Lord C, Sekerovic Z, Carrier J
Département de psychologie, université de Montréal, Pavillon Marie-Victorin, 90, avenue Vincent-d'Indy, H2V 2S9 Montréal, Québec, Canada.
Département de psychologie, université de Montréal, Pavillon Marie-Victorin, 90, avenue Vincent-d'Indy, H2V 2S9 Montréal, Québec, Canada; Center for advanced research in sleep medicine, hôpital du Sacré-Cœur de Montréal, 5400, boulevard Gouin-Ouest, H4J 1C5 Montréal, Québec, Canada; Institut universitaire de gériatrie de Montréal, université de Montréal, Pavillon Côte des neiges, 4565, chemin Queen-Mary, H3W1W5 Montréal, Québec, Canada.
Pathol Biol (Paris). 2014 Oct;62(5):302-10. doi: 10.1016/j.patbio.2014.07.005. Epub 2014 Sep 11.
This review aims to discuss how endogenous and exogenous testosterone exposures in men and estrogens/progesterone exposures in women interact with sleep regulation. In young men, testosterone secretion peaks during sleep and is linked to sleep architecture. Animal and human studies support the notion that sleep loss suppresses testosterone secretion. Testosterone levels decline slowly throughout the aging process, but relatively few studies investigate its impact on age-related sleep modifications. Results suggest that poorer sleep quality is associated with lower testosterone concentrations and that sleep loss may have a more prominent effect on testosterone levels in older individuals. In women, sex steroid levels are characterized by a marked monthly cycle and reproductive milestones such as pregnancy and menopause. Animal models indicate that estrogens and progesterone influence sleep. Most studies do not show any clear effects of the menstrual cycle on sleep, but sample sizes are too low, and research designs often inhibit definitive conclusions. The effects of hormonal contraceptives on sleep are currently unknown. Pregnancy and the postpartum period are associated with increased sleep disturbances, but their relation to the hormonal milieu still needs to be determined. Finally, studies suggest that menopausal transition and the hormonal changes associated with it are linked to lower subjective sleep quality, but results concerning objective sleep measures are less conclusive. More research is necessary to unravel the effects of vasomotor symptoms on sleep. Hormone therapy seems to induce positive effects on sleep, but key concerns are still unresolved, including the long-term effects and efficacy of different hormonal regimens.
本综述旨在探讨男性内源性和外源性睾酮暴露以及女性雌激素/孕激素暴露如何与睡眠调节相互作用。在年轻男性中，睾酮分泌在睡眠期间达到峰值，并与睡眠结构相关。动物和人体研究支持睡眠不足会抑制睾酮分泌这一观点。在整个衰老过程中，睾酮水平会缓慢下降，但相对较少的研究调查其对与年龄相关的睡眠改变的影响。结果表明，较差的睡眠质量与较低的睾酮浓度相关，并且睡眠不足可能对老年人的睾酮水平有更显著的影响。在女性中，性类固醇水平具有明显的每月周期以及怀孕和绝经等生殖里程碑特征。动物模型表明，雌激素和孕激素会影响睡眠。大多数研究未显示月经周期对睡眠有任何明显影响，但样本量过小，且研究设计往往阻碍得出明确结论。激素避孕药对睡眠的影响目前尚不清楚。怀孕和产后时期与睡眠障碍增加有关，但其与激素环境的关系仍有待确定。最后，研究表明绝经过渡及其相关的激素变化与较低的主观睡眠质量有关，但关于客观睡眠指标的结果尚无定论。需要更多研究来阐明血管舒缩症状对睡眠的影响。激素疗法似乎对睡眠有积极影响，但关键问题仍未解决，包括不同激素方案的长期影响和疗效。
