血管舒缩症状和抑郁症状可能与绝经后女性不同的睡眠障碍模式有关。

Vasomotor and depression symptoms may be associated with different sleep disturbance patterns in postmenopausal women.

作者信息

Vousoura Eleni, Spyropoulou Areti C, Koundi Kalliopi L, Tzavara Chara, Verdeli Helen, Paparrigopoulos Thomas, Augoulea Areti, Lambrinoudaki Irene, Zervas Iannis M

机构信息

1Women's Mental Health Clinic, First Department of Psychiatry, Eginition Hospital, Athens University Medical School, Athens, Greece 2Interpersonal Psychotherapy Unit, First Department of Psychiatry, Eginition Hospital, Athens University Medical School, Athens, Greece 3Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY 4Sleep Research Unit, First Department of Psychiatry, Eginition Hospital, Athens University Medical School, Athens, Greece 5Menopause Clinic, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Athens University Medical School, Athens, Greece.

出版信息

Menopause. 2015 Oct;22(10):1053-7. doi: 10.1097/GME.0000000000000442.

DOI:10.1097/GME.0000000000000442

PMID:25783470

Abstract

OBJECTIVE

This study aims to explore the association of vasomotor symptoms (VMS) and depression symptoms with different symptoms of subjective sleep disturbance in postmenopausal women.

METHODS

This is a cross-sectional study of 163 postmenopausal women (not taking hormone therapy) attending a university menopause clinic. Measures included the Athens Insomnia Scale, Greene Climacteric Scale, and Symptom Checklist-90-Revised depression subscale. Covariate-adjusted ordinal logistic regression was used to investigate the association of VMS and depression with each item of the Athens Insomnia Scale.

RESULTS

Controlling for confounding factors, we found VMS to be significantly associated with awakenings during the night (odds ratio [OR], 1.85; P < 0.001), overall quality of sleep (OR, 2.00; P < 0.001), well-being during the day (OR, 1.63; P = 0.008), functioning capacity during the day (OR, 1.72; P = 0.01), and sleepiness during the day (OR, 1.66; P = 0.03); whereas we found Symptom Checklist-90-Revised depression subscale scores to be associated with sleep induction (OR, 2.09; P < 0.001), final awakening earlier than desired (OR, 2.21; P < 0.001), total sleep duration (OR, 1.62; P = 0.01), overall quality of sleep (OR, 1.64; P = 0.009), well-being during the day (OR, 1.67; P = 0.006), functioning capacity during the day (OR, 1.68; P = 0.01), and sleepiness during the day (OR, 1.57; P = 0.04).

CONCLUSIONS

VMS and depression symptoms are associated with different patterns of sleep disturbance. Although both symptoms are related to sleep quality, daytime functioning, and daytime well-being, depression is uniquely associated with difficulty falling asleep and waking up earlier than desired, whereas VMS are related to frequent awakenings during sleep. The findings are limited by the cross-sectional design and relatively small sample size of the study. Recommendations for future research are discussed to guide this line of inquiry and to gain a better understanding of the complex relationship between climacteric and mood symptoms and their contribution to the development of sleep disturbances during menopause.

摘要

目的

本研究旨在探讨绝经后女性血管舒缩症状（VMS）和抑郁症状与主观睡眠障碍不同症状之间的关联。

方法

这是一项对163名就诊于大学更年期诊所的绝经后女性（未接受激素治疗）进行的横断面研究。测量指标包括雅典失眠量表、格林更年期量表和症状自评量表90修订版抑郁分量表。采用协变量调整的有序逻辑回归来研究VMS和抑郁与雅典失眠量表各项目之间的关联。

结果

在控制混杂因素后，我们发现VMS与夜间觉醒（优势比[OR]，1.85；P<0.001）、总体睡眠质量（OR，2.00；P<0.001）、白天幸福感（OR，1.63；P = 0.008）、白天功能能力（OR，1.72；P = 0.01）以及白天嗜睡（OR，1.66；P = 0.03）显著相关；而我们发现症状自评量表90修订版抑郁分量表得分与入睡（OR，2.09；P<0.001）、比期望时间更早终末觉醒（OR，2.21；P<0.001）、总睡眠时间（OR，1.62；P = 0.01）、总体睡眠质量（OR，1.64；P = 0.009）、白天幸福感（OR，1.67；P = 0.006）、白天功能能力（OR，1.68；P = 0.01）以及白天嗜睡（OR，1.57；P = 0.04）相关。

结论

VMS和抑郁症状与不同模式的睡眠障碍相关。虽然这两种症状都与睡眠质量、白天功能和白天幸福感有关，但抑郁与入睡困难和比期望时间更早醒来有独特关联，而VMS与睡眠期间频繁觉醒有关。本研究结果受横断面设计和相对较小样本量的限制。讨论了对未来研究的建议，以指导这一研究方向，并更好地理解更年期症状与情绪症状之间的复杂关系及其对绝经期间睡眠障碍发展的影响。