Changes in circadian sleep-wake and rest-activity rhythms during different phases of menstrual cycle

Transcription

1 Acta Physiologica Sinica, June 25, 2005, 57 (3): ,* ; (actigraphy) (24.01±0.29) h ( interdaily stability, IS) (P<0.05)(P<0.05); (P<0.05) Q492.5; R338.63; R Changes in circadian sleep-wake and rest-activity rhythms during different phases of menstrual cycle LIU Hong-Yan 1, BAO Ai-Min 2, ZHOU Jiang-Ning 2, LIU Rong-Yu 1,* 1 Lung Department of Geriatrics Institute, The First Affiliated Hospital of Anhui Medical University, Hefei , China; 2 Department of Neurobiology, School of Life Science, University of Science and Technology of China, Hefei , China Abstract: The results of previous studies on the menstrual-related sleep changes were inconsistent. The menstrual-related circadian sleepwake and rest-activity rhythms changes are still uncertain. Using actigraphic monitoring of wrist activity, we investigated the sleepwake and rest-activity patterns of 12 normally cyclic healthy women during reproductive life. Multivariate analyses were performed during the four phases of the menstrual cycle: menstrual phase (lst to 5th day of menstrual cycle), late follicular/peri-ovulation phase (11 th to15th day), early to mid luteal phase (18th to 23th day) and late luteal phase (25th to 28th day), respectively. The variables of circadian sleep-wake pattern were similar in the four phases, except an increased tendency of the sleep latency in peri-ovulation phase compared with the early to mid-luteal phase (19±18 vs 9±6), but unfortunately no statistical significance were found (P<0.10). Concerning the circadian patterning of rest and activity, the interdaily stability (IS) in menstrual phase was significantly higher than the early to mid luteal phase (P<0.05). In early to mid luteal phase, the M10 onset time was significantly earlier compared with that of the late follicular/peri-ovulation phase (P<0.05), and the cosinor peak time was significantly earlier compared with that of the late luteal phase (P<0.05). The circadian periodogram calculated the period length of the rhythm of average woman. The average length was (24.01±0. 29) h, and there was no significant difference among the four menstrual phases. The results suggest that the phase of circadian restactivity rhythm may be modulated by the menstrual cycle, but the quantity and quality of the rest-activity rhythm have no essential different, and that menstrual cycle may have no effects on the circadian sleep-wake rhythm in normally cyclic healthy women. Key words: circadian rhythm; menstrual cycle; rest-activity; sleep; actigraphy Received Accepted This work was supported by the National Natural Science Foundation of China (No.C030313), the Ministry of Science and Technology of China (KNAW 01CDP019) and Royal Academy of Science of Netherlands. * Corresponding author. Tel: ; Fax: ; anhuigi@mail.hf.ah.cn

2 [1,2] [1] (slow wave sleep, SWS) [1,3] ; (actigraphy) Actigraphy Rhythmwatch analysis software - - [4] Actigraphy [5] - - Binkley [6] (wrist monitors Motionlogger actigraphs) ( 8 d) 5 min ( 18 d ) - - (actigraphy Actiwatch-L-plus, Cambridge Neurotechnology, Cambridge, UK) Acta Physiologica Sinica, June 25, 2005, 57(3): ( 25~ ) 27~ 30 d (BMI kg/m 2 ) 6 12 [2] ~7 d (1) 1~5 d( Phase ) (2) 11~15 d( Phase ) (3) 18~23 d( Phase ) (4) 25~28 d( Phase ) B B (Actiwatch analysis software 98 version 4.6, Cambridge Neurotechnology, Cambridge, UK) - (Rhythmwatch analysis software) - (Sleepwatch analysis software) Rhythmwatch analysis software (Cambridge Neurotechnology, Cambridge, UK) [7] - (1) (interdaily stability, IS): 24 h - [8] ; (2) (intradaily variability, IV):

3 : - - (3) (maximum 10 h activity, M10) 10 h (4) - (amplitude, AMP) (5)24 h (average-score); (6)(M10 onset); (7)(L5 onset) L5 5 h L5 onset L5 (8) (cosinor peak time) - - Sleepwatch analysis software (Cambridge Neurotechnology, Cambridge, UK) - actigraphy 15 [9] - (1)(time in bed, TIB); (2) (actual sleep time, AST); (3) (actual wake time, AWT); (4) (sleep efficiency, SE); (5) (sleep latency, SL); (6) (wake bouts, WB); (7)(fragmentation index, FI) SPSS10.0 (general linear models) (ANOVA for repeated measure) Green- 391 house-geisser ε t (circular statistics) Mardia-Watson- Wheeler s [2] α= (P>0.05) (SL) (19±18 vs 9±6 P< ) (24.01±0.29) h ( 1) 1. - Fig. 1. Circadian periodogram calculated using periods from 16 to 32 h. The peak value of the periodogram represents the period length of the rhythm and it occurred at Table 1. Menstrual-related differences in the circadian sleep-wake cycle (mean ± SD) Variables Phase Phase Phase Phase TIB (min) 469±30 467±68 460±56 450±56 AST (min) 391±54 386±60 389±74 378±71 AWT (min) 58±15 58±24 53±24 58±20 SE (%) 83.09± ± ± ±4.98 SL (min) 12±15 19±18 9±6 10±10 WB 31±12 30±15 26±14 25±13 FI 34.76± ± ± ±3.86 TIB, time in bed; AST, actual sleep time; AWT, actual wake time; SE, sleep efficiency; SL, sleep latency; WB, wake bouts; FI, fragmentation index. Phase, menstrual phase; Phase, peri-ovulation phase; Phase, early to mid-luteal phase; Phase, late luteal phase.

