire by Buss and Perry (BPAQ); I-structural test by G. Ammon (ISTA). According to the “depression” parameter of the SCL-90R, the group was divided into subgroups with high and medium severity of depression. Analysis of variance (ANOVA) or Mann-Whitney test were. Correlation analysis (Spearman) and stepwise multiple regression analysis were also used.ResultsAt high levels of depression, the indicators of “hostility”, “destructive” and “deficit aggression” are statistically significantly higher. The severity of depression significantly correlates with the severity of “anxiety” in attachment (close relationships), as well as with pathological “narcissism”, “destructive external self-delimitation”, “deficient internal self-delimitation”.For the measure of depression, regression analysis showed that the regression model explained more than 76% of the variance, with the measures of “interpersonal sensitivity”, “deficit narcissism”, and “avoidance” in attachment making significant contributions. For the “hostility” the regression model explains about 62% of the variance, while a significant contribution is made, as in the analysis of “depression”, by the indicators of “interpersonal sensitivity” and “avoidance”, however, unlike “depression”, the contribution of the “destructive narcissism” is noted in contrast to the “deficit narcissism”.ConclusionsWith severe depressive symptoms, indicators of hostility are increased. Hostility in depression is associated with factors caused by a violation of early interpersonal relationships (anxious attachment), which causes increased sensitivity in relations with others, “building a barrier” between oneself and the external environment perceived as hostile in the narcissistic pathology, problems in emotional regulation. One of the targets of psychotherapeutic work may be the ambivalence between desire for symbiotic dependence and the experienced hostility.Disclosure of InterestNone Declared

Effect of dexmedetomidine infusion on postoperative sleep disturbances in women with breast cancer: A monocentric randomized-controlled double-blind trial

BackgroundMost women with breast cancer are prone to postoperative sleep disturbances (POSD). Little is known about the differences between sevoflurane and propofol combined with dexmedetomidine on POSD in the same context. We investigated the effect of intra-operative sevoflurane or propofol combined with intravenous dexmedetomidine on the incidence of POSD and postoperative sleep structures. MethodsA monocentric, randomized-controlled, double-blind trial. Female patients undergoing radical surgery for breast cancer were randomly assigned to receive sevoflurane and placebo, sevoflurane and dexmedetomidine, propofol and placebo, or propofol and dexmedetomidine. Dexmedetomidine was administered at 1.0 μg kg−1 infusion 15 min before induction, then infused at 0.4 μg kg−1 h−1 until the surgical drain started to be placed. The primary outcome was the incidence of POSD within the postoperative first three days (defined as an Athens Insomnia Scale score ≥ 6 points on at least one day of postoperative first three days). The secondary outcome was the duration of sleep structures, collected from the Fitbit Charge 2® smart bracelet (Fitbit, Inc., San Francisco, CA, USA). ResultsThere were 188 women analyzed with the modified intention-to-treat method. The incidences of POSD in the dexmedetomidine and placebo groups were similar (p = 0.649). In the sevoflurane sedation strategy, dexmedetomidine decreased nocturnal wakefulness on postoperative first day (p = 0.001). In the propofol sedation strategy, dexmedetomidine increased nocturnal deep sleep on postoperative first (p < 0.001) and third (p < 0.001) days. ConclusionIntra-operative infusion of dexmedetomidine had no significant effect on POSD but decreased nocturnal wakefulness in the sevoflurane group and increased nocturnal deep sleep in the propofol group. Trial registrationRegistered at www.chictr.org.cn (ChiCTR2300070136).

