Disruption of Sleep Continuity During the Perimenopause: Associations with Female Reproductive Hormone Profiles

Jamie Coborn, Anouk de Wit, Sybil Crawford, Margo Nathan, Shadab Rahman, Lauren Finkelstein, Aleta Wiley, Hadine Joffe*

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    Abstract

    Context Nocturnal vasomotor symptoms (nVMS), depressive symptoms (DepSx), and female reproductive hormone changes contribute to perimenopause-associated disruption in sleep continuity. Hormonal changes underlie both nVMS and DepSx. However, their association with sleep continuity parameters resulting in perimenopause-associated sleep disruption remains unclear. Objective We aimed to determine the association between female reproductive hormones and perimenopausal sleep discontinuity independent of nVMS and DepSx. Methods Daily sleep and VMS diaries, and weekly serum assays of female reproductive hormones were obtained for 8 consecutive weeks in 45 perimenopausal women with mild DepSx but no primary sleep disorder. Generalized estimating equations were used to examine associations of estradiol, progesterone, and follicle stimulating hormone (FSH) with mean number of nightly awakenings, wakefulness after sleep onset (WASO) and sleep-onset latency (SOL) adjusting for nVMS and DepSx. Results Sleep disruption was common (median 1.5 awakenings/night, WASO 24.3 and SOL 20.0 minutes). More awakenings were associated with estradiol levels in the postmenopausal range (beta = 0.14; 95% CI, 0.04 to 0.24; P = 0.007), and higher FSH levels (beta [1-unit increase] = 0.12; 95% CI, 0.02 to 0.22; P = 0.02), but not with progesterone (beta [1-unit increase] = -0.02; 95% CI, -0.06 to 0.01; P = 0.20) in adjusted models. Female reproductive hormones were not associated with WASO or SOL. Conclusion Associations of more awakenings with lower estradiol and higher FSH levels provide support for a perimenopause-associated sleep discontinuity condition that is linked with female reproductive hormone changes, independent of nVMS and DepSx.

    Original languageEnglish
    Number of pages10
    JournalJournal of Clinical Endocrinology & Metabolism
    DOIs
    Publication statusE-pub ahead of print - 25-Jul-2022

    Keywords

    • sleep
    • awakenings
    • estradiol
    • perimenopause
    • FSH
    • HOT FLASHES
    • MENOPAUSAL TRANSITION
    • FOS-IMMUNOREACTIVITY
    • POSTMENOPAUSAL WOMEN
    • VASOMOTOR SYMPTOMS
    • MASS-SPECTROMETRY
    • DEPRESSION SCALE
    • PROGESTERONE
    • ESTRADIOL
    • ESTROGEN

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