Influence of the menopausal transition on polysomnographic sleep characteristics: A longitudinal analysis

SLEEP ◽  
2021 ◽  
Author(s):  
Karen A Matthews ◽  
Laize Lee ◽  
Howard M Kravitz ◽  
Hadine Joffe ◽  
Genevieve Neal-Perry ◽  
...  
Keyword(s):  
Sleep Duration ◽  
Menopausal Status ◽  
Hot Flashes ◽  
Sleep Onset ◽  
Menopausal Transition ◽  
Apnea Hypopnea Index ◽  
Cross Sectional ◽  
Sleep Study ◽  
Beta Power ◽  
Eeg Power

Abstract Study Objectives To evaluate how change in menopausal status related to spectral analysis and polysomnographic measures of sleep characteristics. Methods The Study of Women’s Health Across the Nation (SWAN) Ancillary Sleep Study evaluated sleep characteristics of 159 women who were initially pre- or early perimenopausal and repeated the assessment about 3 ½ years later when 38 were pre- or early perimenopausal, 31 late perimenopausal, and 90 postmenopausal. Participants underwent in-home ambulatory polysomnography for 2 to 3 nights. Average EEG power in the delta and beta frequency bands was calculated during NREM and REM sleep, and sleep duration, wake after sleep onset (WASO), and apnea hypopnea index (AHI) were based on visually-scored sleep. Results The women who transitioned to postmenopause had increased beta NREM EEG power at the second assessment, compared to women who remained pre-or early premenopausal; no other sleep measures varied by change in menopausal status. In multivariate models the associations remained; statistical controls for self-reported hot flashes did not explain findings. In secondary analysis, NREM beta power at the second assessment was greater among women who transitioned into the postmenopause after adjustments for initial NREM beta power. Conclusions Sleep duration and WASO did not vary by menopause transition group across assessments. Consistent with prior cross-sectional analysis, elevated beta EEG power in NREM sleep was apparent among women who transitioned to postmenopause, suggesting that independent of self-reported hot flashes, the menopausal transition is associated with physiological hyperarousal during sleep.

scholarly journals Associations of Sleep Characteristics With Cognitive Function and Decline Among Older Adults

2019 ◽  
Vol 188 (6) ◽  
pp. 1066-1075 ◽  
Author(s):  
V Eloesa McSorley ◽  
Yu Sun Bin ◽  
Diane S Lauderdale
Keyword(s):  
Standard Deviation ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Sleep Duration ◽  
Social Life ◽  
Sleep Onset ◽  
Sleep Disruption ◽  
Cross Sectional ◽  
Sleep Study ◽  
Nationally Representative

Abstract Sleep laboratory studies find that restricted sleep duration leads to worse short-term cognition, especially memory. Observational studies find associations between self-reported sleep duration or quality and cognitive function. However self-reported sleep characteristics might not be highly accurate, and misreporting could relate to cognition. In the Sleep Study of the National Social Life, Health, and Aging Project (NSHAP), a nationally representative cohort of older US adults (2010–2015), we examined whether self-reported and actigraph-measured sleep are associated with cross-sectional cognitive function and 5-year cognitive decline. Cognition was measured with the survey adaptation of the multidimensional Montreal Cognitive Assessment (MoCA-SA). At baseline (n = 759), average MoCA-SA score was 14.1 (standard deviation, 3.6) points of a possible 20. In cross-sectional models, actigraphic sleep-disruption measures (wake after sleep onset, fragmentation, percentage sleep, and wake bouts) were associated with worse cognition. Sleep disruption measures were standardized, and estimates of association were similar (range, −0.37 to −0.59 MoCA-SA point per standard deviation of disruption). Actigraphic sleep-disruption measures were also associated with odds of 5-year cognitive decline (4 or more points), with wake after sleep onset having the strongest association (odds ratio = 1.43, 95% confidence interval: 1.04, 1.98). Longitudinal associations were generally stronger for men than for women. Self-reported sleep showed little association with cognitive function.