Maldistribution of fluid in preeclampsia: a secondary kinetic analysis

BackgroundHypovolemia and peripheral edema are frequent components of preeclampsia. The level of the dysregulation of the body fluid distribution is unclear, which complicates the choice of infusion fluid during surgery. The present fluid kinetic study challenges whether the maldistribution of fluid is due to increased capillary leakage or to poor return of already distributed fluid, which occurs via lymphatic pathways. MethodsRingeŕs solution was infused in 10 awake non-pregnant women, eight healthy pregnant women, and in eight women with mild-to-moderately severe preeclampsia. Distribution and redistribution of the infused fluid was calculated with mixed models kinetics based on the excreted urine volumes and 675 measurements of hemodilution. Differences in fluid kinetics between the three groups were studied with covariance analysis. ResultsThe return flow of fluid volume to the plasma after distribution (rate parameter k21) was almost zero in women with preeclampsia, while the rate was normal in the other two groups (P< 0.001). By contrast, the capillary leakage rate of fluid in response to the infusion (k12) was normal. The urinary excretion (k10) was moderately accelerated. ConclusionDecreased flow of extravascular fluid to the plasma was the key disturbance in women with preeclampsia. Such decreased flow alone promotes hypovolemia, peripheral edema, and hypoalbuminemia, and may be explained by inhibition of lymphatic pumping and/or a decreased interstitial hydrostatic pressure due to the presence of vasoactive and inflammatory signal molecules. The moderately accelerated urine flow may be due to “pressure diuresis” in response to hypertension.

The effects of light therapy on depression and sleep in women during pregnancy or the postpartum period: A systematic review and meta-analysis.

In recent years, light therapy has been tried for the treatment of depression and sleep in pregnancy or postnatal period women, but the results have been inconclusive. This meta-analysis is the first to systematically review the effects of light therapy on depression and sleep disturbances in women during pregnancy and the postnatal period. We searched for randomized controlled studies in PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, and Chinese Biomedical Database up to January 2023. The standardized mean difference (SMD) was used to assess the efficacy of the outcome indicators. Eight studies were eventually included in the analysis. The results showed that light therapy was more effective than the placebo group in terms of depression (SMD=.34, CI=.08-.61) and sleep (SMD=.64,95%CI=.28-1.00). Subgroup analysis could not explain the significant heterogeneity. There were no serious adverse effects in either the light therapy or placebo groups. Light therapy could be considered an effective treatment for depression and sleep disturbances in women during pregnancy and the postnatal period. However, future high-quality trials with larger sample sizes are still needed.

Psychometric evaluation of the PROMIS SD-SF-8b instrument in individuals experiencing vasomotor symptoms due to menopause

BackgroundWomen with vasomotor symptoms (VMS) due to menopause frequently experience poor sleep quality. The Patient-Reported Outcomes Measurement Information System Sleep Disturbance – Short Form 8b (PROMIS SD-SF-8b) has been developed to assess sleep disturbance. The study objective was to use data from the fezolinetant SKYLIGHT 1 and 2 studies in individuals with VMS to assess the psychometric properties of the PROMIS SD-SF-8b.MethodsIndividuals (aged ≥ 40–≤65 years) with moderate-to-severe VMS (≥ 7 hot flashes/day) were enrolled. Besides PROMIS SD-SF-8b, eight other patient-reported outcome (PRO) measures were used for the psychometric evaluation. All the PRO assessments were completed at weeks 4 and 12 during the treatment period and most were completed at baseline. Psychometric analyses included factor analysis and reliability, construct validity, and sensitivity to change assessments. The within-patient threshold for a clinically meaningful change in sleep disturbance was derived.ResultsOverall, 1022 individuals were included from the SKYLIGHT 1 and 2 studies. Mean PROMIS SD-SF-8b total score at baseline was 26.80, which decreased to 22.68 at week 12, reflecting improved sleep disturbance. The confirmatory factor analysis supported the proposed PROMIS SD-SF-8b domain structure. Internal consistency was excellent, with Cronbach’s alpha values of 0.915 and 0.935 and a McDonald’s omega of 0.917. Item-to-item and item-total correlations were sufficient and moderate test-retest reliability was noted. The construct validity assessments showed that moderate Spearman rank correlations (r: 0.608 to 0.651) were observed between PROMIS SD-SF-8b total scores and measures of sleep disturbance and sleep-related impairment, and that significant differences were noted in the total scores across PRO categories. The responsiveness of PROMIS SD-SF-8b total scores was supported by the results from the correlations in change scores and comparisons of mean change scores by PRO categories. Statistically significant differences in mean scores were observed between responder and non-responder PRO groups. A PROMIS SD-SF-8b total score of 8 points was identified as the within-patient threshold to use to confirm a meaningful change in sleep disturbance.ConclusionsThe psychometric properties of the PROMIS SD-SF-8b support its use to measure sleep disturbance in women with VMS due to menopause.Trial registrationClinicalTrials.gov numbers: NCT04003155 and NCT04003142.

