Management of sleep disorders in the menopausal transition

2021 ◽  
pp. 205336912110391
Author(s):  
Zoe Schaedel ◽  
Debra Holloway ◽  
Deborah Bruce ◽  
Janice Rymer
Keyword(s):  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Sleep Problems ◽  
Hormone Replacement ◽  
Treatment Options ◽  
Healthcare Utilisation ◽  
Menopausal Transition ◽  
Vasomotor Symptoms ◽  
Mood Symptoms ◽  
Symptom Profile

The menopausal transition is associated with increasing sleep disorders including sleep apnoea and restless leg syndrome. Insomnia is the most common and is recognised as a core symptom of the menopause. Guidelines to support decision making for women with sleep problems during the menopausal transition are lacking. Sleep problems are associated with negative impacts on healthcare utilisation, quality of life and work productivity. Sleep deprivation is a risk factor for cardiovascular disease, diabetes, obesity and neurobehavioral dysfunction. Declining oestrogen is implicated as a cause of menopausal sleep disruption. Vasomotor symptoms (VMS) and menopausal mood disturbance are also factors in the complex aetiology. VMS commonly precipitate insomnia and, due to their prolonged duration, they often perpetuate the condition. Insomnia in the general population is most effectively treated with cognitive behavioural therapy (CBT) (also effective in the menopausal transition.) The associations of menopausal sleep disturbance with VMS and depression mean that other treatment options must be considered. Existing guidelines outline effectiveness of hormone replacement therapy (HRT), CBT and antidepressants. HRT may indirectly help with sleep disturbance by treating VMS and also via beneficial effect on mood symptoms. The evidence base underpinning menopausal insomnia often references risks associated with HRT that are not in line with current international menopause guidelines. This may influence clinicians managing sleep disorders, leading to hesitation in offering HRT, despite evidence of effectiveness. Viewing sleep symptoms on an axis of menopausal symptoms – towards vasomotor symptoms or towards mood symptoms may help tailor treatment options towards the symptom profile.

scholarly journals The Association of Sleep Disorder, Obesity Status, and Diabetes Mellitus among US Adults—The NHANES 2009-2010 Survey Results

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Jian Liu ◽  
John Hay ◽  
Brent E. Faught
Keyword(s):  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Sleep Problems ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Logistic Regression Models ◽  
Obesity Status ◽  
Overnight Fasting ◽  
The Impact

To examine the association between sleep disorders, obesity status, and the risk of diabetes in adults, a total of 3668 individuals aged 40+ years from the NHANES 2009-2010 without missing information on sleep-related questions, measurements related to diabetes, and BMI were included in this analysis. Subjects were categorized into three sleep groups based on two sleep questions: (a) no sleep problems; (b) sleep disturbance; and (c) sleep disorder. Diabetes was defined as having one of a diagnosis from a physician; an overnight fasting glucose > 125 mg/dL; Glycohemoglobin > 6.4%; or an oral glucose tolerance test > 199 mg/dL. Overall, 19% of subjects were diabetics, 37% were obese, and 32% had either sleep disturbance or sleep disorder. Using multiple logistic regression models adjusting for covariates without including BMI, the odds ratios (OR, (95% CI)) of diabetes were 1.40 (1.06, 1.84) and 2.04 (1.40, 2.95) for those with sleep disturbance and with sleep disorder, respectively. When further adjusting for BMI, the ORs were similar for those with sleep disturbance 1.36 (1.06, 1.73) but greatly attenuated for those with sleep disorders (1.38 [0.95, 2.00]). In conclusion, the impact of sleep disorders on diabetes may be explained through the individuals’ obesity status.

Treatment of Pediatric Sleep Disorders

2021 ◽  
pp. 587-624
Author(s):  
Chana Chin ◽  
Iris A. Perez
Keyword(s):  
Down Syndrome ◽  
Circadian Rhythm ◽  
Sleep Disorders ◽  
Sleep Problems ◽  
Treatment Options ◽  
Childhood And Adolescence ◽  
Prader Willi Syndrome ◽  
Medical Disorders ◽  
Pediatric Sleep Disorders ◽  
Pediatric Sleep

Sleep problems are common in childhood and are associated significant morbidities negatively impacting the patient and family and thus necessitating early intervention and treatment. This chapter is focused on management addressing the etiology and predisposing and precipitating factors of sleep disorders spanning from infancy to childhood and adolescence. Current recommendations for safe infant sleep, promotion of sleep hygiene strategies in childhood, and treatment options of representative pediatric sleep disorders such as sleep-disordered breathing, insomnia, sleep-related movement disorders, circadian rhythm disorders, and hypersomnia are reviewed. Additionally, management of sleep disorders unique to medical disorders such as Prader-Willi syndrome, Down syndrome, and autism also are addressed.