Abstract P203: Association of Sleep Characteristics with Heart Rate Variability: Chicago Area Sleep Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Mercedes Carnethon ◽  
Kristen L Knutson ◽  
Jason Ng ◽  
Peter J de Chavez ◽  
Kwang-Youn Kim ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Sleep Duration ◽  
Sleep Onset ◽  
Apnea Hypopnea Index ◽  
Autonomic Modulation ◽  
Sleep Study ◽  
Chicago Area ◽  
Validated Questionnaire ◽  
Obstructive Sleep

Introduction: Autonomic nervous system (ANS) dysfunction may contribute to the elevated incidence of hypertension, diabetes and coronary heart disease (CHD) among persons with shortened sleep duration. However, prior studies were conducted in adults who had obstructive sleep apnea (OSA), a correlate of short sleep, or using experimental designs that restricted sleep. To explore whether sleep duration is associated with ANS function in adults free from OSA, we tested whether sleep duration was associated with heart rate variability (HRV) indices that represent autonomic modulation of heart rate. Methods: The Chicago Area Sleep Study (CASS) identified men and women ages 35-64 via commercially available telephone listings. Data from 406 participants who had an apnea/hypopnea index<15 based on 1 night of in-home apnea detection (ApneaLink TM ) were studied. Participants wore wrist actigraphs for 7 days (Actiwatch TM ) to determine average sleep duration, sleep percentage (% of time during overnight sleep interval spent sleeping) and minutes of wake after sleep onset (WASO). A validated questionnaire, the Epworth Sleepiness Scale (ESS), was used to determine daytime sleepiness. Electrocardiograms were continuously recorded from participants for 10 minutes s from supine participants; time and frequency domain HRV indices were calculated from the RR interval to estimate overall autonomic modulation of heart rate (standard deviation of normal RR intervals [SDNN]) and parasympathetic modulation heart rate (high frequency power [HF], square root of the mean squared difference of successive R-R intervals [rMSSD]). Height and weight were measured and hypertension and diabetes were determined according to JNC-VII and American Diabetes Association 2010 criteria, respectively. Results: Participants’ mean age was 47.5 years, and 56% were female. Average sleep duration was 7.03 hours (SD=1.15), sleep percentage was 83% (SD=20.1), WASO was 41.4 min (SD=21) and the ESS score was 6.75 (SD=4.1). Following adjustment for age, race, sex, BMI, hypertension, diabetes, physical activity and smoking, sleep duration (per 1 hr) was significantly (p<0.01) inversely associated with SDNN (β=−2.5, SE=1.12), rMSSD (β=−2.6, SE=1.1) and log-transformed HF (β=−0.11, SE=0.05). Findings were similar in the subset of 285 participants with AHI<5. Conclusions: In contrast to prior studies, shorter sleep duration was associated with more favorable parasympathetic modulation of HR. These unexpected findings may suggest that ANS dysfunction associated with OSA may be attributed to hypoxemia rather than the direct effects of shortened sleep duration.

Besteht ein Zusammenhang zwischen Lungenkrebs und obstruktiver Schlafapnoe?

2019 ◽  
Vol 7 (1) ◽  
pp. 32-33
Author(s):  
Wolfgang Galetke
Keyword(s):  
Lung Cancer ◽  
Sleep Apnea ◽  
Tobacco Consumption ◽  
Cross Sectional Study ◽  
Apnea Hypopnea Index ◽  
Cross Sectional ◽  
Sleep Study ◽  
Nocturnal Hypoxemia ◽  
Obstructive Sleep ◽  
Home Sleep Apnea Testing