4 392 Acta Physiologica Sinica, June 25, 2005, 57(3): Table 2. Menstrual-related differences in the circadian rest-activity rhythm (mean ± SD) Variables Phase Phase Phase Phase IS 0.65±0.06 * 0.56± ± ±0.14 IV 1.0± ±0.18 ** 0.96± ±0.23 M ± ± ± ±7635 AMP 14477± ± ± ±7020 Average 153±96 141±61 154±82 154±90 M10 onset 8:08±2:04 8:29±2:08 6:58±1:27 # 8:58±1:30 L5 onset 0:33±1:04 0:30±0:48 0:20±0:37 0:39±1:03 CPT 13:48±1:30 14:07±1:25 13:31±0: :12±1:07 IS, interdaily stability; IV, intradaily variability; M10, maximum 10 h activity; AMP, amplitude of the rhythm; Average, average-score; M10 onset, M10 onset time; L5 onset, L5 onset time; CPT, cosinor peak time. The unit for M10 onset, L5 onset, CPT is hour: minute (time point). * P<0.05 vs phase, ** P=0.10 vs phase, # P<0.05 vs phase (Mardia-Watson-Wheeler χ 2 =7.526 df=2), + P<0.05 vs phase (Mardia-Watson-Wheeler χ 2 =6.44 df=2). 2. Fig. 2. Representative actograms of four menstrual phases, which were registered by actigraphy for about 4~5 consecutive days. Each black bar represents the activity counts in one hour. Note that the interdaily stability (IS) of the phase is much higher than those of other three phases. Furthermore, note that the higher frequency of transitions between rest and activity in phase, indicating the higher intradaily variability (IV) and the fragmentation of the circadian rest-activity rhythm.

5 : d (24 h 5 d) 393 1~2 h (Mardia-Watson-Wheeler χ 2 =7.526 df=2 P<0.05); 0.5 h (Mardia- Watson-Wheeler χ 2 =6.44 df=2 P<0.05)( 3) h Fig. 3. Distribution of the average M10 onset time, cosinor peak time, L5 onset time of all subjects in four menstrual cycle phase., M10 onset;, cosinor peak time;, L5 onset. The Y-axis is events (activity or no acitivity per 1-minute interval); the X-axis is time (24 h) plotted beginning at 04:00 so that the activity period is not interrupted by midnight (IS) - (IS) (P<0.05) (IV) - IV - 24 h (M10 onset) 24 h - (24.01±0.29) h - - Binkley [6] actigraphy - Binkley ( ) Kayo [1] SWS 17:00~ 00:30 01:00~08:30 SWS Manber [10] 1997

6 394 Acta Physiologica Sinica, June 25, 2005, 57(3): actigraphy actigraphy * * * 1 Kayo S, Makoto U, Masako O, Yoshihisa K, Keiko K, Xianchen Liu, Yuichi K, Tatsuro H, Tatsuya A, Katsuya O, Kenichi I. Diurnal fluctuation of sleep propensity and hormonal secretion across the menstrual cycle. Biol Psychiat, 2000; 48: Bao AM, Liu RY, Van Someren EJW, Hofman MA, Zhou JN. Changes in diurnal rhythms of free cortisol secretion during different phases of menstrual cycle. Acta Physiol Sin ( ) 2003; 55(5): Parry BL, Mendelson WB, Duncan WC, Sack DA, Wehr TA. Longitudinal sleep EEG, temperature, and activity measurements across the menstrual cycle in patients with premenstrual depression and in age-matched controls. Psychiat Res 1989; 30: Huang YL, Liu RY, Wang QS, Van Someren EJW, Xu H, Zhou JN. Age-associated difference in circadian sleep-wake and restactivity rhythms. Physiol Behav 2002; 76: Tryon WW. Activity Measurement in Psychology and Medicine. New York: Plenum Press, Binkley S. Wrist activity in a woman: daily, weekly, menstrual, lunar, annual cycles? Physiol Behav 1992; 52(3): Van Someren EJW, Swaab DF, Colenda CC, Cohen W, McCall WV, Rosenquist PB. Bright light therapy: improved sensitivity to its effects on rest-activity rhythms in Alzheimer patients by application of nonparametric methods. Chronobiol Int 1999; 16: Sokolove PG, Bushell WN. The chi square periodogram: its utility for analysis of circadian rhythms. J Theor Biol 1978; 72: Chang A, Kushida C, Palombini L, Carrillo O, Hindman J, Hong S, Hyde P, Guilleminault C. Comparison study of actigraphic, polysomnographic, and subjective perception of sleep parameters. Sleep 1999; 22: S Manber R, Bootzin RR. Sleep and the menstrual cycle. Health Psychol 1997; 16(3):