Trastornos del sueño relacionados con el climaterio femenino y su tratamiento

Autores/as

  • Franklin Escobar-Córdoba
  • Heydy Luz Chica-Urzola
  • Francisco Cuevas-Cendales

DOI:

https://doi.org/10.18597/rcog.419

Palabras clave:

climaterio, menopausia, premenopausia, quimioterapia, terapia de reemplazo de hormonas, trastornos del sueño

Resumen

Objetivo: revisar los aspectos fisiológicos del sueño, el efecto de la menopausia sobre el sueño, el diagnóstico y el tratamiento de las alteraciones del sueño asociadas a la menopausia.

Resultados: los trastornos del sueño son patologías cada vez más frecuentes en la población general, con importantes consecuencias sobre la calidad de vida de quien los padece, por esto deben ser juiciosamente estudiados, diagnosticados y tratados. En el caso de la mujer, estos trastornos pueden aparecer ligados a cambios hormonales importantes durante el climaterio y evolucionar hasta modificar su comportamiento habitual, volviéndose sintomáticos.

Conclusiones: el tratamiento de estos TS es sintomático y la TRH es la más aceptada para las oleadas de calor. Para el insomnio transitorio se recomienda el uso de hipnóticos y para TS preexistentes, que progresan durante este periodo, se recomienda la interconsulta a medicina del sueño, con miras a que dicho tratamiento sea adecuado y específico. Ante la evidencia controversial o insuficiente de muchos de los tópicos del tratamiento, es necesaria la realización de estudios clínicos adicionales.

Biografía del autor/a

Franklin Escobar-Córdoba

Profesor Asociado de Psiquiatría. Facultad de Medicina. Universidad Nacional de Colombia. Ancien Assistant Etranger du Service d’Explorations Fonctionnelles du Système Ner veux. CHU Rangueil Toulouse - France. Université Paul Sabatier - Toulouse III. Doctor (PhD) en Medicina. Universidad Nacional de La Plata, Argentina. 

Heydy Luz Chica-Urzola

Psiquiatra. Universidad Nacional de Colombia. Hospital Santa Clara. Bogotá, Colombia.

Francisco Cuevas-Cendales

Gineco-obstetra y epidemiólogo. Universidad Nacional de Colombia. Coordinador servicio de gineco-obstetricia Clínica San Pedro Claver. Bogotá, Colombia.

Referencias bibliográficas

Medicine Net I. Visitado 2008, Mar 5. Disponible en: http://www.medicinenet.com

American Sleep Disorders Association. Internacional classification of sleep disorders, revised, diagnostic and coding manual. Rochester: American Sleep Disorders Association; 1997.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, DSM-IV-TR. Washington: The American Psychiatric Association; 2002.

Escobar-Córdoba F, Echeverry-Chabur J, Lorenzana-Pombo P. Evaluación clínica del insomnio. (1ª Parte). Rev Fac Med Univ Nac Colomb 2001;49:81-8.

Léger D, Poursain B, Neubauer D, Uchiyama M. An international survey of sleeping problems in the general population. Curr Med Res Opin 2008;24:307-17.

Bixler EO, Vgontzas AN, Lin HM, Vela-Bueno A, Kales A. Insomnia in central Pennsylvania. J Psychosom Res 2002;53:589-92.

Bixler E, Kales A, Soldatos C, Kales J, Healy S. Prevalence of sleep disorders in the Los Angeles metropolitan area. Am J Psychiatr y 1979;136:1257-62.

Chica-Urzola H, Escobar-Córdoba F, Echeverry-Chabur J. Evaluación clínica del hipersomnio. Rev Colomb Psiquiatr 2004;33:45-63.

Zautra AJ, Fasman R, Parish BP, Davis MC. Daily fatigue in women with osteoarthritis, rheumatoid arthritis, and fibromyalgia. Pain 2007;128:128-35.

Pallesen S, Nordhus IH, Omvik S, Sivertsen B, Tell GS, Bjorvatn B. Prevalence and risk factors of subjective sleepiness in the general adult population. Sleep 2007;30:619-24.