Background: Obstructive sleep apnea (OSA) has been linked to tumorigenesis and tumor progression. Objectives: The Sleep Apnea in Lung Cancer (SAIL) study (NCT02764866) was designed to determine the prevalence of OSA in patients with lung cancer. Methods: Cross-sectional study including consecutive patients with newly diagnosed lung cancer. All patients were offered home sleep apnea testing (HSAT) and administered a sleep-specific questionnaire prior to initiating oncologic treatment. Sleep study-related variables, symptoms, and epidemiologic data as well as cancer related variables were recorded. Results: Eighty-three patients were enrolled in the SAIL study. Sixty-six completed HSAT. The mean age was 68 ± 11 years and 58% were male with a mean body mass index of 28.1 ± 5.4. Forty-seven percent were current smokers, 42% former smokers, and 11% never smokers with a median tobacco consumption of 51 pack-years. Fifty percent had COPD with a mean FEV1 of 83 ± 22.6% of predicted and a mean DLCO of 85.5 ± 20.1%. Adenocarcinoma was the most common histologic type (46.7%), followed by squamous cell (16.7%) and small cell (16.7%). Most patients were diagnosed at an advanced stage (65% in stages III-IV). The vast majority (80%) had OSA (apnea-hypopnea index [AHI] > 5), and 50% had moderate to severe OSA (AHI > 15) with a mean Epworth Sleepiness Score of 7.43 ± 3.85. Significant nocturnal hypoxemia was common (Median T90: 10.9% interquartile range 2.4-42.2). Conclusions: Sleep apnea and nocturnal hypoxemia are highly prevalent in patients with lung cancer.

scholarly journals Obstructive Sleep Apnea, Sleep Duration, and Associated Mediators With Carotid Intima-Media Thickness

2021 ◽  
Author(s):  
Silvana P. Souza ◽  
Ronaldo B. Santos ◽  
Itamar S. Santos ◽  
Barbara K. Parise ◽  
Soraya Giatti ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Duration ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
R Package ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Media Thickness ◽  
Obstructive Sleep

Objective: To elucidate the independent associations of obstructive sleep apnea (OSA) and sleep duration (SD) as well as the potential inflammatory and metabolic mediators on carotid intima-media thickness (CIMT) in a large cohort of adults. Approach and Results: Consecutive participants from the ELSA-Brasil performed a clinical evaluation, sleep study, 1-week actigraphy for defining SD and CIMT using standard techniques. Gamma regression models were used to explore the association between OSA and SD with CIMT. Mediation analysis was performed using the mediation R package. A total of 2009 participants were included in the main analysis. As compared with no OSA (apnea-hypopnea index [AHI] <5 events/hour; n=613), patients with mild (AHI, 5–14.9; n=741), moderate (AHI, 15–29.9; n=389), and severe OSA (AHI ≥30 events/hour; n=266) presented a progressive CIMT increase (0.690 [0.610–0.790], 0.760 [0.650–0.890], 0.810 [0.700–0.940], and 0.820 [0.720–0.958] mm; P <0.001). In contrast, CIMTs were similar for those with SD <6 hours (0.760 [0.650–0.888]), 6 to 8 hours (0.750 [0.640–0.880]) and >8 hours (0.740 [0.670–0.900]). All forms of OSA were independently associated with CIMT (mild: β: 0.019, SE 0.008; P =0.022; moderate: β: 0.025, SE 0.011; P =0.022; severe OSA: β: 0.040, SE 0.013; P =0.002). Moreover, the association of AHI with CIMT was mediated by increased C-reactive protein and triglycerides ( P <0.01). SD did not interact with OSA in the association with CIMT. Conclusions: OSA is independently associated with increased CIMT in a dose-response relationship. This association is partially mediated by inflammation and dyslipidemia. In contrast, SD is not associated nor interacted with OSA to increase CIMT.

scholarly journals An Assessment of Sleep Duration and Determinants of Health in a Cross-Sectional Sample of Gynecologic Cancer Survivors in Los Angeles County

2020 ◽  
Vol 17 (2) ◽  
pp. 13-25
Author(s):  
Ma’at Hembrick ◽  
Makala Conner ◽  
Heather Tarleton
Keyword(s):  
Physical Activity ◽  
Ovarian Cancer ◽  
Cervical Cancer ◽  
Los Angeles ◽  
Cancer Survivors ◽  
Sleep Duration ◽  
Los Angeles County ◽  
Menopausal Status ◽  
Cancer Type ◽  
Cross Sectional

