Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Insomnia related to postmenopausal syndrome: Sleep laboratory studies on differences between patients and normal controls, and influence of an estrogen-progestogen combination with dienogest versus estrogen alone and placebo
Autore:
Saletu, B; Anderer, P; Gruber, G; Mandl, M; Gruber, D; Metka, M; Huber, J; Loffler, H; Abu-Bakr, MH; Saletu-Zyhlarz, GM;
Indirizzi:
Univ Vienna, Dept Psychiat, Sect Sleep Res & Pharmacopsychiat, A-1090 Vienna, Austria Univ Vienna Vienna Austria A-1090 armacopsychiat, A-1090 Vienna, Austria Univ Vienna, Dept Gynecol Endocrinol, A-1010 Vienna, Austria Univ Vienna Vienna Austria A-1010 col Endocrinol, A-1010 Vienna, Austria Univ Alexandria, Dept Psychiat, Alexandria, Egypt Univ Alexandria Alexandria Egypt dria, Dept Psychiat, Alexandria, Egypt
Titolo Testata:
DRUGS OF TODAY
, volume: 37, anno: 2001, supplemento:, G
pagine: 39 - 62
SICI:
0025-7656(2001)37:<39:IRTPSS>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
HORMONE REPLACEMENT THERAPY; GENERALIZED ANXIETY DISORDER; POSITIVE AIRWAY PRESSURE; LEGS SYNDROME PATIENTS; NONORGANIC INSOMNIA; MENOPAUSAL WOMEN; APNEA PATIENTS; QUALITY; DISTURBANCE; MEDROXYPROGESTERONE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
82
Recensione:
Indirizzi per estratti:
Indirizzo: Saletu, B Univ Vienna, Dept Psychiat, Sect Sleep Res & Pharmacopsychiat, Wahringer Gurtel 18-20, A-1090 Vienna, Austria Univ Vienna Wahringer Gurtel 18-20 Vienna Austria A-1090 ustria
Citazione:
B. Saletu et al., "Insomnia related to postmenopausal syndrome: Sleep laboratory studies on differences between patients and normal controls, and influence of an estrogen-progestogen combination with dienogest versus estrogen alone and placebo", DRUGS TODAY, 37, 2001, pp. 39-62

Abstract

The present paper reviews two studies. In the first study, 30 patients with the ICD-10 diagnosis of insomnia (G 47.0) related to postmenopausal syndrome (N 95.1) were assessed in comparison with 16 controls. Polysomnography was used to quantify objective sleep quality and a psychometric test battery was used to evaluate subjective sleep and awakening quality, as well as morning thymopsychic and noopsychic variables. Patients showed a significantly lengthened sleep latency, increased nocturnal wakefulness and awakenings, reduced total sleep time and sleep efficiency, increased drowsiness stages S1 and stage shifts, as well as decreased S2. Subjective sleep quality was also reduced, but awakening quality and thymopsychic variables were not. In contrast, the noopsyche showed a deterioration of memory, fine motor activity, reaction time and reaction time variability, as well as increased errors of omission and commission in the reaction test. In a subsequent study, the efficacy of a combined estrogen-progestogen regimen on sleep and awakening quality in 55 insomniac postmenopausal patients was investigated in a2-month double-blind, placebo-controlled, comparative, randomized, 3-arm trial phase (regimen A: estradiol valerate 2 mg + dienogest 3 mg; regimen EV: estradiol valerate 2 mg; regimen P: placebo). This was followed by a 2-month open-label phase in which all patients received estradiol valerate 2 mg+ dienogest 2 mg as regimen A* (Climodien(R) or Lafamme(R)). Polysomnography demonstrated a moderate though nonsignificant improvement in the primaryefficacy variable wakefulness during the total sleep period with both regimen A and regimen EV compared with baseline, while under placebo only minimal changes were observed. Secondary efficacy variables concerning sleep initiation and maintenance and sleep architecture showed similar findings. Respiratory variables, such as the apnea and apnea-hypopnea indices, showed a significant improvement under regimen A, compared with both baseline and placebo. Subjective sleep and awakening quality improved significantly after regimen A and estradiol valerate compared with baseline, with the drug-induced changes being superior to those induced by placebo. In the open-label phase, subjective sleep quality improved further, significantly in the former regimen A group. Awakening quality, somatic complaints and thymopsychic variables in the morning did not yield any significant findings. Numerical memory improved significantly after regimen A compared with baseline, fine motor activity improved with regimen EV and reaction time task performance with all three compounds. In conclusion, the studied estrogen/progestogen combinations with dienogest significantly ameliorated subjective sleep quality and sleep-related breathing disorders of patients with insomnia related to a postmenopausal syndrome, while it only marginally improved variables concerning objective sleep and awakening quality. (C) 2001 Prous Science. Allrights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/07/20 alle ore 01:35:15