Kalpakjian C Z, Quint E H, Toussaint L L
Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor 48109-0491, USA.
Climacteric. 2007 Feb;10(1):51-62. doi: 10.1080/13697130601156645.
Sleep disturbance in polio survivors is a common complaint, yet little is known about the effects of the interaction of physical disability and menopause on sleep. The purpose of this study was to understand the relative contribution of menopause factors and disability to subjective sleep disturbance.
Participants were 465 women aged 50-65 years who had physical disabilities due to poliomyelitis. Hierarchical regression modeling was used to examine menopause (symptoms, status, hormone replacement use, ovarectomy status) and disability factors (post-polio symptoms) in sleep disturbance.
In the final model, 19% (frequency) and 17% (severity) of sleep disturbance variance was explained. Psychological symptoms exerted the most influence (for both outcomes) followed by post-polio symptoms, vasomotor symptoms, an interaction of vasomotor and post-polio symptoms and estrogen use. For women with fewer post-polio symptoms, vasomotor symptoms exerted greater influence on sleep disturbance than for women with greater post-polio symptoms.
Psychological symptoms had the strongest association with sleep disturbance in these women. Controlling for the influence of various menopause factors, our findings show that vasomotor symptoms were only one of several influences on sleep disturbance.
脊髓灰质炎幸存者的睡眠障碍是一个常见的问题,但对于身体残疾与更年期的相互作用对睡眠的影响却知之甚少。本研究的目的是了解更年期因素和残疾对主观睡眠障碍的相对影响。
研究对象为465名年龄在50至65岁之间因脊髓灰质炎而导致身体残疾的女性。采用分层回归模型来研究更年期(症状、状态、激素替代疗法的使用、卵巢切除状态)和残疾因素(脊髓灰质炎后遗症)对睡眠障碍的影响。
在最终模型中,睡眠障碍差异的19%(频率)和17%(严重程度)得到了解释。心理症状的影响最大(对两个结果而言),其次是脊髓灰质炎后遗症、血管舒缩症状、血管舒缩症状与脊髓灰质炎后遗症的相互作用以及雌激素的使用。对于脊髓灰质炎后遗症较少的女性,血管舒缩症状对睡眠障碍的影响比对脊髓灰质炎后遗症较多的女性更大。
心理症状与这些女性的睡眠障碍关联最为紧密。在控制了各种更年期因素的影响后,我们的研究结果表明,血管舒缩症状只是影响睡眠障碍的多种因素之一。