Sleep

Sleep and Diabetes Risk in Men Is Testosterone Also Involved?
Researchers writing in the medical journal Diabetes Care say that too little or too much sleep increases diabetes risk. The researchers say that men getting 5 to 6 hours of sleep a night were twice as likely to develop diabetes, men getting more than 8 hours were three times more likely to develop diabetes. They also noted that testosterone may be a factor in sleep on diabetes.

Poor Sleep and Cognitive Function
Researchers writing in the medical journal The Journals of Gerontology Series A: Biological Sciences and Medical Sciences say that Disturbed Sleep was related to poorer cognition.

Hot Flashes and Insomnia
Researchers writing in the Archives of Internal Medicine say: “Severe hot flashes are strongly associated with chronic insomnia in midlife women. The presence of hot flashes should be systematically investigated in women with insomnia. Treating hot flashes could improve sleep quality and minimize the deleterious consequences of chronic insomnia.”

Hot Flashes and Sleep
Researchers writing in the medical journal Menopause say that ambient temperature and REM sleep patterns effect sleep in postmenopausal women.

Warm Feet and Sleep
Researchers writing in the medical journal Physiology and Behavior say they “present new data indicating age- and insomnia-related changes in the sleep-onset latency response to foot warming, and evaluate whether different methods of foot warming could provide an applicable strategy to address sleep complaints.”

Why take progesterone?

As cited above, progesterone down-regulates estrogen. Other reasons are listed below:

Progesterone deficiency may possibly lead to:
1. Irregular and heavy menstrual bleeding
2. Osteoporosis
3. Heart disease
4. Decrease in libido

Progesterone supplementation has been used for:
1. PMS syndrome
2. Infertility
3. Supporting healthy pregnancy

Other potential benefits
1. Benefits against certain cancers
2. Prevents osteoporosis
3. Improves well-being, antidepressant
4. Helps restore sex drive
5. Helps convert fat to energy.

Warnings
The American College of Obstetricians and Gynecologists warns that there is no proof bio-identical hormones are any safer than the combination estrogen/progestin therapy.

Although there are no long-term studies on prolonged effects of progesterone, it appears that Progesterone therapy is a safe therapy, when indicated. Improper use of progesterone can lead to irregular menses and bleeding. This should be reported to your physician immediately.

SELECTED RESEARCH
Hot Flashes
Haimov-Kochman R, Hochner-Celnikier D.Acta Obstet Gynecol Scand. 2005 Oct;84(10):972-9.

Hot flashes revisited: pharmacological and herbal options for hot flashes management. What does the evidence tell us?

Background: Hot flashes are the most frequent symptoms of menopause and the most common reason for climacteric women seeking medical advice. Estrogen therapy is by far the most effective therapy. However, fears of side-effect of estrogen therapy urged many patients to seek alternative modalities for symptomatic relief.

Results and Conclusions: A critical review of the literature shows that progesterone may have an independent effect on relieving hot flashes.

SELECTED RESEARCH
Effects on Skin
Holzer G, Riegler E, Honigsmann H, Farokhnia S, Schmidt JB. Br J Dermatol. 2005 Sep;153(3):626-34

Effects and side-effects of 2% progesterone cream on the skin of peri-and postmenopausal women: results from a double-blind, vehicle-controlled, randomized study.

Background: For many years topical progesterone has been prescribed by gynecologists as an antiageing and skin-firming treatment, without any clinical scientific evidence of its effects, tolerability and safety when applied to skin.

Objectives: To evaluate the influence of 2% progesterone cream on function and texture of the skin in peri- and postmenopausal women.

Results: The study demonstrated a significant…increase of the elastic skin properties in the treatment group, as demonstrated by objective measurements of three skin elasticity parameters, whereas in the control group no such effect was observed. This effect in the treatment group was further paralleled by the results of the clinical monitoring, where the 2% progesterone cream yielded consistent superiority over vehicle in counteracting different signs of ageing in the skin of peri- and postmenopausal women.

Clinical monitoring showed a greater reduction in wrinkle…around the right eye, a greater decrease in nasolabial wrinkle depth…and a significantly higher…increase in skin firmness…in the treatment group. Epidermal hydration and skin surface lipids did not change significantly in either group during the study. Progesterone was well absorbed in the systemic circulation…No serious side-effects of the treatment were observed.

