Postmenopausal hormones and sleep quality in the elderly: A population based study

Gregory J. Tranah, Neeta Parimi, Terri Blackwell, Sonia Ancoli-Israel, Kristine E. Ensrud, Jane A. Cauley, Susan Redline, Nancy E Lane, Misti L. Paudel, Teresa A. Hillier, Kristine Yaffe, Steven R. Cummings, Katie L. Stone

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Sleep disturbance and insomnia are commonly reported by postmenopausal women. However, the relationship between hormone therapy (HT) and sleep disturbances in postmenopausal community-dwelling adults is understudied. Using data from the multicenter Study of Osteoporotic Fractures (SOF), we tested the relationship between HT and sleep-wake estimated from actigraphy.Methods: Sleep-wake was ascertained by wrist actigraphy in 3,123 women aged 84 ± 4 years (range 77-99) from the Study of Osteoporotic Fractures (SOF). This sample represents 30% of the original SOF study and 64% of participants seen at this visit. Data were collected for a mean of 4 consecutive 24-hour periods. Sleep parameters measured objectively included total sleep time, sleep efficiency (SE), sleep latency, wake after sleep onset (WASO), and nap time. All analyses were adjusted for potential confounders (age, clinic site, race, BMI, cognitive function, physical activity, depression, anxiety, education, marital status, age at menopause, alcohol use, prior hysterectomy, and medical conditions).Results: Actigraphy measurements were available for 424 current, 1,289 past, and 1,410 never users of HT. Women currently using HT had a shorter WASO time (76 vs. 82 minutes, P = 0.03) and fewer long-wake (≥ 5 minutes) episodes (6.5 vs. 7.1, P = 0.004) than never users. Past HT users had longer total sleep time than never users (413 vs. 403 minutes, P = 0.002). Women who never used HT had elevated odds of SE <70% (OR,1.37;95%CI,0.98-1.92) and significantly higher odds of WASO ≥ 90 minutes (OR,1.37;95%CI,1.02-1.83) and ≥ 8 long-wake episodes (OR,1.58;95%CI,1.18-2.12) when compared to current HT users.Conclusions: Postmenopausal women currently using HT had improved sleep quality for two out of five objective measures: shorter WASO and fewer long-wake episodes. The mechanism behind these associations is not clear. For postmenopausal women, starting HT use should be considered carefully in balance with other risks since the vascular side-effects of hormone replacement may exceed its beneficial effects on sleep.

Original languageEnglish (US)
Article number15
JournalBMC Women's Health
Volume10
DOIs
StatePublished - May 4 2010

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Sleep
Hormones
Population
Actigraphy
Osteoporotic Fractures
Therapeutics
Independent Living
Marital Status
Sleep Initiation and Maintenance Disorders
Menopause
Wrist
Hysterectomy
Cognition
Multicenter Studies
Blood Vessels
Anxiety
Alcohols
Exercise
Depression

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Tranah, G. J., Parimi, N., Blackwell, T., Ancoli-Israel, S., Ensrud, K. E., Cauley, J. A., ... Stone, K. L. (2010). Postmenopausal hormones and sleep quality in the elderly: A population based study. BMC Women's Health, 10, [15]. https://doi.org/10.1186/1472-6874-10-15

Postmenopausal hormones and sleep quality in the elderly : A population based study. / Tranah, Gregory J.; Parimi, Neeta; Blackwell, Terri; Ancoli-Israel, Sonia; Ensrud, Kristine E.; Cauley, Jane A.; Redline, Susan; Lane, Nancy E; Paudel, Misti L.; Hillier, Teresa A.; Yaffe, Kristine; Cummings, Steven R.; Stone, Katie L.

In: BMC Women's Health, Vol. 10, 15, 04.05.2010.

