Midlife Women's Responses to a Hospital Sleep Challenge: Aging and Menopause Effects on Sleep Architecture

Objective: To distinguish aging from menopause effects on sleep architecture, we studied an episode of disturbed hospital sleep in asymptomatic midlife women during the follicular phase of an ovulatory cycle and three control groups differing by age or menopause status. Methods: Fifty-one studies were conducted in four groups of volunteers: young cycling (YC, 20-30 years, n = 14), older cycling (OC, 40-50 years, n = 15), ovariectomized receiving estrogen therapy (OVX, 40-50 years, n = 12), and spontaneously postmenopausal (PM, 40-50 years, n = 10). Subjects were admitted to the University Hospital General Clinical Research Center (GCRC) for a first-night sleep study conducted during a 24-hour, frequent blood sampling protocol. Results: Despite similar estrogen concentrations in the YC (28 ± 4 pg/ml) and OC (34 ± 6 pg/ml) groups, OC women had reduced sleep efficiency (79% ± 2%) vs. YC (87% ± 3%; p = 0.009). In the OVX and PM groups where estrogen concentrations were markedly different, sleep efficiency was also reduced vs. the YC group (OVX vs. YC, 79% ± 3% vs. 87% ± 3%, p = 0.05; PM vs. YC, 75% ± 3% vs. 87% ± 3%, p = 0.007). Wake time was longer in the three older groups (103 ± 10 minutes, 101 ± 12 minutes, 123 ± 12 minutes for OC, OVX, PM, respectively) vs. YC (63 ± 13 minutes, p < 0.05). The number of stage shifts was positively associated with advancing age (rho = 0.3, p < 0.03) but not with estrogen concentration. Conclusions: Aging-related sleep deficits in response to an experimental stressor occur in midlife women prior to menopause.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63173/1/154099904323016491.pd

Hypnosis for hot flashes among postmenopausal women study: A study protocol of an ongoing randomized clinical trial

<p>Abstract</p> <p>Background</p> <p>Hot flashes are a highly prevalent problem associated with menopause and breast cancer treatments. The recent findings from the Women's Health Initiative have important implications for the significance of a non-hormonal, mind-body intervention for hot flashes in breast cancer survivors. Women who take hormone therapy long-term may have a 1.2 to 2.0 fold increased risk of developing breast cancer. In addition, it is now known that hormone therapy with estrogen and progestin is associated with increased risk of cardiovascular disease and stroke. Currently there are limited options to hormone replacement therapy as non-hormonal pharmacological agents are associated with only modest activity and many adverse side effects. Because of this there is a need for more alternative, non-hormonal therapies. Hypnosis is a mind-body intervention that has been shown to reduce self-reported hot flashes by up to 68% among breast cancer survivors, however, the use of hypnosis for hot flashes among post-menopausal women has not been adequately explored and the efficacy of hypnosis in reducing physiologically measured hot flashes has not yet been determined.</p> <p>Methods/design</p> <p>A sample of 180 post-menopausal women will be randomly assigned to either a 5-session Hypnosis Intervention or 5-session structured-attention control with 12 week follow-up. The present study will compare hypnosis to a structured-attention control in reducing hot flashes (perceived and physiologically monitored) in post-menopausal women in a randomized clinical trial. Outcomes will be hot flashes (self-report daily diaries; physiological monitoring; Hot Flash Related Daily Interference Scale), anxiety (State-Trait Anxiety Inventory; Hospital Anxiety and Depression Scale (HADS); anxiety visual analog scale (VAS rating); depression (Center for Epidemiologic Studies Depression Scale), sexual functioning (Sexual Activity Questionnaire), sleep quality (Pittsburgh Sleep Quality Index) and cortisol.</p> <p>Discussion</p> <p>This study will be the first full scale test of hypnosis for hot flashes; one of the first studies to examine both perceived impact and physiologically measured impact of a mind-body intervention for hot flashes using state-of-the-art 24 hour ambulatory physiological monitoring; the first study to examine the effect of hypnosis for hot flashes on cortisol; and the first investigation of the role of cognitive expectancies in treatment of hot flashes in comparison to a Structured-Attention Control.</p> <p>Trial Registration</p> <p>This clinical trial has been registered with ClinicalTrials.gov, a service of the U.S. National Institutes of Health, ClinicalTrials.gov Identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01293695">NCT01293695</a>.</p