Latimer Hill E, Cumming RG, Lewis R, Carrington S, Le Couteur DG. Sleep disturbances and falls in older people. J Gerontol A Biol Sci Med Sci 2007;62:62-6.

Hublin C, Partinen M, Koskenvuo M, Kaprio J. Sep and mortality: a population-based 22-year follow-up study. Sleep 2007;30:1245-53.

Zhang L, Samet J, Caffo B, Punjabi NM. Cigarette smoking and nocturnal sleep architecture. Am J Epidemiol 2006;164:529-37.

Soares CN, Murray BJ. Sleep disorders in women: clinical evidence and treatment strategies. Psychiatr Clin North Am 2006;29:1095-113.

Crum RM, Storr CL, Chan YF, Ford DE. Sleep disturbance and risk for alcohol-related problems. Am J Psychiatry 2004;161:1197-203.

Hauri PJ, Esther MS. Insomnia. Mayo Clin Proc 1990;65:869-82.

Escobar-Córdoba F. Trastornos del sueño asociados a alteraciones psiquiátricas. En: Osuna E, ed. Enfoque del paciente con trastornos del sueño. Bogotá -Colombia: Asociación Colombiana de Medicina del Sueño; 2000. p. 57-69.

Calvet U, Escobar-Córdoba F. Impotencia y sueño. Vigilia y sueño 1999;11:111-25.

Roth T, Roehrs T, Pies R. Insomnia: pathophysiology and implications for treatment. Sleep Med Rev 2007;11:71-9.

Parish JM, Adam T, Facchiano L. Relationship of metabolic syndrome and obstructive sleep apnea. J Clin Sleep Med 2007;3:467-72.

Thorpy MJ, Adler CH. Parkinson’s disease and sleep. Neurol Clin 2005;23:1187-208.

Cole MG, Dendukuri N. Risk factors for depression among elderly community subjects: a systematic review and meta-analysis. Am J Psychiatry 2003;160:1147-56.

Winfree AT. Circadian timing of sleepiness in man and woman. Am J Physiol 1982;243:R193-204.

Young T. Menopause, hormone replacement therapy, and sleep-disordered breathing: are we ready for the heat? Am J Respir Crit Care Med 2001;163:597-8.

Attarian HP. Helping patients who say they cannot sleep. Practical ways to evaluate and treat insomnia. Postgrad Med 2000;107:127-42.

Osuna E, Rubiano A. Ayudas diagnósticas. En: Principios de la medicina del sueño. Bogotá - Colombia: Upjohn Company; 1994.

Sateia MJ, Doghramji K, Hauri PJ, Morin CM. Evaluation of chronic insomnia. An American Academy of Sleep Medicine review. Sleep 2000;23:243-308.

Osuna E. Consenso Asociación Colombiana de Medicina del Sueño. El Polisomnograma. En: Asociación Colombiana de Medicina del Sueño, ed. Enfoque del paciente con trastornos del sueño Asociación Colombiana de Medicina del Sueño Bogotá, Colombia; 2000. p. 23-33.

Gallup Organization. Sleep in America. Princeton, NJ.: The Gallup Organization; 1991.

Sleep in America: Gallup Poll conducted for the National Sleep Foundation. National Sleep Foundation; 1995.

National Comission on Sleep Disorders Research. Wake up America: A national sleep alert. Bethesda, MD; 1995.

Orr W, Stahl ML, Dement WC, Reddington D. Physician education in sleep disorders. J Med Educ 1980;55:367-9.

Borbély A. A two-process model of sleep regulation. Hum Neurobiol 1982;1:195-204.

Folkard S, Akerstedt T. Toward a model for the prediction of alertness and/or fatigue on different sleep/wake schedules. En: Oginski A, Polorski J, Rutenfranz J, eds. Contemporary Advances in Shiftwork Research: Theoretical and Practical Aspects in the Late Eighties. Krakow, Poland: Medical Academy; 1987. p. 231-40.

