Longitudinal sleep EEG, temperature, and activity measurements across the menstrual cycle in patients with premenstrual depression and in age-matched controls
Abstract
After a 2-month evaluation period, eight women with moderate to severe premenstrual depression and eight age- and sex-matched controls underwent sleep electroencephalographic (EEG) and temperature recordings 2 nights a week over the course of one menstrual cycle. Overall, patients had more Stage 2 (%) sleep and less rapid eye movement (REM) sleep (% and minutes) than normal controls. Stage 3 sleep and number of intermittent awakenings varied with phases of the menstrual cycle. Temperature minima were earlier in patients compared with controls, but this difference was not statistically significant, and there was no significant effect of menstrual cycle phase on the timing of temperature minima. Wrist motor activity did not change during the menstrual cycle in patients or controls. Thus, in this sample of women with premenstrual depression, we did not find sleep EEG alterations similar to those reported in some patients with major depressive disorder. In light of the small number of subjects and the large individual variability, the absence of marked changes with the menstrual cycle may be a function of a Type II error.
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A four-phase study found significant menstrual phase variations for stage 3 sleep, with a trough at the late luteal phase, and for intermittent awakenings, with a peak at the late luteal phase.
“The first, which included eight healthy participants at the early-FP, the late-FP, the early-LP and the late-LP, found significant menstrual phase variations for stage 3 sleep (min), with a trough at the late-LP, and intermittent awakenings, with a peak at the late-LP [45].”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [45]
A second four-phase study found a significant variation only for slow wave sleep, which was lowest during the luteal phase compared with the late follicular phase and menses.
“The second, which included recordings of seven healthy females at menses, the late-FP, the early-LP and the late-LP, only found a significant variation for SWS (min), which, like the aforementioned study [45], was lowest during the LP compared to the late-FP and menses [47].”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [45]
There is a nonsignificant trend for a phase-advanced temperature minimum in PMDD patients compared to controls across the entire menstrual cycle.
“Finally, a nonsignificant trend for a phase-advanced temperature minimum in PMDD patients compared to controls was observed across the entire menstrual cycle [45].”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [45]
Compared with controls, PMS patients had more stage 2 sleep and less REM sleep, and within these patients stage 3 sleep and intermittent awakenings varied significantly across the menstrual cycle.
“Another study revealed that, compared to controls, PMS patients had more stage 2 sleep (%) and less REM sleep (%), and within these patients, stage 3 sleep (min; peaks near the late-FP/early-LP) and intermittent awakenings (peaks near the late-LP) varied significantly across the menstrual cycle [45].”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [45]
PMDD women show a tendency for phase-advanced CBT rhythms compared to controls.
“Lending further support to the idea that PMDD women experience a phase-advance of circadian rhythms similar to what is observed in MDD [108], these women also experienced a tendency for phase-advanced CBT rhythms as well as significantly advanced melatonin and TSH when compared with controls (Table 2).”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [45]
Some PSG studies have shown increased stage 2 sleep and decreases in SWS or REM sleep in PMDD compared to healthy women.
“PSG-based studies do not consistently demonstrate disrupted objective sleep in PMDD (see Table 1), though some have shown increased stage 2 sleep and decreases in SWS or REM sleep compared to healthy women [45, 46].”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [45]
Some studies have reported further nocturnal increases and phase-advanced CBT rhythms in PMS/PMDD patients compared to healthy women.
“Some studies have reported further nocturnal increases and phase-advanced rhythms in PMS/PMDD patients compared to healthy women [45, 104].”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [45]
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- Authors
- Parry, B. L., Mendelson, W. B., Duncan, W. C., Sack, D. A., & Wehr, T. A.
- Affiliations
- University of California San Diego (US)
- State University of New York (US)
- National Institute of Mental Health (US)
- Long Beach Medical Center (US)
- Corresponding author
- Parry, Barbara L.
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 1989-12
- Volume
- 30
- Issue
- 3
- Pages
- 285-303
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2129353454
- Cited by
- 135
- References
- 42
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 4 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 5 · 2015: 2 · 2014: 3 · 2013: 3 · 2012: 7
- FWCI
- 4.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- premenstrual depression, menstrual cycle, sleep EEG, REM sleep, stage 2 sleep, body temperature, sleep architecture, women's mental health
- MeSH terms
- Adult, Body Temperature Regulation, Cerebral Cortex, Circadian Rhythm, Depressive Disorder, Electroencephalography, Evoked Potentials, Female, Humans, Menstrual Cycle, Pregnancy, Premenstrual Syndrome, Puerperal Disorders, Gonadal Steroid Hormones, Sleep Stages, Sleep, REM
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