SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science XIII. Sleep and Gender
0917
DOES MENOPAUSE INFLUENCE NOCTURNAL
AWAKENING WITH HEADACHE?
Lucchesi L 1 , Hachul H 1 , Speciali JG 2 , Santos-Silva R 1 , Bittencourt LA 1 ,
Tufik S 1
1
Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil,
2
Neurologia, Universidade de Sao Paulo, Ribeirao Preto, Brazil
Introduction: Our previous study presented a high prevalence of complaints
of nocturnal awakening with headache (NAH) in women, 50-59
years old, in the population of São Paulo city (Brazil). Sleep disturbances
are very frequent in menopausal transition and postmenopause. Headache
is also a common symptom in women in this period. Therefore,
our aim was to evaluate the influence of the menopausal status in the
complaint of NAH and the association with sleep disorders in the female
population of this city.
Methods: We used a population-based survey with a representative
3-stage cluster sample. All participants (N=1042) answered a sleep
questionnaire and underwent polysomnographic recording. The women
(N=576) had hormonal measures taken. They also filled out a gynecologic
questionnaire in order to be classified in premenopause, perimenopause
or postmenopause period. Perimenopausal (N=15) and pregnant
(N=2) women were excluded from the sample.
Results: The presence of NAH at least once a week in the population
studied was 8.4%. Among the women evaluated (55.3% of the total sample),
12.9% (N=75) had NAH [OR (CI 95%): 4.5 (2.9-7.4) as compared
to men]. Premenopausal women represented 63% of the female sample
and 34% were in postmenopause. We found no significant difference in
the prevalence of NAH in premenopausal or postmenopausal women
(12.4% vs. 11.7%, respectively). Moreover, we found no complaint of
NAH in postmenopausal women under hormone therapy or using isoflavone.
Insomnia and nightmares were highly frequent in women with
NAH, but the association with restless legs syndrome (RLS) was only
observed in the premenopausal women who presented NAH.
Conclusion: The frequent complaint of waking up during the night with
headache in the population of São Paulo had a great predominance in
women (four times higher) and was associated with insomnia, nightmares
and RLS. We found no influence of the menopausal status, but
interestingly no women in postmenopause under treatment complained
about NAH.
Support (If Any): AFIP, FAPESP (CEPID)
0918
INSULIN RESISTANCE AND INFLAMMATION IN
POSTMENOPAUSAL WOMEN WITH SLEEP APNEA:
EFFECTS OF CPAP
Basta M 1 , Kritikou I 1 , Vgontzas AN 1 , Nazir R 1 , Liao D 2 ,
Tsaoussoglou M 1 , Chrousos G 3 , Bixler EO 1
1
Psychiatry, Penn State College of Medicine, Hershey, PA, USA,
2
Public health Sciences, Penn State College of Medicine, Hershey, PA,
USA, 3 First Department of Pediatrics, University of Athens, Athens,
Greece
Introduction: Sleep apnea is associated with increased inflammation
and insulin resistance. However, the study of the association of the effects
of inflammatory and metabolic biomarkers, as well as continuous
positive airway pressure (CPAP) in women has been limited. The aim of
this study was to determine whether CPAP reverses hypercytokinemia
and insulin resistance in a sample of postmenopausal women with sleep
apnea.
Methods: Seventeen postmenopausal women with obstructive sleep apnea,
and twenty postmenopausal controls were monitored in the sleep
laboratory for four nights. 24h blood sampling was performed during the
fourth day for the assessment of inflammatory (IL-6, TNFR1, CRP) and
insulin resistance markers (leptin, adiponectin, fasting glucose and insulin).
The study design included two 2-month treatment periods of either
CPAP or sham/CPAP in a counterbalanced order. Prior to and following
each 2-month treatment period a 4-night PSG with a 24-hour cortisol
sample on night 4 was completed.
Results: There were not significant differences between controls and
apneics in terms of insulin resistance, and mean 24h values of leptin,
adiponectin, TNR1 and IL-6. After controlling for BMI and age, early
morning IL-6 levels were higher in the sleep apneic group compared to
controls [at 5.00 am, 6.00 am, 7.00 am (all p