月经周期对女性睡眠—觉醒和静息—活动的影响

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

目前有关月经周期对睡眠影响的研究结果并不一致,而对月经周期中昼夜睡眠-觉醒及静息-活动节律尚缺乏系统性的研究。本研究旨在观察正常育龄期女性月经周期中睡眠-觉醒及静息-活动昼夜节律的变化。我们采用静息-活动监测仪(actigraphy)和睡眠日志,调查了12个自然生活状态下健康育龄期妇女在月经周期不同阶段,即行经期、围排卵期、黄体早期及黄体晚期中睡眠与活动节律的变化。结果显示,睡眠-觉醒节律参数在四期之间无统计学显著差异;而静息-活动节律方面,所有受试女性静息-活动节律的平均日周期长度为(24.01±0.29)h,并且四期之间无显著性差异。行经期日间稳定系数(interdailystability,IS)比黄体早期显著增加(P<0.05)。黄体早期日间活动开始时间明显较黄体晚期提前(P<0.05);黄体早期的活动峰值时相比围排卵期显著提前(P<0.05)。月经周期可以影响静息-活动昼夜节律时相。而总体静息-活动数量与质量未发生显著变化;健康育龄期妇女在月经周期的各阶段中睡眠-觉醒节律亦无明显变异。

The results of previous studies on the menstrual-related sleep changes were inconsistent. The menstrual-related circadian sleep-wake and rest-activity rhythms changes are still uncertain. Using actigraphic monitoring of wrist activity, we investigated the sleep-wake and rest-activity patterns of 12 normally cyclic healthy women during reproductive life. Multivariate analyses were performedduring 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 ofcircadian sleep-wake pattern were similar in the four phases, except an increased tendency of the sleep latency in peri-ovulation phasecompared 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 theearly to mid luteal phase (P<0.05). In early to mid luteal phase, the M10 onset time was significantly earlier compared with that of thelate 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 rest-activity rhythm may be modulated by the menstrual cycle, but the quantity and quality of the rest-activity rhythm have no essentialdifferent, and that menstrual cycle may have no effects on the circadian sleep-wake rhythm in normally cyclic healthy women.