Jehan Shazia, Masters-Isarilov Alina, Salifu Idoko, Zizi Ferdinand, Jean-Louis Girardin, Pandi-Perumal Seithikurippu R, Gupta Ravi, Brzezinski Amnon, McFarlane Samy I
Center for Healthful Behavior Change, New York University School of Medicine, New York, USA.
Division of Endocrinology, Department of Medicine, SUNY Downstate Medical Center, USA.
J Sleep Disord Ther. 2015 Aug;4(5). Epub 2015 Aug 25.
One of the core symptoms of the menopausal transition is sleep disturbance. Peri-menopausal women often complain of difficulties initiating and/or maintaining sleep with frequent nocturnal and early morning awakenings. Factors that may play a role in this type of insomnia include vasomotor symptoms, changing reproductive hormone levels, circadian rhythm abnormalities, mood disorders, coexistent medical conditions, and lifestyle. Other common sleep problems in this age group, such as obstructive sleep apnea and restless leg syndrome, can also worsen the sleep quality. Exogenous melatonin use reportedly induces drowsiness and sleep and may ameliorate sleep disturbances, including the nocturnal awakenings associated with old age and the menopausal transition. Recently, more potent melatonin analogs (selective melatonin-1 (MT1) and melatonin-2 (MT2) receptor agonists) with prolonged effects and slow-release melatonin preparations have been developed. They were found effective in increasing total sleep time and sleep efficiency as well as in reducing sleep latency in insomnia patients. The purpose of this review is to give an overview on the changes in hormonal status to sleep problems among menopausal and postmenopausal women.
更年期过渡的核心症状之一是睡眠障碍。围绝经期女性常常抱怨入睡困难和/或维持睡眠困难,夜间频繁醒来且早醒。可能导致这类失眠的因素包括血管舒缩症状、生殖激素水平变化、昼夜节律异常、情绪障碍、并存的内科疾病以及生活方式。该年龄组的其他常见睡眠问题,如阻塞性睡眠呼吸暂停和不宁腿综合征,也会使睡眠质量恶化。据报道,外源性褪黑素可诱导嗜睡和睡眠,并可能改善睡眠障碍,包括与衰老和更年期过渡相关的夜间觉醒。最近,已开发出作用更强、效果持久的褪黑素类似物(选择性褪黑素-1(MT1)和褪黑素-2(MT2)受体激动剂)以及缓释褪黑素制剂。它们被发现可有效增加失眠患者的总睡眠时间和睡眠效率,并减少睡眠潜伏期。本综述的目的是概述绝经和绝经后女性激素状态变化与睡眠问题之间的关系。