Conclusions: The results of this study demonstrate that topical 2% progesterone acts primarily in increasing elasticity and firmness in the skin of peri-and postmenopausal women. These effects in combination with good tolerability make progesterone a possible treatment agent for slowing down the ageing process of female skin after onset of the menopause.

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Hot Flashes and Sleep

Researchers writing in the medical journal Menopause say that ambient temperature and REM sleep patterns effect sleep in postmenopausal women.

Freedman RR, Roehrs TA.Effects of REM sleep and ambient temperature on hot flash-induced sleep disturbance. Menopause. 2006 Jul-Aug;13(4):576-83.

From the study abstract:
OBJECTIVE:: To determine whether hot flashes produce sleep disturbance in postmenopausal women.

DESIGN:: This study was performed in a university medical center laboratory with 18 postmenopausal women with hot flashes, six with no hot flashes, and 12 cycling women, all healthy and medication free. Polysomnography, skin and rectal temperatures, and skin conductance to detect hot flashes were recorded for four nights.

Nights 2, 3, and 4 were run at 30 degrees C (86 degrees F), 23 degrees C (about 73.5 degrees F), and 18 degrees C (about 64.5 degrees F) in randomized order.

RESULTS:: During the first half of the night, the women with hot flashes had significantly more arousals and awakenings than the other two groups and the 18 degrees C ambient temperature (about 64.5 degrees F) significantly reduced the number of hot flashes.

These effects did not occur in the second half of the night. In the first half of the night, most hot flashes preceded arousals and awakenings. In the second half, this pattern was reversed.

CONCLUSIONS: In the second half of the night, rapid eye movement sleep suppresses hot flashes and associated arousals and awakenings. This may explain previous discrepancies between self-reported and laboratory-reported data in postmenopausal women with hot flashes.

Hot Flashes and Insomnia

Researchers writing in the Archives of Internal Medicine say: “Severe hot flashes are strongly associated with chronic insomnia in midlife women. The presence of hot flashes should be systematically investigated in women with insomnia. Treating hot flashes could improve sleep quality and minimize the deleterious consequences of chronic insomnia.”

Ohayon MM. Severe hot flashes are associated with chronic insomnia. Arch Intern Med. 2006 Jun 26;166(12):1262-8

BACKGROUND: Because hot flashes can occur during the night, their presence has been frequently associated with insomnia in women with symptoms of menopause. However, many factors other than hot flashes or menopause can be responsible for insomnia, and several factors associated with insomnia in the general population are also commonly observed in perimenopausal and postmenopausal women who have hot flashes.

METHODS: A random sample of 3243 subjects (aged >/=18 years) representative of the California population was interviewed by telephone. Included were 982 women aged 35 to 65 years. Women were divided into 3 groups according to menopausal status: premenopause (57.2%), perimenopause (22.3%), and postmenopause (20.5%). Hot flashes were counted if they were present for at least 3 days per week during the last month and were classified as mild, moderate, or severe according to their effect on daily functioning.

Chronic insomnia was defined as global sleep dissatisfaction, difficulty initiating sleep, difficulty maintaining sleep, or nonrestorative sleep, for at least 6 months. Diagnoses of insomnia were assessed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, classification.

RESULTS: Prevalence of hot flashes was 12.5% in premenopause, 79.0% in perimenopause, and 39.3% in postmenopause. Prevalence of chronic insomnia was reported as 36.5% in premenopause, 56.6% in perimenopause, and 50.7% in postmenopause.

Prevalence of symptoms of chronic insomnia increased with the severity of hot flashes, reaching more than 80% in perimenopausal women and postmenopausal women who had severe hot flashes. In multivariate analyses, severe hot flashes were significantly associated with symptoms and a diagnosis of chronic insomnia. Poor health, chronic pain, and sleep apnea were other significant factors associated with chronic insomnia.

CONCLUSIONS: Severe hot flashes are strongly associated with chronic insomnia in midlife women. The presence of hot flashes should be systematically investigated in women with insomnia. Treating hot flashes could improve sleep quality and minimize the deleterious consequences of chronic insomnia.