Foret J. Variations spontanées et expérimentales. En: Benoît O, ed. Le sommeil humain Bases expérimentales, physiologiques et physiopathologiques. 2 ed. Paris: Masson; 1995. p. 75-88.

Kupfer DJ. Pathophysiology and management of insomnia during depression. Ann Clin Psychiatry 1999;11:267-76.

Ball EM. Sleep disorders in primary care. Compr Ther 1997;23:25-30.

Daan S, Bersma DG, Borbély AA. Timing of human sleep: Recovery process gated by circadian pace-maker. Am J Physiology 1984;246:R161-R83.

McCarley RW. Neurobiology of REM and NREM sleep. Sleep Med 2007;8:302-30.

Harris CD. Neurophysiology of sleep and wakefulness. Respir Care Clin N Am 2005;11:567-86.

Sinton CM, McCarley RW. Neuroanatomical and neurophysiological aspects of sleep: basic science and clinical relevance. Semin Clin Neuropsychiatry 2000;5:6-19.

Kayumov L, Zhdanova IV, Shapiro CM. Melatonin, sleep, and circadian rhythm disorders. Semin Clin Neuropsychiatry 2000;5:44-55.

Vanitallie TB. Sleep and energy balance: Interactive homeostatic systems. Metabolism 2006;55:S30-5.

Escobar-Córdoba F. Trastornos del sueño. En: Arteaga C, Ospina J, eds. Recomendaciones básicas para la atención de los trastornos psiquiátricos. Bogotá, Colombia: Asociación Colombiana de Psiquiatría, Noosfera Editorial; 1999. p. 119-33.

Iber C, Ancoli-Israel S, Chesson A, Quan S. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. First ed. Westchester, Illinois: American Academy of Sleep Medicine; 2007.

Eiser AS. Physiology and psychology of dreams. Semin Neurol 2005;25:97-105.

Dement WC. The paradox of sleep: the early years. Arch Ital Biol 2004;142:333-45.

Sinton CM, McCarley RW. Neurophysiological mechanisms of sleep and wakefulness: a question of balance. Semin Neurol 2004;24:211-23.

Walker MP, Liston C, Hobson JA, Stickgold R. Cognitive flexibility across the sleep-wake cycle: REM-sleep enhancement of anagram problem solving. Brain Res 2002;14:317-24.

National Institutes of Health. National Institutes of Health State-of-the-Science Conference Statement. Management of Menopause-Related Symptoms. Ann Intern Med 2005;142:1003-13.

Arigo D, Kloss JD, Kniele K, Gilrain K. Beliefs about sleep and perceived sleep quality are associated with quality of life among perimenopausal women. Behav Sleep Med 2007;5:241-55.

Bachmann GA. Vasomotor flushes in menopausal women. Am J Obstet Gynecol 1999;180:S312-6.

Gelfand MM. Role of androgens in surgical menopause. Am J Obstet Gynecol 1999;180:S325-7.

Erlik Y, Tataryn IV, Meldrum DR, Lomax P, Bajorek JG, Judd HL. Association of waking episodes with menopausal hot flushes. JAMA 1981;245:1741-4.

Shaver JL, Zenk SN. Sleep disturbance in menopause. J Women Health Gend Based Med 2000;9:109-18.

Manber R, Armitage R. Sex, steroids, and sleep: a review. Sleep 1999;22:540-55.

Ohayon MM. Severe hot flashes are associated with chronic insomnia. Arch Intern Med 2006;166:1262-8.

Manber R, Bootzin RR. Sleep and the menstrual cycle. Health Psychol 1997;16:209-14.

Mauri M. Sleep and the reproductive cycle: a review. Health Care Women Int 1990;11:409-21.

Miller EH. Women and insomnia. Clin Cornerstone 2004;6(Suppl 1B):S8-18.

Millman RP, Carlisle CC, McGarvey ST, Eveloff SE, Levinson PD. Body fat distribution and sleep apnea severity in women. Chest 1995;107:362-6.

