Women with primary ovarian insufficiency receiving hormone therapy report poorer sleep quality — including taking longer to fall asleep and more fatigue — than similarly aged women with preserved ovarian function, according to findings from a cross-sectional study.
“[Primary] ovarian insufficiency causes physical and psychological effects resulting from hypoestrogenism, such as the loss of fertility, bone loss, an increased cardiovascular risk, psychological disturbances, altered sexuality, and even the risk of earlier mortality,” Cristina Laguna Benetti-Pinto, MD, PhD, a professor in the department of gynecology and obstetrics at the University of Campinas School of Medical Sciences in Sao Paulo, and colleagues wrote. “The treatment must minimize such repercussions. One of the seemingly overlooked or unknown aspects is the repercussion of early hypoestrogenism on sleep quality and fatigue, and also the extent to which HT can act on these aspects.”
Benetti-Pinto and colleagues analyzed data from 61 women with primary ovarian insufficiency (POI) receiving HT (mean duration of HT, 7.84 years; 75% nulliparous) and 61 women with preserved ovarian function (controls) who were matched by age, recruited between June 2016 and September 2017 (mean age, 35 years). Women completed the Pittsburgh Sleep Quality Index (PSQI) and Chalder Fatigue Scale to assess sleep quality and fatigue.
Researchers found that PSQI scores were similar between groups, with mean scores of 7.69 and 8.03 for women with POI and controls, respectively (P = .79).
“However, considering that the cutoff level adopted to indicate poor sleeping quality for this scale is 5, it was verified that the average/mean scores pointed toward poor sleep quality in both groups,” the researchers wrote.
Women with primary ovarian insufficiency receiving hormone therapy report poorer sleep quality — including taking longer to fall asleep and more fatigue — than similarly aged women with preserved ovarian function.
Researchers also observed that the women with POI had higher and, therefore, worse scores for the sleep latency component (mean scores, 1.74 vs. 1.18; P < .001) and use of medication to sleep (mean scores, 1.28 vs. 0.85; P = .008).
In comparing fatiguability, women with POI had higher fatigue indices vs. controls (mean scores, 5.25 vs. 3.49; P < .001), with fatigue present in 59% of women with POI and 18% of controls, according to the researchers.
In correction analysis, researchers found that the total sleep quality score for women with POI was correlated with number of children, meaning sleep quality was worse among women with a greater number of children (P = .001).
“Our results show that women with POI receiving HT have poor sleep quality, but it is similar to that of women of the same age with preserved ovarian function; however, the former presented with a higher rate of fatigue,” the researchers wrote. “Variables directly related to ovarian insufficiency, such as the diagnosis time or treatment time, were not related to sleep; nevertheless, it was found that the greater the number of children, the worse the quality of sleep.”
The researchers wrote that the findings suggest clinicians should discuss and evaluate sleep quality when treating women with POI. – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.