Lampio Laura, Polo-Kantola Päivi, Himanen Sari-Leena, Kurki Samu, Huupponen Eero, Engblom Janne, Heinonen Olli J, Polo Olli, Saaresranta Tarja
Department of Physiology, Sleep Research Centre, University of Turku, Turku, Finland.
Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland.
Sleep. 2017 Jul 1;40(7). doi: 10.1093/sleep/zsx090.
Menopausal transition is associated with increased dissatisfaction with sleep, but the effects on sleep architecture are conflicting. This prospective 6-year follow-up study was designed to evaluate the changes in sleep stages and sleep continuity that occur in women during menopausal transition.
Sixty women (mean age 46.0 years, SD 0.9) participated. All women were premenopausal at baseline, and at the 6-year follow-up, women were in different stages of menopausal transition. Polysomnography was used to study sleep architecture at baseline and follow-up. The effects of aging and menopause (assessed as change in serum follicle-stimulating hormone [S-FSH]) on sleep architecture were evaluated using linear regression models.
After controlling for body mass index, vasomotor, and depressive symptoms, aging of 6 years resulted in shorter total sleep time (B -37.4, 95% confidence interval [CI] -71.5 to (-3.3)), lower sleep efficiency (B -6.5, 95%CI -12.7 to (-0.2)), as well as in increased transitions from slow-wave sleep (SWS) to wakefulness (B 1.0, 95%CI 0.1 to 1.9), wake after sleep onset (B 37.7, 95%CI 12.5 to 63.0), awakenings per hour (B 1.8, 95%CI 0.8 to 2.8), and arousal index (B 2.3, 95%CI 0.1 to 4.4). Higher S-FSH concentration in menopausal transition was associated with increased SWS (B 0.09, 95%CI 0.01 to 0.16) after controlling for confounding factors.
A significant deterioration in sleep continuity occurs when women age from 46 to 52 years, but change from premenopausal to menopausal state restores some SWS.
围绝经期过渡与睡眠满意度下降有关，但对睡眠结构的影响存在争议。这项前瞻性6年随访研究旨在评估女性在围绝经期过渡期间睡眠阶段和睡眠连续性的变化。
60名女性（平均年龄46.0岁，标准差0.9）参与研究。所有女性在基线时均处于绝经前状态，在6年随访时，处于围绝经期过渡的不同阶段。采用多导睡眠图在基线和随访时研究睡眠结构。使用线性回归模型评估衰老和绝经（以血清促卵泡生成素[S-FSH]变化评估）对睡眠结构的影响。
在控制体重指数、血管舒缩症状和抑郁症状后，6年的衰老导致总睡眠时间缩短（B -37.4，95%置信区间[CI] -71.5至(-3.3)）、睡眠效率降低（B -6.5，95%CI -12.7至(-0.2)），以及从慢波睡眠（SWS）到清醒的转换增加（B 1.0，95%CI 0.1至1.9）、睡眠开始后觉醒（B 37.7，95%CI 12.5至63.0）、每小时觉醒次数（B 1.8，95%CI 0.8至2.8）和觉醒指数（B 2.3，95%CI 0.1至4.4）。在控制混杂因素后，围绝经期过渡期间较高的S-FSH浓度与SWS增加有关（B 0.09，95%CI 0.01至0.16）。
女性从46岁到52岁时睡眠连续性显著恶化，但从绝经前状态转变为绝经状态可恢复一些慢波睡眠。
