Department of Obstetrics and Gynecology, University of Turku, FI-20014 Turku, Finland.
Department of Public Health, University of Helsinki, PO BOX 20, 00014 Helsinki, Finland.
Maturitas. 2024 Sep;187:108053. doi: 10.1016/j.maturitas.2024.108053. Epub 2024 Jun 18.
Worsening of sleep quality during menopause is well recognized. However, the underlying hormonal regulation is insufficiently described. In this study, we evaluated associations between sleep and cortisol levels.
Seventeen perimenopausal and 18 postmenopausal women were enrolled in a three-night sleep study. Diurnal blood sampling was performed during the third night and the following day.
Self-reported insomnia and sleepiness were evaluated with the Basic Nordic Sleep Questionnaire and sleep architecture with all-night polysomnography. Diurnal cortisol samples were collected at 20-min intervals. Correlation analyses and generalized linear models adjusted by age, body mass index, vasomotor symptoms and depressive symptoms were conducted.
In correlation analyses, self-reported insomnia and sleepiness were not associated with cortisol levels. Lower sleep efficiency, slow-wave sleep and stage 1 percentages, number of slow-wave sleep and of rapid-eye-movement (REM) periods, longer slow-wave sleep latency and higher wake after sleep onset percentage were associated with higher cortisol levels (all p < 0.05). Further, lower slow-wave sleep percentage and longer slow-wave sleep latency correlated with steeper daytime cortisol slope (i.e. day cortisol decrease, both p < 0.05). In adjusted generalized linear models, lower sleep efficiency and number of rapid-eye-movement periods as well as higher wake after sleep onset percentage correlated with higher cortisol levels; lower slow-wave sleep percentage correlated with higher cortisol awakening response.
Worse sleep architecture but not worse self-reported insomnia and sleepiness was associated with higher cortisol levels. This is important for understanding sleep in women, especially during the menopausal period.
绝经期间睡眠质量恶化是众所周知的。然而，其潜在的激素调节还描述不足。在这项研究中，我们评估了睡眠与皮质醇水平之间的关系。
17 名围绝经期和 18 名绝经后妇女参加了为期三晚的睡眠研究。在第三晚和第二天进行了日间血液采样。
使用基本北欧睡眠问卷评估自我报告的失眠和嗜睡，使用整夜多导睡眠图评估睡眠结构。日间皮质醇样本每 20 分钟采集一次。进行了相关性分析和广义线性模型分析，模型调整因素包括年龄、体重指数、血管舒缩症状和抑郁症状。
在相关性分析中，自我报告的失眠和嗜睡与皮质醇水平无关。睡眠效率较低、慢波睡眠和 1 期百分比、慢波睡眠和快速眼动（REM）期次数、慢波睡眠潜伏期较长和睡眠后觉醒百分比较高与皮质醇水平较高相关（均 p<0.05）。此外，慢波睡眠百分比较低和慢波睡眠潜伏期较长与日间皮质醇斜率较大（即日间皮质醇下降，均 p<0.05）相关。在调整后的广义线性模型中，睡眠效率和 REM 期次数较低以及睡眠后觉醒百分比较高与皮质醇水平较高相关；慢波睡眠百分比较低与皮质醇觉醒反应相关。
较差的睡眠结构而不是较差的自我报告的失眠和嗜睡与较高的皮质醇水平相关。这对于理解女性的睡眠很重要，尤其是在围绝经期。
