Effects of early midlife ovarian removal on sleep: Polysomnography-measured cortical arousal, homeostatic drive, and spindle characteristics.

Bilateral salpingo-oophorectomy (BSO; removal of ovaries and fallopian tubes) prior to age 48 is associated with elevated risk for both Alzheimer's disease (AD) and sleep disorders such as insomnia and sleep apnea. In early midlife, individuals with BSO show reduced hippocampal volume, function, and hippocampal-dependent verbal episodic memory performance associated with changes in sleep. It is unknown whether BSO affects fine-grained sleep measurements (sleep microarchitecture) and how these changes might relate to hippocampal-dependent memory. We recruited thirty-six early midlife participants with BSO. Seventeen of these participants were taking 17ß-estradiol therapy (BSO+ET) and 19 had never taken ET (BSO). Twenty age-matched control participants with intact ovaries (AMC) were also included. Overnight at-home polysomnography recordings were collected, along with subjective sleep quality and hot flash frequency. Multivariate Partial Least Squares (PLS) analysis was used to assess how sleep varied between groups. Compared to AMC, BSO without ET was associated with significantly decreased time spent in non-rapid eye movement (NREM) stage 2 sleep as well as increased NREM stage 2 and 3 beta power, NREM stage 2 delta power, and spindle power and maximum amplitude. Increased spindle maximum amplitude was negatively correlated with verbal episodic memory performance. Decreased sleep latency, increased sleep efficiency, and increased time spent in rapid eye movement sleep were observed for BSO+ET. Findings suggest there is an association between ovarian hormone loss and sleep microarchitecture, which may contribute to poorer cognitive outcomes and be ameliorated by ET.

Chronic pain experiences of immigrant Indian women in Canada: A photovoice exploration.

Background: Over the past two decades, the prevalence of chronic pain has significantly increased globally, with approximately 20% of the world's population living with pain. Although quantitative measures are useful in identifying pain prevalence and severity, qualitative methods, and especially arts-based ones, are now receiving attention as a valuable means to understand lived experiences of pain. Photovoice is one such method that utilizes individuals' own photography to document their lived experiences. Aims: The current study utilized an arts-based method to explore immigrant Indian women's chronic pain experiences in Canada and aimed to enhance the understanding of those experiences by creating a visual opportunity for them to share their stories. Methods: Twelve immigrant Indian women captured photographs and participated in one-on-one interviews exploring daily experiences of chronic pain. Results: Women's photographs, and description of these photographs, provided a visual entry into their lives and pain experiences. Three themes emerged from our analysis: (1) bodies in pain, (2) traversing spaces including immigration, and (3) pain management methods. Findings revealed that women's representations of pain were shaped by a clash between culturally shaped gender role expectations and changing gender norms due to immigration processes. The use of photovoice visually contextualized and represented pain experiences, proving to be a valuable tool for self-reflection. Conclusions: This research uncovers the multifaceted nature of chronic pain and identifies the influence of immigration, gender, and social relations on the exacerbation of pain in immigrant Indian women.

Contexte : Au cours des deux dernières décennies, la prévalence de la douleur chronique a considérablement augmenté au niveau mondial, alors qu'environ 20 % de la population mondiale vit désormais avec la douleur. Bien que les mesures quantitatives soient utiles pour déterminer la prévalence et la sévérité de la douleur, les méthodes qualitatives, en particulier celles basées sur les arts, sont désormais considérées comme un moyen précieux de comprendre les expériences vécues de la douleur. La méthode Photovoice, qui utilise les photographies prises par les individus pour documenter leurs expériences vécues, est l'une de ces méthodes.Objectifs : Cette étude a utilisé une méthode basée sur les arts pour explorer les expériences de douleur chronique vécues par des femmes immigrantes d'origine indienne au Canada. Elle visait à améliorer la compréhension de ces expériences en leur donnant l'occasion de partager leurs histoires.Méthodes : Douze femmes immigrantes d'origine indienne ont pris des photos et ont participé à des entrevues individuelles portant sur leur expérience quotidienne de la douleur chronique.Résultats : Les photographies des femmes, ainsi que la description de ces photographies, ont permis d'entrer visuellement dans leur vie et leur expérience de la douleur. Trois thémes ont émergé de notre analyse : (1) les corps en souffrance, (2) la traversée des espaces, y compris l'immigration, et (3) les méthodes de prise en charge de la douleur. Les résultats ont révélé que les représentations de la douleur chez les femmes étaient façonnées par un conflit entre les attentes culturelles en matiére de rôle de genre et l'évolution des normes de genre due aux processus d'immigration. L'utilisation de la méthode Photovoice a permis de contextualiser et de représenter visuellement les expériences de la douleur, ce qui s'est avéré un outil précieux pour l'autoréflexion.Conclusions : Cette recherche met en lumiére la nature multifacette de la douleur chronique et révéle l'influence de l'immigration, du genre et des relations sociales sur l'exacerbation de la douleur chez les femmes immigrantes d'origine indienne.

Disturbed sleep is associated with reduced verbal episodic memory and entorhinal cortex volume in younger middle-aged women with risk-reducing early ovarian removal.

Introduction: Women with early ovarian removal (<48 years) have an elevated risk for both late-life Alzheimer's disease (AD) and insomnia, a modifiable risk factor. In early midlife, they also show reduced verbal episodic memory and hippocampal volume. Whether these reductions correlate with a sleep phenotype consistent with insomnia risk remains unexplored. Methods: We recruited thirty-one younger middleaged women with risk-reducing early bilateral salpingo-oophorectomy (BSO), fifteen of whom were taking estradiol-based hormone replacement therapy (BSO+ERT) and sixteen who were not (BSO). Fourteen age-matched premenopausal (AMC) and seventeen spontaneously peri-postmenopausal (SM) women who were ~10y older and not taking ERT were also enrolled. Overnight polysomnography recordings were collected at participants' home across multiple nights (M=2.38 SEM=0.19), along with subjective sleep quality and hot flash ratings. In addition to group comparisons on sleep measures, associations with verbal episodic memory and medial temporal lobe volume were assessed. Results: Increased sleep latency and decreased sleep efficiency were observed on polysomnography recordings of those not taking ERT, consistent with insomnia symptoms. This phenotype was also observed in the older women in SM, implicating ovarian hormone loss. Further, sleep latency was associated with more forgetting on the paragraph recall task, previously shown to be altered in women with early BSO. Both increased sleep latency and reduced sleep efficiency were associated with smaller anterolateral entorhinal cortex volume. Discussion: Together, these findings confirm an association between ovarian hormone loss and insomnia symptoms, and importantly, identify an younger onset age in women with early ovarian removal, which may contribute to poorer cognitive and brain outcomes in these women.