Motivational processes contributing to disturbances in women's body image and eating

Reinforcement Sensitivity Theory (RST) provides a neurobiological personality framework for understanding approach and avoidance behavioural patterns. Recent research suggests an association between RST personality traits (reward interest and behavioural inhibition system [BIS]) and women's body image and eating behaviours. The current study aimed to extend this research by testing for indirect relationships between reward interest and BIS and eating disorder symptoms, as mediated through thin ideal internalisation. Adult female participants (N = 354, M = 22.06 years of age, SD = 6.78) completed self-report measures of reward interest, BIS, thin ideal internalisation, and eating disorder symptoms (i.e., restraint, eating concerns, weight and shape concerns). Indirect relationships were tested using bootstrapped mediation analyses. Results showed thin ideal internalisation mediated the pathways between the BIS and restraint, eating concern, and weight and shape concerns. Reward interest was not associated with thin ideal internalisation, or with eating disorder symptoms. Although the application of RST to women's body image is an emerging research area, these novel findings suggest BIS trait sensitivity may increase women's risk of body image concerns and restricted eating, via increased levels of thin ideal internalisation. Overall, these findings provide preliminary support for inclusion of individual differences in BIS sensitivity in risk factor models of body image and eating disturbances. Future research should aim to replicate these findings in more diverse samples, using longitudinal designs.

Genetic Doping in Sports: A Biological and Legal Examination!

Doping is commonly perceived as a moral and ethical violation. This matter is of global significance. Doping is the illicit use of certain substances and methods to enhance sports performance and stamina. This is accomplished by consuming these medications, which enhance the body's ability to supply a larger quantity of oxygenation to the muscles. However, the ingestion of these chemicals has a multitude of detrimental effects on an individual's well-being, encompassing but not restricted to infections, allergies, cardiovascular diseases, ischemic stroke, pulmonary embolism, hypertension, acne, male erectile dysfunction, and disturbances in women's menstrual cycles. Therefore, doping can directly impact sporting events. The ongoing development of novel drug delivery techniques presents a formidable obstacle to the battle against doping, rendering it progressively arduous for experts to detect these chemicals and medications. The government must remain updated on the latest advancements in chemicals and pharmaceuticals, and implement steps to regulate their usage to ensure fair competition. This article aims to comprehensively examine the practices of gene doping in athletics, with a specific emphasis on their biological and legal examination.

Menopause and sleep disturbances

The menopause in a woman’s life is one of the most significant events indicating the large-scale changes in the hypothalamus-pituitary-ovarian axis function. Gonadal steroid hormones are actively involved in the central nervous system (CNS) growth, differentiation, physiology and ageing processes. Sleep provides restoration of the central nervous system, and also contributes to memory consolidation. Sleep influences the two primary effector systems, the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS), which in turn regulate adaptive and innate immune responses. During sleep, blood levels of cortisol, adrenaline and norepinephrine drop, whereas the levels of neurotransmitters such as growth hormone, prolactin and melatonin show a steep increase. We get more and more facts showing the role of sleep in the processes of immunogenesis and metabolism, in particular fat metabolism. A systematic modern literature analysis on the prevalence and structure of sleep disturbances in women during pre-, peri- and postmenopause was carried out. The results of individual studies revealing the relationship between sleep disturbances and hormone levels including levels of sex steroids are presented. A review of current scientific evidence shows conclusively that the neuroendocrine system significantly determines the sleep quality. Sleep disturbances associated with RLS, COAC are highly prevalent, especially among postmenopausal women, due to declining ovarian function and deficiency of sex steroids. The results of conducted studies support the continued study and analysis of the relationships between gender, neuroendocrine factors, sleep disorders and the search for effective methods for their treatment. SonNorm Duo containing melatonin, peppermint leaf oil, and motherwort herb extract is one of the drugs used to manage sleep disturbances. SonNorm Duo is an adaptogenic sedative drug that is indicated for sleep disturbances, circadian rhythm sleep-wake disorders associated with rapid travel across multiple time zones.

