Puberty, pregnancy, and menopause impacts on nightmare disorder due to hormonal fluctuations
In the realm of sleep irregularities, nightmare disorder—a type of parasomnia characterized by recurring terrifying dreams—has been found to be significantly influenced by hormonal fluctuations in women. This article explores the intricate relationship between hormonal changes and nightmare disorder, primarily focusing on the impact on sleep quality and architecture throughout various life stages.
During the menstrual cycle, especially the premenstrual phase, women often experience poorer sleep quality and increased reports of disturbing dreams or nightmares. This is due to the decline in estrogen and progesterone levels, which disrupts sleep and potentially exacerbates sleep disorders that coexist with nightmares.
Pregnancy and postpartum periods, characterized by substantial hormonal shifts and sleep fragmentation, also heighten vulnerability to nightmares and other sleep disturbances. The luteal phase of the menstrual cycle for individuals assigned female at birth (AFAB) has been identified as a period of increased sleep disturbances, with most disruptions occurring during this phase.
Perimenopause and menopause, marked by a marked decrease in estrogen, are associated with increased insomnia, nocturnal awakenings, and potentially more frequent nightmares. These hormonal effects are compounded by higher prevalence of mood disorders in women, such as anxiety and depression, which in turn affect sleep and dream quality.
Hormone replacement therapy has shown benefits in improving sleep quality during menopause, offering a potential therapeutic strategy to manage nightmare disorder in women.
During puberty, young people assigned female at birth (AFAB) are almost three times more at risk of developing insomnia compared to young people assigned male at birth (AMAB). From the second to the third trimester, pregnant individuals report a decline in sleep duration and quality compared to the first trimester.
It's essential to note that nightmare disorder is not limited to these life stages. The first trimester of pregnancy, for instance, is associated with increased wakefulness following sleep onset and decreased sleep quality compared to pre-pregnancy. Nightmares normally happen during the second half of the sleep period when rapid eye movement (REM) occurs.
Melatonin, a hormone essential for regulating sleep, can be beneficial in managing sleep disorders associated with nightmare disorder. Medicated melatonin can reduce sleep latency, increase total sleep time, and enhance sleep maintenance.
Understanding the relationship between female hormonal changes and nightmare disorder underscores the importance of tailored therapeutic strategies addressing hormonal influences to better manage this condition in women. Comprehensive reviews focused on nightmare disorder are limited, but current evidence suggests a close relationship between hormonal changes and increased risk of nightmares as part of broader sleep disturbances.
References:
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- Hormonal fluctuations in women, particularly during the premenstrual phase, often lead to poorer sleep quality and increased nightmares due to declining estrogen and progesterone levels.
- Pregnancy and postpartum periods, which involve substantial hormonal shifts, increase the likelihood of sleep disturbances and nightmares.
- Menopause, marked by a sharp decrease in estrogen, is associated with insomnia, nocturnal awakenings, and potentially more frequent nightmares, which may be further exacerbated by mood disorders like anxiety and depression.
- Hormone replacement therapy can improve sleep quality during menopause, offering a potential strategy for managing nightmare disorder in women.
- Melatonin, a hormone that regulates sleep, can be beneficial in managing sleep disorders linked to nightmare disorder, reducing sleep latency, increasing total sleep time, and enhancing sleep maintenance.
