Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Heart Center, Turku University Hospital and University of Turku, Turku, Finland; Sleep Research Center, Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland.
Sleep Med. 2021 May;81:52-61. doi: 10.1016/j.sleep.2021.02.011. Epub 2021 Feb 9.
Sleep quality typically decreases after menopause, but the underlying mechanisms are poorly understood. Concentrations of melatonin are lower and its secretion profiles different before and after menopause. However, whether and how melatonin and sleep architecture are associated in women of different reproductive states have not been examined to date.
Overnight serum melatonin samples were taken from 17 perimenopausal and 18 postmenopausal healthy women. Sleep quality was measured with all-night polysomnography recordings.
Melatonin concentrations tended to be the lowest during NREM sleep, and were associated with higher odds of transitions from wake to NREM sleep. The curves of predicted overnight melatonin values from linear mixed models varied according to sleep phases (NREM, REM, Wake) in perimenopausal, but not in postmenopausal women. In perimenopause higher melatonin area under curve (AUC) correlated with higher slow-wave activity (p = 0.043), and higher minimum concentrations with shorter slow-wave sleep (SWS) latency (p = 0.029). In postmenopause higher mean and maximum melatonin concentrations and AUC correlated with lower SWS percentage (p = 0.044, p = 0.029, p = 0.032), and higher mean (p = 0.032), maximum (p = 0.032) and minimum (p = 0.037) concentrations with more awakenings from REM sleep. In the age- and BMI- adjusted regression models, the association between higher maximum (p = 0.046) melatonin concentration and lower SWS percentage remained.
The relationship between melatonin and sleep architecture differed in perimenopausal and postmenopausal women. After menopause, high melatonin concentrations were associated with worse sleep. Whether these different patterns are related to aging of the reproductive system, and to decrease in menopausal sleep quality, remains to be elucidated.
绝经后女性的睡眠质量通常会下降，但其中的潜在机制尚不清楚。绝经前后，褪黑素浓度降低，分泌模式也不同。然而，目前尚未研究不同生殖状态的女性中褪黑素及其睡眠结构之间的关系。
从 17 名围绝经期和 18 名绝经后健康女性中采集了整夜血清褪黑素样本。使用整夜多导睡眠图记录来测量睡眠质量。
褪黑素浓度在非快速眼动（NREM）睡眠期间最低，与从清醒到 NREM 睡眠的转变几率较高相关。线性混合模型预测的夜间褪黑素值曲线根据围绝经期的睡眠阶段（NREM、REM、觉醒）而变化，但在绝经后女性中则没有。在围绝经期，较高的褪黑素曲线下面积（AUC）与慢波活动（SWA）增加相关（p=0.043），而最低浓度与慢波睡眠（SWS）潜伏期缩短相关（p=0.029）。在绝经后，较高的平均和最大褪黑素浓度和 AUC 与 SWS 百分比降低相关（p=0.044，p=0.029，p=0.032），而较高的平均（p=0.032）、最大（p=0.032）和最低（p=0.037）浓度与 REM 睡眠中的更多觉醒相关。在年龄和 BMI 调整的回归模型中，较高的最大褪黑素浓度与 SWS 百分比降低之间的关联仍然存在。
褪黑素与睡眠结构的关系在围绝经期和绝经后女性中有所不同。绝经后，高褪黑素浓度与睡眠质量较差有关。这些不同的模式是否与生殖系统衰老以及绝经后睡眠质量下降有关，还有待进一步阐明。