Cancer survivors have an increased risk of treatment-related deficits in physical health and low health-related quality of life. In this cross-sectional study, a health questionnaire was mailed to women from the Los Angeles County Cancer Surveillance Program aged 45-70 and diagnosed with cervical, endometrial, or ovarian cancer in 2005-2014. Of the 5,941 surveys with valid postal addresses, 586 (10%) were completed and returned. The average age of respondents was 66 years old, and 36% identified as non-white. Non-white respondents were less likely to have a college degree (p<0.001), more likely to sleep for less than seven hours each night (p<0.001), experience bodily pain (p<0.001), and have a diagnosis of cervical cancer (p=0.002), when compared to white respondents. Health behaviors and determinants were examined across cervical, endometrial, and ovarian cancer cases. Cervical cancer survivors reported sleeping less than 7 hours per night, on average (p=0.015). Race was associated with sleep duration among endometrial (p=0.002) and ovarian (p=0.003) cancer survivors. Menopausal status was associated with the relationship between race and sleep duration (p<0.001). Depression was inversely related to sleep duration (p = 0.022) but was not associated with race, menopausal status, time since treatment, physical activity, or cancer type. Postmenopausal cervical cancer survivors reported a moderate concern about fall risk compared to their premenopausal counterparts (p=0.048). Physical activity levels increased as time since treatment increased (p=0.003) regardless of cancer type. Race, menopausal status, depression, and cancer type impacted the sleep duration. KEYWORDS: Health Disparities; Sleep Duration; Depression; Gynecologic Cancers; Survivorship Care

358 Daridorexant Improves Sleep in Patients with Mild/Moderate Obstructive Sleep Apnea

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A143-A143
Author(s):  
Marie-Laure Boof ◽  
Ingo Fietze ◽  
Katharina Lederer ◽  
Anne-Sophie Guern ◽  
Vincent Lemoine ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Duration ◽  
Sleep Onset ◽  
Sleep Architecture ◽  
Sleep Stages ◽  
Apnea Hypopnea Index ◽  
Treatment Difference ◽  
Obstructive Sleep ◽  
Sleep Parameters

Abstract Introduction Daridorexant is a dual orexin receptor antagonist developed for the treatment of insomnia. The effect of the highest phase-3 dose of 50 mg daridorexant on nighttime respiratory function was evaluated in patients with mild/moderate obstructive sleep apnea (OSA). This study showed that repeated doses of daridorexant had no clinically meaningful effect on the apnea-hypopnea index (AHI) or on peripheral oxygen saturation. In the same study, the effect on objective sleep parameters was also explored by polysomnography (PSG). Methods In this randomized, double-blind, placebo-controlled, two-period, crossover study, daridorexant or placebo was administered in each period once daily for 5 consecutive nights to 28 patients. Treatment difference (daridorexant – placebo) for total sleep time (TST), latency to persistent sleep (LPS), and wake after sleep onset (WASO) was analyzed for Night 5 using linear mixed-effects modeling. In addition, sleep was further explored based on sleep duration during each hour of PSG recording, duration of the different sleep phases (rapid eye movement [REM], non-REM [including N1 to N3 sleep stages]), as well as number and mean/longest duration of awakenings. Results Of 28 patients enrolled, 25 completed the study and were included in the analysis (n=15/10 with mild/moderate OSA; mean [standard deviation] AHI: 16.3 [8.2] events/h). One patient had mild insomnia symptoms at baseline. Compared to placebo, daridorexant prolonged mean TST by 38.8 min (90% confidence interval: 19.7–57.9), shortened mean LPS by 17.2 min (-35.5–1.02), and reduced mean WASO by 31.0 min (-47.3 to 14.7). Sleep architecture was maintained as no treatment differences in the duration of the evaluated sleep stages were observed when normalized to TST. Sleep duration was prolonged in the second part of the night. mean and longest duration of awakenings were decreased by a mean (90% CI) of 2.0 min (-3.1 to 0.9) and 16.3 min (-24.1 to -8.6), respectively, without treatment difference for the total number of awakenings. Conclusion Daridorexant improved objective sleep parameters in patients with mild to moderate OSA without modifying sleep architecture. Support (if any) Funded by Idorsia Pharmaceuticals Ltd.

