Résumé
Whether sleep problems of menopausal women are associated with vasomotor symptoms and/or changes in estrogen levels associated with menopause or age-related changes in sleep architecture is unclear. This study aimed to determine if poor sleep in middle-aged women is correlated with menopause. This study recruited women seeking care for the first time at the menopause outpatient department of our hospital. Inclusion criteria were an age ≥40 years, not taking any medications for menopausal symptoms, and no sleeping problems or depression. Patients were assessed with the Pittsburgh Sleep Quality Index (PSQI), modified Kupperman Index (KI), and Menopause Rating Scale (MRS). A PSQI score of <7 indicated no sleep disorder and ≥7 indicated a sleep disorder. Blood specimens were analyzed for follicle-stimulating hormone and estradiol levels. A total of 244 women were included in the study; 103 (42.2%) were identified as having a sleep disorder and 141 as not having one. In addition, 156 (64%) women were postmenopausal and 88 (36%) were not menopausal. Follicle-stimulating hormone and estradiol levels were similar between the groups. Patients with a sleep disorder had a significantly higher total modified KI score and total MRS score (both, P<0.001) compared with those without a sleep disorder. Correlations of the PSQI total score with the KI and MRS were similar in menopausal and non-menopausal women. These results do not support that menopause per se specifically contributes to sleep problems.
Sujets)
Adulte , Sujet âgé , Femelle , Humains , Adulte d'âge moyen , Oestrogènes/sang , Ménopause/sang , Troubles de la veille et du sommeil/étiologie , Échelle d'évaluation du comportement , Dépression/diagnostic , Oestradiol/sang , Hormone folliculostimulante/sang , Bouffées de chaleur/complications , Patients en consultation externe , Post-ménopause/sang , Qualité de vie , Enquêtes et questionnaires , Sudation , Évaluation des symptômes , Troubles de la veille et du sommeil/sang , Troubles de la veille et du sommeil/diagnostic , Troubles de la veille et du sommeil/physiopathologieRésumé
BACKGROUND/AIMS: Poor sleep quality (SQ) is associated with increased cardiovascular mortality and morbidity. Additionally, asymmetric dimethylarginine (ADMA) is an independent predictor of cardiovascular mortality and morbidity. However, no sufficient data regarding the relationship between ADMA levels and SQ have been reported. The goal of the current study was to evaluate the association between SQ and ADMA levels in normotensive patients with type 2 diabetes mellitus. METHODS: The study participants consisted of 78 normotensive type 2 diabetics. The SQ of all participants was assessed using the Pittsburgh Sleep Quality Index (PSQI). Patients with a global PSQI score > 5 were defined as "poor sleepers." Factors associated with poor SQ were analyzed using a multiple regression model. Serum ADMA levels were measured using high performance liquid chromatography. RESULTS: The median ADMA levels of the poor sleepers were increased compared with patients defined as good sleepers (5.5 [4.2 to 6.6] vs. 4.4 [2.9 to 5.4], p < 0.01, respectively). However, the L-arginine/ADMA ratio was decreased in poor sleepers (p < 0.01). Global PSQI scores were positively correlated with ADMA levels (p < 0.01) and negatively correlated with the L-arginine/ADMA ratio (p = 0.02). ADMA levels were correlated with sleep latency (p < 0.01) and sleep efficiency (p = 0.01). Logistic regression analysis showed that ADMA levels (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.16 to 2.44; p = 0.01) and body mass index (OR, 1.15; 95% CI, 1.01 to 1.31; p = 0.04) were associated with poor SQ independently of glomerular filtration rate, sex, age, duration of diabetes, hemoglobin A1c, total cholesterol, and systolic blood pressure. CONCLUSIONS: Self-reported SQ was independently associated with ADMA levels in normotensive patients with diabetes mellitus.
Sujets)
Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Arginine/analogues et dérivés , Marqueurs biologiques/sang , Maladies cardiovasculaires/sang , Loi du khi-deux , Chromatographie en phase liquide à haute performance , Études transversales , Diabète de type 2/sang , Modèles logistiques , Odds ratio , Facteurs de risque , Sommeil , Troubles de la veille et du sommeil/sang , Enquêtes et questionnairesRésumé
PURPOSE: This study was to examine the effects of foot reflexion massage on sleep disturbance, depression disorder, and the physiological index of the elderly in nursing homes. METHOD: The research design was a non-equivalent control group pretest-posttest quasi-experimental study. The subjects in this study were 50 elderly people who resided in two different nursing homes in the same region. An experimental group and a control group were organized with 25 subjects respectively, and foot reflexion massage was provided for 12 sessions, 30 minutes per session. The selected dependent variables were sleep disturbance, depression disorder, and physiological indices(blood plasma serotonin, serum cortisol), which were all measured before and after foot reflexion massage was offered. Data analysis included chi2-test, t-test, paired t-test, and ANCOVA, using the SPSS program package. RESULT: 1. The experimental group improved sleep quality more than the control group. 2. The experimental group had less depression disorder than the control group. 3. The experimental group had higher serotonin levels than the control group. CONCLUSION: It's necessary to give foot reflexion massage as a successful nursing intervention to elderly who undergo a change in sleep, and suffer from a depression disorder due to a deterioration in sleep.
Sujets)
Adulte d'âge moyen , Mâle , Humains , Femelle , Sujet âgé de 80 ans ou plus , Sujet âgé , Troubles de la veille et du sommeil/sang , Sérotonine/sang , Massage , Hydrocortisone/sang , Pied , Dépression/sangRésumé
PURPOSE: This study was to examine the effects of foot reflexion massage on sleep disturbance, depression disorder, and the physiological index of the elderly in nursing homes. METHOD: The research design was a non-equivalent control group pretest-posttest quasi-experimental study. The subjects in this study were 50 elderly people who resided in two different nursing homes in the same region. An experimental group and a control group were organized with 25 subjects respectively, and foot reflexion massage was provided for 12 sessions, 30 minutes per session. The selected dependent variables were sleep disturbance, depression disorder, and physiological indices(blood plasma serotonin, serum cortisol), which were all measured before and after foot reflexion massage was offered. Data analysis included chi2-test, t-test, paired t-test, and ANCOVA, using the SPSS program package. RESULT: 1. The experimental group improved sleep quality more than the control group. 2. The experimental group had less depression disorder than the control group. 3. The experimental group had higher serotonin levels than the control group. CONCLUSION: It's necessary to give foot reflexion massage as a successful nursing intervention to elderly who undergo a change in sleep, and suffer from a depression disorder due to a deterioration in sleep.