Overnight Melatonin Concentration and Sleep Quality Are Associated with the Clinical Features of Polycystic Ovary Syndrome.

Circulating melatonin is elevated in women with polycystic ovary syndrome (PCOS); whether circadian disruptions coincide with sleep disturbances in women with PCOS or their symptom severity is unclear. The objective of this observational pilot study was to determine whether altered patterns of melatonin excretion are associated with reduced sleep quality in women with versus without PCOS. Participants underwent a clinical assessment, transvaginal ultrasound, and reproductive hormone testing. Morning and evening urine samples were assayed for urinary 6-sulfatoxymelatonin (MEL) as a proxy for melatonin production. The night (morning MEL)-to-day (evening MEL) ratio, or N:D ratio, was determined to approximate the rhythm of MEL production. Sleep quality and duration were assessed using the Pittsburgh Sleep Quality Index (PSQI) and wrist actigraphy. No differences were detected in overnight MEL, daytime MEL, or the N:D ratio in participants with PCOS versus controls. The PCOS group experienced reduced weekend sleep efficiency vs. controls (81% vs. 88% p < 0.05). The number of follicles per ovary (FNPO) was positively associated with overnight MEL (r = 0.359, p < 0.05). Weekend sleep time and overnight MEL concentrations were dependent on PCOS status. Therefore, diagnostic features of PCOS were associated with MEL production and sleep disturbances, suggesting that women with a more severe clinical presentation of PCOS may be more likely to experience altered MEL production or sleep disturbances.

Sleep disturbances in women with early-onset menopausal transition: a population-based study.

The aim of this study was to investigate sleep disturbances in 46-yr-old women and their association with early-onset menopausal transition. The women of this cross-sectional birth cohort study were divided into climacteric (n = 359) and preclimacteric (n = 2,302) groups by their menopausal status, defined by follicle-stimulating hormone levels and menstrual history. Sleep disturbances were evaluated with Athens Insomnia Scale 5. We performed univariable and multivariable logistic regression models in which sleep parameters were dependent variables and climacteric status, hot flashes, smoking, and education level were independent variables. The use of hormone therapy was also evaluated in women suffering from sleeping disturbances. On the basis of the scale questions, climacteric women experienced significantly delayed sleep induction (12.2% vs 8.7%, P = 0.047), more problems with awakenings during the night (23.4% vs 14.6%, P < 0.001), earlier final awakening (13.8% vs 9.9%, P = 0.039), and more unsatisfying sleep quality (11.9% vs 7.9%, P = 0.023). Climacteric women who were experiencing hot flashes reported unsatisfactory sleep quality more frequently compared with climacteric women who did not experience hot flashes (17.0% vs 9.2%, P = 0.047). In the univariable and multivariable logistic regression models, being climacteric was independently associated with different impaired sleeping parameters. Most climacteric women who had a scale score of 4 or greater were not using hormone therapy, according to their medicine purchases over the past year. Being climacteric was associated with sleep disturbances in women in their mid-40s. However, this association seemed to be particularly driven by hot flashes. Most climacteric women with clinically significant sleeping disturbances were not using hormone therapy.