Insights into fear: A phenomenological study of Black mothers

Aim: The aim of the study was to explore the lived experience of stress as described by Black childbearing women. Design: A phenomenological approach was used. Methods: Seven mothers who met inclusion criteria participated in both individual and group interviews between August 2018 and August 2019. Each session was audio recorded and professionally transcribed. Consistent with van Manen\u27s phenomenological approach, three rounds of reflective transcript analysis were conducted over several months. Results: Several stress themes were identified from the data. However, the most pervasive theme was the fear of having a son and keeping him safe. In this paper, the themes of Living in Fear and Living with Fear are detailed. Conclusion: Previous research has found that Black populations in America fear for their safety. This study identified a pervasive and profound fear for their children, specifically sons who are at a higher risk of being killed in normal daily activities. Mothers also expressed fears about their responsibility to keep them safe by providing the right tools. Impact: Although scientists have long studied poor pregnancy outcomes for Black American women, the disparity persists. This study sought to identify stressors acknowledged by Black mothers themselves. For the first time, Black mothers stated that their primary stress is fear for their children\u27s lives. The role this fear has in adverse pregnancy outcomes, if any, is yet to be determined

Raise Your Hand if You are a Great Reader or Writer: How to use wordless books and September routines to get every hand up.

How we read a book and establish meaning in our routines in September can impact the final literacy product we get in June. We will discuss how wordless books and routines can build comprehension, increase the use of higher level vocabulary and help your students recognize themselves as readers and writers with power and influence

Insights into fear: A phenomenological study of Black mothers

Aim: The aim of the study was to explore the lived experience of stress as described by Black childbearing women. Design: A phenomenological approach was used. Methods: Seven mothers who met inclusion criteria participated in both individual and group interviews between August 2018 and August 2019. Each session was audio recorded and professionally transcribed. Consistent with van Manen\u27s phenomenological approach, three rounds of reflective transcript analysis were conducted over several months. Results: Several stress themes were identified from the data. However, the most pervasive theme was the fear of having a son and keeping him safe. In this paper, the themes of Living in Fear and Living with Fear are detailed. Conclusion: Previous research has found that Black populations in America fear for their safety. This study identified a pervasive and profound fear for their children, specifically sons who are at a higher risk of being killed in normal daily activities. Mothers also expressed fears about their responsibility to keep them safe by providing the right tools. Impact: Although scientists have long studied poor pregnancy outcomes for Black American women, the disparity persists. This study sought to identify stressors acknowledged by Black mothers themselves. For the first time, Black mothers stated that their primary stress is fear for their children\u27s lives. The role this fear has in adverse pregnancy outcomes, if any, is yet to be determined

The Lived Experience of Pregnancy as a Black Woman in America: A Descriptive Phenomenological Case Study

For more than fifty years, black women have faced more than double the U.S. average risk for both maternal mortality [1] and severe morbidity [2]. In addition, black women face two to three times the risk for preterm and low birth weight infant outcomes [3 - 7]. Poverty, barriers to healthcare access, and lifestyle choices are commonly identified factors influencing this disparity [5, 7, 8]. These stress-related factors are credible; however, half a century of studies, based on the same, have not led to improved outcomes. Large population studies indicate that such factors alone are inadequate to explain the problem [9], and the disparity persists. While individual stressors have a role in race related health disparities, particularly in pregnancy outcomes, a comprehensive explanation of the problem incorporating complex social, environmental, interpersonal factors with individual components are needed. Yet, there is a paucity of such comprehensive evidence. Specifically, there is insufficient description of the lived experience of adversity for pregnant black women

The Lived Experience of Pregnancy as a Black Woman in America: A Descriptive Phenomenological Case Study

For more than fifty years, black women have faced more than double the U.S. average risk for both maternal mortality [1] and severe morbidity [2]. In addition, black women face two to three times the risk for preterm and low birth weight infant outcomes [3 - 7]. Poverty, barriers to healthcare access, and lifestyle choices are commonly identified factors influencing this disparity [5, 7, 8]. These stress-related factors are credible; however, half a century of studies, based on the same, have not led to improved outcomes. Large population studies indicate that such factors alone are inadequate to explain the problem [9], and the disparity persists. While individual stressors have a role in race related health disparities, particularly in pregnancy outcomes, a comprehensive explanation of the problem incorporating complex social, environmental, interpersonal factors with individual components are needed. Yet, there is a paucity of such comprehensive evidence. Specifically, there is insufficient description of the lived experience of adversity for pregnant black women