Regulation of Negative and Positive Affect by an Experimentally Induced Sleep Fragmentation and Estradiol Withdrawal Paradigm Mimicking Menopause

Margo Nathan, MD
Department of Psychiatry
Poster Overview

Background: Women are at risk for emotional dysregulation during the menopausal transition. We examined changes in negative and positive emotions when healthy women were exposed to sleep interruption and withdrawal of estrogen mimicking menopause.

 

Methods: 17 healthy premenopausal women had a 5-day inpatient stay during the high-estrogen follicular menstrual phase that included undisturbed sleep followed by experimentally induced sleep fragmentation. A subset (n=10) repeated these procedures after receiving the medication leuprolide which suppresses estrogen. Positive/negative emotions were evaluated using the Positive Affect Negative Affect Schedule (PANAS; range 10-50/each; higher=more positive/negative emotions).

 

Results: During high estrogen state, negative emotions increased by 18% after sleep fragmentation compared to after unfragmented sleep (p=0.007) and positive emotions decreased by 13% (p=0.02). Under low estrogen conditions, negative emotions increased by 20% after sleep fragmentation (p=0.02) and positive emotions decreased by 26% (p=0.006).

 

Conclusions: Exposure to sleep fragmentation precipitates adverse effects on both negative and positive emotion in healthy women under both high and low estrogen states. These findings provide important insights for how emotions respond rapidly to sleep disturbance and hormonal shifts common in menopause.

Scientific Abstract

Background: Women are at risk for affective dysregulation during the menopausal transition. We examined changes in negative and positive affect when healthy women were exposed to an experimental sleep fragmentation and estradiol withdrawal paradigm to mimic menopause.

 

Methods: 17 healthy premenopausal women had a 5-day inpatient stay during the high-estradiol mid-to-late-follicular menstrual phase that included unfragmented sleep followed by experimentally induced fragmented sleep. A subset (n=10) repeated these procedures after experimentally induced estradiol withdrawal. Affect was evaluated daily using the Positive Affect Negative Affect Schedule (PANAS; range 10-50/each; higher=more positive/negative affect).

 

Results: During high estradiol state, negative affect increased by 18% after sleep fragmentation compared to after unfragmented sleep (p=0.007) and positive affect decreased by 13% (p=0.02). When hypoestrogenic, negative affect increased by 20% after sleep fragmentation (p=0.02) and positive affect decreased by 26% (p=0.006).

 

Conclusions: Exposure to sleep fragmentation precipitates both adverse negative and positive affective changes in healthy women when estrogenized and after estradiol withdrawal. These findings provide important insights for how affect responds rapidly to sleep disturbance and hormonal shifts common in menopause, which may contribute to the elevated risk for mood disturbance.

Clinical Implications
These findings show that healthy women are susceptible to adverse emotional changes when exposed to sleep disruption and hormonal changes characteristic of the menopausal transition. This contributes to our understanding of risk factors for emotional disturbance during midlife.
Research Areas
Authors
Margo Nathan, Mathena Abramson, Shadab Rahman, Aleta Wiley, Aviva Cohn, Hadine Joffe
Principal Investigator
Hadine Joffe MD MSc

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