Moline ML, Broch L, Zak R, Gross V. Sleep in women across the life cycle from adulthood through menopause. Sleep Med Rev 2003;7:155-77.

Leineweber C, Kecklund G, Akerstedt T, Janszky I, Orth-Gomér K. Snoring and the metabolic syndrome in women. Sleep Med 2003;4:531-6.

Gislason T, Benediktsdóttir B, Björnsson JK, Kjartansson G, Kjeld M, Kristbjarnarson H. Snoring, hypertension, and the sleep apnea syndrome. An epidemiologic survey of middle-aged women. Chest 1993;103:1147-51.

Ohayon MM, Roth T. What are the contributing factors for insomnia in the general population? J Psychosom Res 2001;51:745-55.

Roth T. Insomnia: definition, prevalence, etiology, and consequences. J Clin Sleep Med 2007;3:S7-10.

D’Ambrosio C, Stachenfeld NS, Pisani M, Mohsenin V. Sleep, breathing, and menopause: the effect of fluctuating estrogen and progesterone on sleep and breathing in women. Gend Med 2005;2:238-45.

Collop NA, Adkins D, Phillips BA. Gender differences in sleep and sleep-disordered breathing. Clin Chest Med 2004;25:257-68.

Young T, Finn L, Austin D, Peterson A. Menopausal status and sleep-disordered breathing in the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med 2003;167:1181-5.

Franceschi M, Zamproni P, Crippa D, Smirne S. Excessive daytime sleepiness: a 1-year study in an unselected inpatient population. Sleep 1982;5:239-47.

Mitler MM. US Modafinil in Narcolepsy Multicenter Study Group: Modafinil for the treatment of pathological somnolence in patients with narcolepsy. Sleep Res 1997;26:527.

Dávila M. Los parasomnios. En: Osuna E. ed. Enfoque del paciente con trastornos del sueño. Bogotá - Colombia: Asociación Colombiana de Medicina del Sueño; 2000. p. 94-113.

Walters JF, Hampton SM, Ferns GA, Skene DJ. Effect of menopause on melatonin and alertness rhythms investigated in constant routine conditions. Chronobiol Int 2005;22:859-72.

Haimov I, Lavie P, Laudon M, Herer P, Vigder C, Zisapel N. Melatonin replacement therapy of elderly insomniacs. Sleep 1995;18:598-603.

Kravitz H, Janssen I, Santoro N, Bromberger J, Schocken M, Everson-Rose S, et al. Relationship of day-to-day reproductive hormone levels to sleep in midlife women. Arch Intern Med 2005;165:2370-6.

Shin C, Lee S, Lee T, Shin K, Yi H, Kimm K, et al. Prevalence of insomnia and its relationship to menopausal status in middle-aged Korean women. Psychiatry Clin Neurosci 2005;59:395-402.

Hsu HC, Lin MH. Exploring quality of sleep and its related factors among menopausal women. J Nurs Res 2005;13:153-64.

Viot-Blanc V. Modèles biologiques de la dépression: l’effet des antidépresseurs sur le sommeil. L’Encéphale 1995;7:35-40.

O´Connell E. Mood, energy, cognition, and physical complaints: a mind/body approach to symptom management during the climacteric. J Obstet Gynecol Neonatal Nurs 2005;34:274-9.

Carranza-Lira S, Gooch AL, Saldivar N, Osterwalder MS. Climacteric symptom control after the addition of low-dose esterified conjugated estrogens to raloxifene standard doses. Int J Fertil Womens Med 2007;52:93-6.

Alexander JL, Neylan T, Kotz K, Dennerstein L, Richardson G, Rosenbaum R. Assessment and treatment for insomnia and fatigue in the symptomatic menopausal woman with psychiatric comorbidity. Expert Rev Neurother 2007;7:S139-55.

Eichling PS, Sahni J. Menopause related sleep disorders. J Clin Sleep Med 2005;1:291-300.