Abstract MP93: Actigraphy Measured Sleep Indices and Adiposity: The Multi-Ethnic Study of Atherosclerosis

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Rachel Ogilvie ◽  
Susan Redline ◽  
Alain G Bertoni ◽  
Xiaoli Chen ◽  
Moyses Szklo ◽  
...  
Keyword(s):  
Sleep Duration ◽  
Abdominal Obesity ◽  
Linear Models ◽  
Sleep Efficiency ◽  
Poor Sleep ◽  
Reverse Causality ◽  
Cross Sectional ◽  
Sleep Study ◽  
Black African ◽  
Prevalence Of Obesity

Background: Previous findings on sleep and adiposity in adults have been inconsistent. Limitations of these studies include self-reported sleep measures, one measure of adiposity, and racially/ethnically homogenous populations. Objectives: We examined the cross-sectional relationship between indices of objectively measured sleep and adiposity in 2,146 MESA Sleep study participants. Methods: Sleep duration, sleep efficiency (% time asleep during sleep period), and night-to-night variability in sleep duration were assessed using at-home 7-day actigraphy and were modeled categorically. Adiposity was measured as body mass index (BMI) and waist circumference (WC). Multivariate linear models were used to examine relationships between sleep exposures and each outcome. In models with dichotomous outcomes, we used logistic regression post-estimation commands to calculate adjusted probabilities standardized to the total population for each sleep measure category. These probabilities were used to calculate prevalence differences for overweight (BMI 25-29.9 kg/m 2 ), obesity (BMI ≥ 30 kg/m 2 ), and abdominal obesity (men: WC ≥102 cm; women ≥88 cm). Results: Of 2146 participants (mean age 68.6 years), 53.7% were female, 30% were white, 46.2% Black/African American, 5.0% Chinese, and 41.9% Hispanic. Participants who slept <6 hours/night had significantly higher BMI and WC relative to those who slept 7-8 hours. Those who slept <5 hours had a 15% excess prevalence of obesity (BMI ≥ 30 vs. <25 kg/m 2 ) (95% CI: 0.07-0.23) and a 10% excess prevalence of abdominal obesity (95% CI: 0.03-0.17) compared to those who slept 7-8 hours. Poor sleep efficiency and greater night-to-night sleep variability were also associated with a greater prevalence of obesity. Conclusions: Among a multi-racial/ethnic cohort, we found robust associations across multiple indices of sleep and adiposity. Targeting sleep characteristics may be of benefit in obesity interventions, but more research is needed to rule out reverse causality.

Abstract MP90: Association of Sleep Duration and Quality with Incident Diabetes: Coronary Artery Risk Development in Young Adults Sleep Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Mercedes R Carnethon ◽  
Peter John D De Chavez ◽  
Diane S Lauderdale ◽  
April P Carson ◽  
Kiang Liu ◽  
...  
Keyword(s):  
Sleep Duration ◽  
Daytime Sleepiness ◽  
Population Sample ◽  
Sleep Onset ◽  
Demographic Characteristics ◽  
Incident Diabetes ◽  
Diabetes Incidence ◽  
Sleep Study ◽  
Sleep Maintenance ◽  
Sleep Parameters

Background: Most prior longitudinal studies investigating the association of sleep characteristics with incident diabetes are based on self-reported sleep duration and quality. However, self-reported sleep is prone to differential error that is based on the amount of actual sleep that a person gets. Objective: To test whether objectively-measured sleep duration and quality or self-reported sleepiness were associated with the development of diabetes in a population sample. Methods: Participants from the Chicago, IL center of the CARDIA study who wore wrist actigraphs (Actiwatch TM ) twice between 2003-2005 and who were free from diabetes in 2000-2001 were included in the analysis (n=594). The following sleep parameters were averaged over 6 days: sleep duration, sleep maintenance (percentage of sleep period actually sleeping) and minutes of wake after sleep onset (WASO). The Epworth Sleepiness Scale (ESS) assessed daytime sleepiness; higher scores reflect more sleepiness. Diabetes was determined based on fasting glucose >126 mg/dL, medication use, post-load glucose >200 mg/dL or Hemoglobin A1c >6.5% during examinations in 2005-2006 and 2010-2011. Results: Participants were 40.1 years old (SD=3.6), average sleep duration was 365.8 min (SD=64.3), sleep maintenance was 88.9% (SD=5.4), WASO was 46.0 min (SD=24.0) and the ESS was 7.5 (SD=4.3). Over ~10 years, 68 participants (11.4%) developed diabetes. Each sleep measure was associated with diabetes incidence in unadjusted models; however, only the association with daytime sleepiness remained significant following adjustment for demographic characteristics and diabetes risk factors. Conclusions: Self-reported daytime sleepiness is a straightforward measurement of sleep quality that can identify adults at risk for diabetes. Although objective measures of sleep duration and quality are associated with incident diabetes, the association is entirely explained by demographic characteristics.