An overview of sleep dysfunction in Parkinson disease

2017 ◽  
Author(s):  
Elisaveta Sokolov ◽  
K. Ray Chaudhuri
Keyword(s):  
Quality Of Life ◽  
Parkinson Disease ◽  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Case Series ◽  
Nocturnal Sleep ◽  
Drug Induced

Disturbances in nocturnal sleep and their consequences during waking in Parkinson disease (PD) were recognized in 1817 by James Parkinson, who described sleep problems in his case series as follows: “His attendants observed, that of late the trembling would sometimes begin in his sleep, and increase until it awakened him: when he always was in a state of agitation and alarm.” Sleep disturbance in PD is complex, with a prevalence of up to 98%, and has been shown to be a key determinant of quality of life. Sleep disturbances in PD are heterogeneous, ranging from insomnia to drug-induced sleep disorders, and now can be assessed by simple validated bedside tools such as the Parkinson’s Disease Sleep Scale (PDSS). Also, sleep, contrary to previous perceptions, can be disordered not just in advanced PD, but also in the pre-motor as well as the untreated states.

scholarly journals Prevalence of Sleep Disturbance and Potential Associated Factors among Medical Students from Mashhad, Iran

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Ahmad Janatmakan Amiri ◽  
Negar Morovatdar ◽  
Atefeh Soltanifar ◽  
Ramin Rezaee
Keyword(s):  
Medical Students ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Associated Factors ◽  
Sleep Problems ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Related Factors ◽  
Cross Sectional

Study Objectives. A very limited number of studies have evaluated the prevalence of sleep problems, and related factors, in Iranian medical students. The aim of this study was to determine the prevalence of sleep disturbance and potential associated factors among medical students of Mashhad University of Medical Sciences, Mashhad, Iran. Methods. In this cross-sectional study, 315 medical students chosen by stratified random sampling participated in the academic year 2018-2019. The Pittsburgh Instrument and DASS-21 questionnaire were used to evaluate sleep quality and anxiety, depression, and stress, respectively. Also, demographic, educational, and socioeconomic information was collected. SPSS 16 software was used for data analysis. Results. Out of 300 students who completed the questionnaires, 165 (55%) were male, with a mean age of 21.94±2.28 years old. The prevalence of poor sleep quality was 51.3%. We did not find significant associations among age, sex, and poor sleep quality. Concurrent psychological symptoms such as stress, depression, and anxiety were significantly associated with sleep disorders. After adjusting variables in the multivariable regression model, depression (OR=2.81, 95% CI: 1.35-5.87; p=0.006) and the number of hours spent on using smartphones in 24 hours (OR=1.13, 95% CI: 1.02-1.25; p=0.01) were significantly associated with poor sleep quality among medical students. Conclusion. The prevalence of poor sleep quality among medical students was high, and we found that increased use of smartphones during the day and depression were associated with sleep disorders.

Sleep in Autism

2017 ◽  
Vol 37 (04) ◽  
pp. 413-418 ◽  
Author(s):  
Beth Malow ◽  
Angela Maxwell-Horn
Keyword(s):  
Autism Spectrum Disorder ◽  
Sleep Disorders ◽  
Sleep Problems ◽  
Neurodevelopmental Disorder ◽  
Treatment Options ◽  
Significant Proportion ◽  
Autism Spectrum ◽  
Hyperactivity Disorder ◽  
Children With Asd ◽  
Melatonin Production

AbstractAutism spectrum disorder (ASD) is a neurodevelopmental disorder that has increased in prevalence over the last several decades. A significant proportion of children with ASD have comorbid sleep disorders. The interplay between ASD and sleep is multifactorial and bidirectional. There is evidence for physiological differences in ASD that contribute to sleep problems, including sensory overresponsiveness (SOR) and abnormal melatonin production. Comorbidities associated with ASD (attention deficit hyperactivity disorder [ADHD], mood disorders) as well as medications used to treat these comorbidities often have effects on sleep architecture. In this article the authors discuss the etiology and manifestations of sleep disorders in children with ASD, as well as their clinical evaluation and treatment options.

scholarly journals Sleep Disturbance, Cognitive Decline, and Dementia: A Review

2017 ◽  
Vol 37 (04) ◽  
pp. 395-406 ◽  
Author(s):  
Mark Wu ◽  
Paul Rosenberg ◽  
Adam Spira ◽  
Alexandra Wennberg
Keyword(s):  
Cognitive Decline ◽  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Behavior Disorder ◽  
Sleep Behavior ◽  
Disturbed Sleep ◽  
People With Dementia ◽  
Sleep Parameters

AbstractApproximately half of older people report sleep disturbances, which are associated with various health conditions, including neurodegenerative disease and dementia. Indeed, 60 to 70% of people with cognitive impairment or dementia have sleep disturbances, which are linked to poorer disease prognosis. Sleep disturbances in people with dementia have long been recognized and studied; however, in the past 10 years, researchers have begun to study disturbed sleep, including sleep fragmentation, abnormal sleep duration, and sleep disorders, as risk factors for dementia. In this review the authors summarize evidence linking sleep disturbance and dementia. They describe how specific aspects of sleep (e.g., quality, duration) and the prevalence of clinical sleep disorders (e.g., sleep-disordered breathing, rapid eye movement sleep behavior disorder) change with age; how sleep parameters and sleep disorders are associated with the risk of dementia; how sleep can be disturbed in dementia; and how disturbed sleep affects dementia prognosis. These findings highlight the potential importance of identifying and treating sleep problems and disorders in middle-aged and older adults as a strategy to prevent cognitive decline and dementia. The authors also review recent evidence linking sleep disturbances to the pathophysiology underlying dementing conditions, and briefly summarize available treatments for sleep disorders in people with dementia.

