Many women suffer with insomnia symptoms, and these can get worse as a woman approaches menopause. A case series was published in the April edition of the Journal of Clinical Sleep Medicine about using Gabapentin for this problem. The author, Dr. Guttoso, hypothesizes that in women who are approaching menopause, low estradiol levels may contribute to nighttime awakenings. Gabapentin is an anti-seizure medication, but it has been shown to improve sleep quality and can improve deep sleep amounts. It's not clear how Gabapentin would improve sleep quality in pre-menopausal women with nighttime awakenings.
He presents histories of three women, all of which had insomnia symptoms. In the first case, the woman took Gabapentin nightly. Within a few weeks, she was sleeping better, had more daytime alertness, better concentration, and improved mood. She did have dizziness, but this was not all the time and did not seem to interfere with her functioning. The second woman reported that nightly Gabapentin also relieved her insomnia symptoms, with a temporary side effect of daytime sleepiness and irritability. However, after about three weeks of therapy, those side effects disappeared. For the last woman, she again reported elimination of her insomnia symptoms with nightly Gabapentin. She denied any side effects, and stated that Gabapentin enhanced her daytime alertness, improved her concentration, and gave her more daytime energy. She was even able to stop drinking coffee at work.
Of course more research is needed to determine if women that are close to menopause have nighttime awakenings in associated with low estradiol levels, and whether Gabapentin can improve sleep quality in randomized controlled clinical trials.
Showing posts with label Menopause. Show all posts
Showing posts with label Menopause. Show all posts
Monday, May 28, 2012
Thursday, February 24, 2011
Isoflavones, Menopause, and Insomnia
Saw an article abstract in the February edition of Menopause about isoflavones, insomnia, and hot flashes in post-menopausal women. Researchers studied 38 post-menopausal women - admittedly a small number. The study was placebo-controlled and double-blinded.
The women participants took either a placebo or 80 mg of isoflavones (found in soybeans) daily for four months. They did sleep studies to determine how much they slept while in bed on the night of the study - called sleep efficiency. I use 85% or more as a cutoff for normal sleep efficiency. This means, that you are asleep 85% or more of the time you are in bed. For the isoflavone group, sleep efficiency went from 77.9% to 83.9%. For the placebo group, sleep efficiency went from 77.6% to 81.2%. The difference between the placebo and isoflavone group was deemed statistically significant. These numbers are very underwhelming and neither placebo nor isoflavone were able to get the sleep efficiency to what I consider the normal level.
Insomnia intensity went down over four months for both the placebo group and the isoflavone group, but the isoflavone group had a greater decrease. Specifically, 95% of the placebo group and 90% of the isoflavone group rated their insomnia as moderate or intense at the beginning of the study. After four months, 63% of the placebo group and 37% of the isoflavone group had moderate or intense insomnia.
Finally, the number of hot flashes experienced trended downward by two months and was statistically less by four months in the isoflavone group than the placebo group. Numbers were not given in the abstract so I don't know how much each group changed by themselves. Apparently, hot flash intensity also was significantly lower in the isoflavone than placebo group - again no numbers were given in the abstract to put this into perspective like for the sleep efficiency data above.
The women participants took either a placebo or 80 mg of isoflavones (found in soybeans) daily for four months. They did sleep studies to determine how much they slept while in bed on the night of the study - called sleep efficiency. I use 85% or more as a cutoff for normal sleep efficiency. This means, that you are asleep 85% or more of the time you are in bed. For the isoflavone group, sleep efficiency went from 77.9% to 83.9%. For the placebo group, sleep efficiency went from 77.6% to 81.2%. The difference between the placebo and isoflavone group was deemed statistically significant. These numbers are very underwhelming and neither placebo nor isoflavone were able to get the sleep efficiency to what I consider the normal level.
Insomnia intensity went down over four months for both the placebo group and the isoflavone group, but the isoflavone group had a greater decrease. Specifically, 95% of the placebo group and 90% of the isoflavone group rated their insomnia as moderate or intense at the beginning of the study. After four months, 63% of the placebo group and 37% of the isoflavone group had moderate or intense insomnia.
Finally, the number of hot flashes experienced trended downward by two months and was statistically less by four months in the isoflavone group than the placebo group. Numbers were not given in the abstract so I don't know how much each group changed by themselves. Apparently, hot flash intensity also was significantly lower in the isoflavone than placebo group - again no numbers were given in the abstract to put this into perspective like for the sleep efficiency data above.
Monday, July 26, 2010
Insomnia and Women
I saw an article in Current Psychiatry about insomnia across women's life stages. It was a nice review of how menstruation, pregnancy, and menopause can change sleep. I'll point out some of the highlights.
Compared to men, women have a 1.3 to 1.8-fold greater risk of developing insomnia. The reasons vary, but include hormonal changes, a greater chance of developing mood and anxiety disorders, and other factors like being single, separated, or widowed.
Sleep complaints are common in Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD).
Of course, any woman who has been pregnant will tell you how difficult it can be to sleep as the baby grows. Usually, sleep worsens as women approach the delivery date. Difficulty breathing is a common complaint, as the baby pushes up on the diaphragm, which then compresses the lungs. Obstructive sleep apnea can also become an issue during pregnancy, usually associated with weight gain. Pregnancy can also bring on Restless Legs Syndrome, possibly related to temporary iron deficiency.
Finally, post-menopausal women can have sleeping difficulties due to hot flashes at night. Also, they are at increased risk of obstructive sleep apnea as their female hormone levels diminish.
Compared to men, women have a 1.3 to 1.8-fold greater risk of developing insomnia. The reasons vary, but include hormonal changes, a greater chance of developing mood and anxiety disorders, and other factors like being single, separated, or widowed.
Sleep complaints are common in Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD).
Of course, any woman who has been pregnant will tell you how difficult it can be to sleep as the baby grows. Usually, sleep worsens as women approach the delivery date. Difficulty breathing is a common complaint, as the baby pushes up on the diaphragm, which then compresses the lungs. Obstructive sleep apnea can also become an issue during pregnancy, usually associated with weight gain. Pregnancy can also bring on Restless Legs Syndrome, possibly related to temporary iron deficiency.
Finally, post-menopausal women can have sleeping difficulties due to hot flashes at night. Also, they are at increased risk of obstructive sleep apnea as their female hormone levels diminish.
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