绝经过渡期和绝经早期的睡眠症状：西雅图中年女性健康研究的观察结果。
Sleep symptoms during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women's Health Study.
机构信息
Department of Family and Child Nursing, University of Washington, T318 Health Sciences Bldg., Box 357260, Seattle, WA 98195-7260, USA.
出版信息
Sleep. 2010 Apr;33(4):539-49. doi: 10.1093/sleep/33.4.539.
STUDY OBJECTIVES
Describe the severity of getting to sleep, nighttime awakening, and early morning awakening across the menopausal transition (MT) and early postmenopause (PM) and their relationship to age, menopausal transition factors, symptoms, stress-related factors, and health related factors.
DESIGN
Cohort.
SETTING
community.
PARTICIPANTS
286 women from the Seattle Midlife Women's Health Study cohort.
MEASUREMENTS
Participants completed annual menstrual calendars for MT staging, diaries in which they rated their symptoms, stress levels, and perceived health multiple times per year from 1990-2007 and provided first morning urine samples assayed for E1G, FSH, cortisol, and catecholamines. Multilevel modeling (R program) was used for data analysis.
RESULTS
Severity of self-reported problems going to sleep was associated with all symptoms, perceived stress, history of sexual abuse, perceived health (-), alcohol use (-) (all P < 0.001), and lower cortisol (P = 0.009), but not E1G or FSH. Severity of nighttime awakening was significantly associated with age, late MT stage, and early PM, FSH, E1G (-), hot flashes, depressed mood, anxiety, joint pain, backache, perceived stress, history of sexual abuse, perceived health (-), and alcohol use (-) (all P < 0.001, except E1G for which P = 0.030). Severity of early morning awakening was significantly associated with age, hot flashes, depressed mood anxiety, joint pain, backache, perceived stress, history of sexual abuse, perceived health (-) (all P < or = 0.001, except E1G for which P = 0.02 and epinephrine (P = 0.038), but not MT stages or FSH. Multivariate models for each symptom included hot flashes, depressed mood, and perceived health.
CONCLUSION
Sleep symptoms during the MT may be amenable to symptom management strategies that take into account the symptom clusters and promote women's general health rather than focusing only on the MT.
研究目的
描述绝经过渡（MT）和早期绝经后（PM）期间入睡、夜间觉醒和清晨觉醒的严重程度，并探讨其与年龄、MT 相关因素、症状、与压力相关的因素以及健康相关因素的关系。
设计
队列研究。
设置
社区。
参与者
来自西雅图中年女性健康研究队列的 286 名女性。
测量方法
参与者完成了 MT 分期的年度月经日历，在 1990-2007 年期间，他们多次使用日记记录了自己的症状、压力水平和感知健康状况，并提供了第一个早晨的尿液样本，用于检测 E1G、FSH、皮质醇和儿茶酚胺。使用多水平模型（R 程序）进行数据分析。
结果
自我报告入睡问题的严重程度与所有症状、感知压力、性虐待史、感知健康状况（均 P < 0.001）以及皮质醇水平降低（P = 0.009）相关，但与 E1G 或 FSH 无关。夜间觉醒的严重程度与年龄、晚期 MT 阶段和早期 PM、FSH、E1G 水平降低（P < 0.001）、热潮红、抑郁情绪、焦虑、关节痛、背痛、感知压力、性虐待史、感知健康状况（均 P < 0.001，除 E1G 为 P = 0.030）以及饮酒（均 P < 0.001）相关。清晨觉醒的严重程度与年龄、热潮红、抑郁情绪、焦虑、关节痛、背痛、感知压力、性虐待史、感知健康状况（均 P < 0.001，除 E1G 为 P = 0.02 和肾上腺素（P = 0.038）以及 FSH 无关。每个症状的多变量模型均包括热潮红、抑郁情绪和感知健康。
结论
MT 期间的睡眠症状可能可以通过症状管理策略来改善，这些策略应考虑到症状群，并促进女性的整体健康，而不仅仅是关注 MT。
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