Ensrud Kristine E, Stone Katie L, Blackwell Terri L, Sawaya George F, Tagliaferri Mary, Diem Susan J, Grady Deborah
Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MN 55417, USA.
Menopause. 2009 Mar-Apr;16(2):286-92. doi: 10.1097/gme.0b013e31818c0485.
To determine whether greater frequency and severity of hot flashes are independently associated with insomnia symptoms and objective measures of disrupted sleep among healthy postmenopausal women with hot flashes.
A baseline cross-sectional analysis of a multicenter, randomized trial in 217 healthy postmenopausal women aged 40 to 60 years with hot flashes was conducted. Hot flash frequency and severity were recorded in a daily diary; frequency of moderate to severe hot flashes was the primary measure. Insomnia symptoms were assessed with the Insomnia Severity Index (ISI). Hot flash frequency and severity and objective parameters of sleep-wake patterns (using a wrist actigraph) were concurrently measured over an average of seven consecutive 24-hour periods in a subcohort of 112 women.
The mean age of participants was 54 years, and 80% were white; 33% had an ISI score greater than 14, consistent with at least moderate insomnia. In multivariable analysis, the mean ISI score showed a stepwise increase in magnitude with higher frequency of moderate to severe hot flashes (adjusted mean ISI score, 9.5, 11.4, 11.9, and 13.0 for quartiles 1-4, respectively; P for trend = 0.002). Higher frequency of moderate to severe hot flashes was also independently associated in a graded manner with greater nighttime wakefulness (P for trend = 0.028) and a higher number of long wake episodes (P for trend = 0.008) but was not related to sleep efficiency, total sleep time, or sleep latency.
Among healthy postmenopausal women with hot flashes, frequency of moderate to severe hot flashes was independently associated in a graded manner with severity of insomnia symptoms and objective measures of nighttime wakefulness and sleep fragmentation.
确定潮热发作频率和严重程度增加是否与潮热的健康绝经后女性的失眠症状及睡眠中断的客观指标独立相关。
对217名年龄在40至60岁有潮热症状的健康绝经后女性进行的多中心随机试验进行基线横断面分析。潮热频率和严重程度通过每日日记记录；中度至重度潮热的频率是主要测量指标。使用失眠严重程度指数（ISI）评估失眠症状。在112名女性的亚组中，连续七个24小时期间平均同时测量潮热频率和严重程度以及睡眠-觉醒模式的客观参数（使用手腕活动记录仪）。
参与者的平均年龄为54岁，80%为白人；33%的ISI评分大于14，符合至少中度失眠。在多变量分析中，平均ISI评分随着中度至重度潮热频率的增加而呈逐步上升趋势（第1-4四分位数的调整后平均ISI评分分别为9.5、11.4、11.9和13.0；趋势P值 = 0.002）。中度至重度潮热的较高频率也以分级方式与更高的夜间觉醒程度（趋势P值 = 0.028）和更长的长时间觉醒发作次数（趋势P值 = 0.008）独立相关，但与睡眠效率、总睡眠时间或睡眠潜伏期无关。
在有潮热症状的健康绝经后女性中，中度至重度潮热的频率与失眠症状的严重程度以及夜间觉醒和睡眠片段化的客观指标以分级方式独立相关。
