Terauchi Masakazu, Obayashi Satoshi, Akiyoshi Mihoko, Kato Kiyoko, Matsushima Eisuke, Kubota Toshiro
Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan.
J Obstet Gynaecol Res. 2011 Jul;37(7):741-9. doi: 10.1111/j.1447-0756.2010.01424.x. Epub 2011 Mar 13.
To assess the effects of estrogen and hypnotics on Japanese peri- and postmenopausal women with sleep disturbance.
Among the records of 1451 participants enrolled in the Systematic Health and Nutrition Education Program conducted at the Menopause Clinic of the Tokyo Medical and Dental University Hospital between 1995 and 2009, those of 202 peri- and postmenopausal women were retrospectively analyzed. These women, who had moderate to severe sleep disturbances, had either received only health and nutrition education (control; n = 119), or had received education with either conjugated estrogen (estrogen [0.625 mg/day]; n = 55) or nightly hypnotics (hypnotics; n = 28), and were followed up for a median interval of six months.
Both oral estrogen and hypnotics improved the subjective sleep disturbance scores, while administration of hypnotics decreased the percentage of women reporting difficulty in initiating sleep or non-restorative sleep. Oral estrogen was also effective in alleviating various menopausal symptoms, while hypnotics were not. The health-related quality of life of these patients was significantly promoted by health and nutrition education alone, and neither estrogen nor hypnotics had an additive effect on it. Administration of hypnotics substantially lowered the blood pressure of the subjects (systolic pressure, -10.2%; diastolic pressure, -8.3%) and significantly reduced body weight (-2.1%), body mass index (-2.2%) and body fat (-7.8%), without affecting lean body mass.
Oral estrogen and hypnotics are effective for sleep disturbance in Japanese peri- and postmenopausal women. They can be admininstered either singly or in combination, according to the patient's characteristics.
评估雌激素和催眠药对有睡眠障碍的日本绝经前后妇女的影响。
在东京医科齿科大学医院更年期诊所1995年至2009年开展的系统健康与营养教育项目的1451名参与者记录中,对202名绝经前后有中度至重度睡眠障碍的妇女记录进行回顾性分析。这些妇女要么仅接受了健康与营养教育(对照组;n = 119),要么接受了结合雌激素(雌激素[0.625毫克/天];n = 55)或每晚催眠药(催眠药组;n = 28)的教育,并进行了为期6个月的中位随访。
口服雌激素和催眠药均改善了主观睡眠障碍评分,而服用催眠药降低了报告入睡困难或睡眠无恢复感的妇女百分比。口服雌激素在缓解各种更年期症状方面也有效,而催眠药则无效。仅健康与营养教育就显著提高了这些患者的健康相关生活质量,雌激素和催眠药对此均无叠加作用。服用催眠药显著降低了受试者的血压(收缩压,-10.2%;舒张压,-8.3%),并显著降低了体重(-2.1%)、体重指数(-2.2%)和体脂(-7.8%),而不影响瘦体重。
口服雌激素和催眠药对日本绝经前后妇女的睡眠障碍有效。可根据患者特点单独或联合使用。