Research output: Contribution to journalArticle

Tranah, GJ, Parimi, N, Blackwell, T, Ancoli-Israel, S, Ensrud, KE, Cauley, JA, Redline, S, Lane, NE, Paudel, ML, Hillier, TA, Yaffe, K, Cummings, SR & Stone, KL 2010, 'Postmenopausal hormones and sleep quality in the elderly: A population based study', BMC Women's Health, vol. 10, 15. https://doi.org/10.1186/1472-6874-10-15
Tranah GJ, Parimi N, Blackwell T, Ancoli-Israel S, Ensrud KE, Cauley JA et al. Postmenopausal hormones and sleep quality in the elderly: A population based study. BMC Women's Health. 2010 May 4;10. 15. https://doi.org/10.1186/1472-6874-10-15
Tranah, Gregory J. ; Parimi, Neeta ; Blackwell, Terri ; Ancoli-Israel, Sonia ; Ensrud, Kristine E. ; Cauley, Jane A. ; Redline, Susan ; Lane, Nancy E ; Paudel, Misti L. ; Hillier, Teresa A. ; Yaffe, Kristine ; Cummings, Steven R. ; Stone, Katie L. / Postmenopausal hormones and sleep quality in the elderly : A population based study. In: BMC Women's Health. 2010 ; Vol. 10.
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abstract = "Background: Sleep disturbance and insomnia are commonly reported by postmenopausal women. However, the relationship between hormone therapy (HT) and sleep disturbances in postmenopausal community-dwelling adults is understudied. Using data from the multicenter Study of Osteoporotic Fractures (SOF), we tested the relationship between HT and sleep-wake estimated from actigraphy.Methods: Sleep-wake was ascertained by wrist actigraphy in 3,123 women aged 84 ± 4 years (range 77-99) from the Study of Osteoporotic Fractures (SOF). This sample represents 30{\%} of the original SOF study and 64{\%} of participants seen at this visit. Data were collected for a mean of 4 consecutive 24-hour periods. Sleep parameters measured objectively included total sleep time, sleep efficiency (SE), sleep latency, wake after sleep onset (WASO), and nap time. All analyses were adjusted for potential confounders (age, clinic site, race, BMI, cognitive function, physical activity, depression, anxiety, education, marital status, age at menopause, alcohol use, prior hysterectomy, and medical conditions).Results: Actigraphy measurements were available for 424 current, 1,289 past, and 1,410 never users of HT. Women currently using HT had a shorter WASO time (76 vs. 82 minutes, P = 0.03) and fewer long-wake (≥ 5 minutes) episodes (6.5 vs. 7.1, P = 0.004) than never users. Past HT users had longer total sleep time than never users (413 vs. 403 minutes, P = 0.002). Women who never used HT had elevated odds of SE <70{\%} (OR,1.37;95{\%}CI,0.98-1.92) and significantly higher odds of WASO ≥ 90 minutes (OR,1.37;95{\%}CI,1.02-1.83) and ≥ 8 long-wake episodes (OR,1.58;95{\%}CI,1.18-2.12) when compared to current HT users.Conclusions: Postmenopausal women currently using HT had improved sleep quality for two out of five objective measures: shorter WASO and fewer long-wake episodes. The mechanism behind these associations is not clear. For postmenopausal women, starting HT use should be considered carefully in balance with other risks since the vascular side-effects of hormone replacement may exceed its beneficial effects on sleep.",
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AU - Tranah, Gregory J.

AU - Parimi, Neeta

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AU - Ancoli-Israel, Sonia

AU - Ensrud, Kristine E.

AU - Cauley, Jane A.

AU - Redline, Susan

AU - Lane, Nancy E

AU - Paudel, Misti L.

AU - Hillier, Teresa A.

AU - Yaffe, Kristine

AU - Cummings, Steven R.

AU - Stone, Katie L.

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N2 - Background: Sleep disturbance and insomnia are commonly reported by postmenopausal women. However, the relationship between hormone therapy (HT) and sleep disturbances in postmenopausal community-dwelling adults is understudied. Using data from the multicenter Study of Osteoporotic Fractures (SOF), we tested the relationship between HT and sleep-wake estimated from actigraphy.Methods: Sleep-wake was ascertained by wrist actigraphy in 3,123 women aged 84 ± 4 years (range 77-99) from the Study of Osteoporotic Fractures (SOF). This sample represents 30% of the original SOF study and 64% of participants seen at this visit. Data were collected for a mean of 4 consecutive 24-hour periods. Sleep parameters measured objectively included total sleep time, sleep efficiency (SE), sleep latency, wake after sleep onset (WASO), and nap time. All analyses were adjusted for potential confounders (age, clinic site, race, BMI, cognitive function, physical activity, depression, anxiety, education, marital status, age at menopause, alcohol use, prior hysterectomy, and medical conditions).Results: Actigraphy measurements were available for 424 current, 1,289 past, and 1,410 never users of HT. Women currently using HT had a shorter WASO time (76 vs. 82 minutes, P = 0.03) and fewer long-wake (≥ 5 minutes) episodes (6.5 vs. 7.1, P = 0.004) than never users. Past HT users had longer total sleep time than never users (413 vs. 403 minutes, P = 0.002). Women who never used HT had elevated odds of SE <70% (OR,1.37;95%CI,0.98-1.92) and significantly higher odds of WASO ≥ 90 minutes (OR,1.37;95%CI,1.02-1.83) and ≥ 8 long-wake episodes (OR,1.58;95%CI,1.18-2.12) when compared to current HT users.Conclusions: Postmenopausal women currently using HT had improved sleep quality for two out of five objective measures: shorter WASO and fewer long-wake episodes. The mechanism behind these associations is not clear. For postmenopausal women, starting HT use should be considered carefully in balance with other risks since the vascular side-effects of hormone replacement may exceed its beneficial effects on sleep.

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