Objective sleep interruption and reproductive hormone dynamics in the menstrual cycle.
OBJECTIVE
Women report greater sleep disturbance during the premenstrual phase of the menstrual cycle and during menses. However, the putative hormonal basis of perceived menstrual cycle-related sleep disturbance has not been investigated directly. We examined associations of objective measures of sleep fragmentation with reproductive hormone levels in healthy, premenopausal women.


METHODS
Twenty-seven women with monthly menses had hormone levels measured at two time points during a single menstrual cycle: the follicular phase and the peri-ovulatory to mid-luteal phase. A single night of home polysomnography (PSG) was recorded on the day of the peri-ovulatory/mid-luteal-phase blood draw. Serum progesterone, estradiol, and estrone levels concurrent with PSG and rate of change in progesterone (PROGslope) from the follicular blood draw to PSG were correlated with log-transformed wake after sleep onset (lnWASO%) and number of wakes/hour of sleep (lnWake-Index) using linear regression.


RESULTS
Sleep was more fragmented in association with a steeper PROGslope (lnWASO% p=0.016; lnWake-Index p=0.08) and higher concurrent estrone level (lnWASO% p=0.03; lnWake-Index p=0.01), but the effect of estrone on WASO was lost after accounting for PROGslope. WASO% and Wake-Index were not associated with concomitant progesterone or estradiol levels.


CONCLUSIONS
A steeper rate of rise in progesterone levels from the follicular phase through the mid-luteal phase was associated with significantly greater WASO, establishing a link between reproductive hormone dynamics and sleep fragmentation in the luteal phase of the menstrual cycle.
Departments of Medicine and Psychiatry & Human Behavior, Alpert Medical School of Brown University/Rhode Island Hospital, 300 Duncan Drive, Providence, RI, USA.
Katherine M
KM
Sharkey
Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Shaw Building Room 228, Worcester, MA 01655, USA.
Sybil L
SL
Crawford
Women's Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Semmie
S
Kim
Women's Hormones and Aging Research Program, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA; Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Harvard Medical School, 44 Binney Street, Boston, MA 02115, USA. Electronic address: hjoffe@partners.org.
Hadine
H
Joffe
D000328:Adult; D004958:Estradiol / Q000097:blood* / Q000502:physiology; D004970:Estrone / Q000097:blood* / Q000502:physiology; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000502:physiology*; D017286:Polysomnography; D011374:Progesterone / Q000097:blood* / Q000502:physiology; D012890:Sleep / Q000502:physiology; D012892:Sleep Deprivation / Q000097:blood / Q000503:physiopathology*
D004970:Estrone; D011374:Progesterone; D004958:Estradiol
Estradiol; Estrone; Menstrual cycle; Polysomnography; Premenopausal; Progesterone; Sleep