Saletu-Zyhlarz G, Anderer P, Gruber G, Mandl M, Gruber D, Metka M, et al. Insomnia related to postmenopausal syndrome and hormone replacement therapy: sleep laboratory studies on baseline differences between patients and controls and double-blind, placebo-controlled investigations on the effects of a novel estrogen-progestogen combination (Climodien, Lafamme) versus estrogen alone. J Sleep Res 2003;12:239-54.

Zuleta JJ. Visión actual de la terapia de sustitución hormonal en la mujer posmenopáusica. Rev Colomb Obstet Ginecol 2005;56:46-58.

Sarti C, Chiantera A, Graziottin A, Ognisanti F, Sidoli C, Mincigrucci M, et al. Hormone therapy and sleep quality in women around menopause. Menopause 2005;12:545-51.

Heinrich A, Wolf O. Investigating the effects of estradiol or estradiol/progesterone treatment on mood, depressive symptoms, menopausal symptoms and subjective sleep quality in older healthy hysterectomized women: a questionnaire study. Neuropsychobiology 2005;52:17-23.

Gambacciani M, Ciaponi M, Cappagli B, Monteleone P, Benussi C, Bevilacqua G, et al. Effects of low-dose, continuos combined hormone replacement therapy on sleep in symptomatic postmenopausal women. Maturitas 2005;50:91-7.

Wesstrom J, Ulfberg J, Nilsson S. Sleep apnea and hormone replacement therapy: a pilot study and a literature review. Acta Obstet Gynecol Scand 2005;84:54-7.

Alhola P, Tallus M, Kylmälä M, Portin R, Polo-Kantola P. Sleep deprivation, cognitive performance, and hormone therapy in postmenopausal women. Menopause 2005;12:149-55.

Morin AK, Jarvis CI, Lynch AM. Therapeutic options for sleep-maintenance and sleep-onset insomnia. Pharmacotherapy 2007;27:89-110.

Wetzler RG, Winslow DH. New solutions for treating chronic insomnia: an introduction to behavioral sleep medicine. J Ky Med Assoc 2006;104:502-12.

Passos GS, Tufik S, Santana MG, Poyares D, Mello MT. [Nonpharmacologic treatment of chronic insomnia]. Rev Bras Psiquiatr 2007;29:279-82.

Morin CM, Bootzin RR, Buysse DJ, Edinger JD, Espie CA, Lichstein KL. Psychological and behavioral treatment of insomnia: update of the recent evidence (1998-2004). Sleep 2006;29:1398-414.

Escobar-Córdoba F, Echeverry-Chabur J, Lorenzana-Pombo P. Tratamiento farmacológico del insomnio. (2ª Parte). Rev Fac Med Univ Nac Colomb 2001;49:147-54.

Nowell PD, Mazumdar S, Buysse DJ, Dew MA, Reynolds CF 3rd, Kupfer Dj. Benzodiazepines and zolpidem for chronic insomnia: a meta-analysis of treatment efficacy. JAMA 1997;278:2170-7.

Holm KJ, Goa KL. Zolpidem: an update of its pharmacology, therapeutic efficacy and tolerability in the treatment of insomnia. Drugs 2000;59:865-89.

Suvanto-Luukkonen E, Koivunen R, Sundström H, Bloigu R, Karjalainen E, Häivä-Mällinen L, et al. Citalopram and fluoxetine in the treatment of postmenopausal symptoms: a prospective, randomized, 9-month, placebo-controlled, double-blind study.Menopause 2005;12:18-26.

Cómo citar

1.
Escobar-Córdoba F, Chica-Urzola HL, Cuevas-Cendales F. Trastornos del sueño relacionados con el climaterio femenino y su tratamiento. Rev. colomb. obstet. ginecol. [Internet]. 30 de junio de 2008 [citado 16 de abril de 2024];59(2):131-9. Disponible en: https://revista.fecolsog.org/index.php/rcog/article/view/419

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2008-06-30

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