scholarly journals Cross-sectional and Longitudinal Associations Between Objectively Measured Sleep Duration and Body Mass Index: The CARDIA Sleep Study

2009 ◽  
Vol 170 (7) ◽  
pp. 805-813 ◽  
Author(s):  
D. S. Lauderdale ◽  
K. L. Knutson ◽  
P. J. Rathouz ◽  
L. L. Yan ◽  
S. B. Hulley ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Sleep Duration ◽  
Body Mass ◽  
Cross Sectional ◽  
Sleep Study ◽  
Longitudinal Associations ◽  
Objectively Measured

scholarly journals 0784 Associations Of Sleep Regularity And Chronotype With Hypertension Among African Americans In The Jackson Heart Sleep Study

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A298-A298
Author(s):  
D A Johnson ◽  
N Guo ◽  
S Redline
Keyword(s):  
African Americans ◽  
Sleep Duration ◽  
Sleep Onset ◽  
Self Report ◽  
Future Research ◽  
Prevalence Odds Ratio ◽  
Sleep Study ◽  
Shift Workers ◽  
Logistic Regression Models ◽  
Onset Timing

Abstract Introduction Emerging evidence suggests that disparities in sleep regularity, a marker of circadian disruption, contributes to hypertension disparities; however, data among African Americans are limited. We examined associations of sleep regularity and chronotype with hypertension among African Americans in the Jackson Heart Sleep Study (JHSS). Methods Participants underwent 7-day actigraphy, completed questionnaires, and had seated blood pressure (BP) measured as part of the JHSS (2012 - 2016). Sleep regularity was defined as the standard deviation (SD) of actigraphy-measured sleep onset timing or sleep duration. Chronotype was assessed by the Morningness-Eveningness Questionnaire. Prevalent hypertension was defined as either a systolic BP ≥ 130 mmHg or diastolic BP ≥ 80mmHg, antihypertensive medication use, or self-report of diagnosed hypertension. Multivariable logistic regression models were fit to estimate the prevalence odds ratio (OR) and 95% confidence intervals for the associations of hypertension with sleep regularity measures (SD of sleep onset timing and sleep duration) and chronotype adjusted for covariates. Results Participants (n=830) on average were 63.4 years (SD:10.7), mostly female (66.3%) and hypertensive (85.8%). Compared to individuals with sleep onset SD &lt; 30 minutes, higher adjusted odds of hypertension was observed with increasing variability: OR:1.87 (CI:0.99-3.56); OR:2.16 (1.06-4.39), and OR:2.41 (1.12-5.20), for SD &gt; 30 & ≤ 60, &gt; 60 & ≤ 90 and &gt; 90 minutes, respectively. Among non-shift workers, definite morning and evening types compared to intermediates had higher adjusted odds of hypertension, OR:1.71 (1.04-2.83) and OR:2.56 (1.12-5.84), respectively. There were no observed associations for the SD of sleep duration with hypertension. Conclusion Increased sleep onset variability and extreme chronotypes were associated with prevalent hypertension, supporting interventions targeting sleep hygiene recommendations promoting regular sleep. Future research is needed to understand sleep patterns and risk of cardiovascular disease according to chronotype. Support NHLBI K01HL138211 and HL110068-03S1

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