Irene Gonsalvez, MD

Pronouns

She/her

Rank

Instructor

Institution

Brigham and Women's Hospital/ Harvard Medical School

Department

Psychiatry

Authors

Irene Gonsalvez, Jessica A. Harder, Margo D. Nathan, Doruntina Fida, Hannah Kim, Aleta Wiley, Hadine Joffe, Shadab A. Rahman.

Principal Investigator

Categories:

Acute Effects of Sleep Interruption on Mood Disturbance and Oxytocin in Women Under High and Low Estradiol Conditions

Abstract

Background: Reproductive transitions in women are characterized by behavioral (e.g., sleep interruption) and physiological (e.g., decline in estradiol) changes, which can increase susceptibility to mood disturbance. Whether oxytocin, which is critical during labor and postpartum, plays a role in mitigating mood disturbance during reproductive transitions is unclear. We examined the impact of sleep interruption and pharmacologic estradiol suppression on mood disturbance and oxytocin levels in an experimental model that mimics both the menopausal and postpartum transitions.
Methods: Healthy premenopausal women completed two 5-night inpatient studies (2 nights of uninterrupted sleep followed by 3 nights of experimentally induced sleep interruption, with similar sleep duration in both conditions, ~7 hours/night), once in the mid-to-late follicular phase (n=38) and again after pharmacological estradiol suppression (n=27). Mood disturbance was evaluated using the Profile of Mood States (POMS) and oxytocin was measured by LCMS. In both estradiol states, mood assessments were performed in the morning and serum samples for oxytocin were collected in the afternoon (~9 hours after the mood assessments, assay analysis ongoing, ~80% completed).
Results: Analysis of available data show that, across both estradiol states, sleep interruption significantly increased mood disturbance (n=37, [mean±SE] 12.3±2.4 vs. 5.5±2.4, p<0.0001) and oxytocin levels (n=38, 37.2±2.4 vs. 30.5±2.6, p=0.02) after sleep interruption. Estradiol suppression increased mood disturbance and oxytocin levels, but these changes did not reach statistical significance (both ~6% higher; both p≥0.17). More mood disturbance was significantly associated with higher oxytocin levels (n=37, Cohen’s d=0.54, p=0.048). Conclusion: Sleep interruption acutely increases both mood disturbance and oxytocin levels in healthy women. These results indicate an association between oxytocin and mood disturbance during reproductive transitions, and underscore the need to treat sleep interruption, even when sleep duration may be sufficient. Further studies are needed to better characterize the impact of oxytocin on mood.

Research Context

Mood disturbances are highly prevalent throughout reproductive transitions in women. 50% of women experience mood disturbance lasting up to several months postpartum, while during the perimenopausal transition there is a 1.5- to 3-fold greater risk of first onset depression. Multiple factors have been shown to increase the risk of postpartum and perimenopausal mood disturbance, including sleep disturbances, changes in the endocrine milieu (i.e., significant decrease in progesterone and estradiol) psychosocial factors including history of psychiatric disorder, marital conflict, lack of social support, and stressful life events. A lot of efforts have been dedicated to the early diagnosis and treatment implementation for mood disorders, however, less has been done to focus on identifying resilience factors and promotion of those to prevent mood disturbances. In this project, we explore the potential role of oxytocin as a resilience factor of mood disturbance during reproductive transitions in women.