scholarly journals Cognition, Mood and Sleep in Menopausal Transition: The Role of Menopause Hormone Therapy

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 668 ◽  
Author(s):  
Gava ◽  
Orsili ◽  
Alvisi ◽  
Mancini ◽  
Seracchioli ◽  
...  
Keyword(s):  
Sleep Disturbance ◽  
Hormone Therapy ◽  
Sleep Problems ◽  
Menopausal Transition ◽  
Ovarian Activity ◽  
Hormone Levels ◽  
Mood Changes ◽  
Menopause Hormone Therapy

During the menopausal transition, which begins four to six years before cessation of menses, middle-aged women experience a progressive change in ovarian activity and a physiologic deterioration of hypothalamic-pituitary-ovarian axis function associated with fluctuating hormone levels. During this transition, women can suffer symptoms related to menopause (such as hot flushes, sleep disturbance, mood changes, memory complaints and vaginal dryness). Neurological symptoms such as sleep disturbance, “brain fog” and mood changes are a major complaint of women transitioning menopause, with a significant impact on their quality of life, productivity and physical health. In this paper, we consider the associations between menopausal stage and/or hormone levels and sleep problems, mood and reduced cognitive performance. The role of estrogen and menopause hormone therapy (MHT) in cognitive function, sleep and mood are also discussed.

scholarly journals Sleep Disturbance, Sleep Disorders and Co-Morbidities in the Care of the Older Person

2021 ◽  
Vol 9 (2) ◽  
pp. 31
Author(s):  
Christine E. Mc Carthy
Keyword(s):  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Older Patients ◽  
Disease Risk ◽  
Medication Management ◽  
Sleep Complaints ◽  
Co Morbidity ◽  
Sleep Assessment ◽  
Form Part

Sleep complaints can be both common and complex in the older patient. Their consideration is an important aspect of holistic care, and may have an impact on quality of life, mortality, falls and disease risk. Sleep assessment should form part of the comprehensive geriatric assessment. If sleep disturbance is brought to light, consideration of sleep disorders, co-morbidity and medication management should form part of a multifaceted approach. Appreciation of the bi-directional relationship and complex interplay between co-morbidity and sleep in older patients is an important element of patient care. This article provides a brief overview of sleep disturbance and sleep disorders in older patients, in addition to their association with specific co-morbidities including depression, heart failure, respiratory disorders, gastro-oesophageal reflux disease, nocturia, pain, Parkinson’s disease, dementia, polypharmacy and falls. A potential systematic multidomain approach to assessment and management is outlined, with an emphasis on non-pharmacological treatment where possible.

scholarly journals Why Do Our Cancer Patients Sleep So Badly? Sleep Disorders in Cancer Patients: A Frequent Symptom with Multiple Causes

2021 ◽  
pp. 1-7
Author(s):  
Herwig Strik ◽  
Werner Cassel ◽  
Michael Teepker ◽  
Thomas Schulte ◽  
Jorge Riera-Knorrenschild ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Cancer Patients ◽  
Treatment Options ◽  
Ethics Committee ◽  
Breathing Disorders ◽  
The One ◽  
Diagnosis Therapy ◽  
The University ◽  
Insomnia Symptoms

<b><i>Introduction:</i></b> On the one hand, sleep disorders in cancer patients are reported in 30–50% of cancer patients. On the other hand, specific causes for these sleep disorders are little known. This study was done to evaluate factors which may affect sleep of cancer patients. To our knowledge, this is the first study which includes return to work as one factor of sleep disturbance. <b><i>Methods:</i></b> 107 patients with various types of cancer treated in 2 hospitals were interviewed with a battery of questionnaires after having given informed consent. The questionnaires intended to detect abnormalities of sleep and related pain, breathing disorders, restless legs syndrome, depression, rumination, medication, and psychosocial distress. The study was approved by the ethics committee of the University of Marburg. <b><i>Results:</i></b> The analysis of the 6 sleep-related questionnaires indicated a sleep disorder of any kind in 68% of all patients. Insomnia symptoms were present in 48 patients (44.9%). Pain, depression, anxiety, and worries about the workplace were significantly related to sleep disorders. <b><i>Conclusion:</i></b> Sleep disorders are common in cancer patients. The causes are manifold and should be considered by caregivers during diagnosis, therapy, and aftercare of cancer patients. Tumour patients should actively be asked about sleep disorders. If these are present, they should be addressed, and as they have a large impact on quality of life, treatment options should be offered in cooperation with sleep specialists.

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