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Jerilynn C Prior - One of the best experts on this subject based on the ideXlab platform.
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oral micronized progesterone for perimenopausal Night Sweats and hot flushes a 12 week randomized phase iii canada wide clinical trial
Social Science Research Network, 2020Co-Authors: Jerilynn C Prior, Christine L Hitchcock, Andrea Cameron, Michelle Fung, Patricia A Janssen, Terry Lee, Joel SingerAbstract:Background: Oral micronized progesterone (progesterone) has been shown superior to placebo for vasomotor symptoms (VMS, Night Sweats and/or hot flushes) in menopausal women (>1 year after final flow). A VMS Score difference ≥3 was clinically important. VMS begin in perimenopause; however, all but two VMS randomized placebo-controlled trials (RCT) were in menopausal women. No well-performed RCT has proven any therapy to be effective for perimenopausal VMS. Methods: To test progesterone for perimenopausal VMS, we ran a quadruple masked, randomized (1:1), placebo-controlled trial (2012-2016) with 28-day run-in and 84 days’ experimental phases. Our academic medical centre recruited locally/nationally for women ages 35-58 with cycle irregularity but menstruation within 12 months plus untreated, problematic VMS. Our primary, intent-to-treat outcome was participant-recorded daily VMS Score ([# Night Sweats x intensity]+[#daytime hot flushes x intensity]) days 56-84, adjusted for run-in VMS Score. Our secondary outcome was Women’s Perceived VMS Change (-5 to +5) on day 84. Findings: We randomized 189 women of mean (SD) age 49·9 (4·6) years to progesterone, 300 mg/bedtime [n=93], vs placebo [n=96]. The mean run-in VMS Score (n=189) was 12·2 (11·3). VMS Scores days 56-84 were not different by progesterone vs placebo (Rate Ratio [RR] 0·79 [95% CI 0·54, 1·15]; Rate Difference [RD] -1·51 [95% CI -3·97, 0·95]; P=0·222). RD 95% CI included -3, thus did not exclude a clinically important effect. Perceived VMS Change indicated progesterone significantly improved Night Sweats over placebo (-3 vs -2, P=0·023). No serious adverse events occurred. Interpretation: Progesterone-treated perimenopausal women perceived significantly improved Night Sweats. These results show trends toward clinically important VMS benefits from perimenopausal progesterone. Given the previously undocumented high perimenopausal VMS variability, a larger RCT of progesterone for perimenopause VMS is still needed. Trial Registered: ClinicalTrials.gov NCT0146469. Funding Statement: Funded by a grant from the Canadian Institutes for Health Research (#MOP106644). Extended enrollment was funded by an arms-length unrestricted grant to the Centre for Menstrual Cycle and Ovulation Research of the University of British Columbia from Besins Healthcare International. Declaration of Interests: None of the investigators, co-investigators or collaborators in this RCT has a financial or other conflict of interest with these data or other ethical conflicts. Ethics Approval Statement: The University of British Columbia Clinical Research Ethics Board approved this protocol and its amendments.
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women s mid life Night Sweats and 2 year bone mineral density changes a prospective observational population based investigation from the canadian multicentre osteoporosis study camos
International Journal of Environmental Research and Public Health, 2018Co-Authors: Evelyn Wong, George Tomlinson, Marsha M. Pinto, Claudie Berger, Angela M. Cheung, Jerilynn C PriorAbstract:Women’s hot flushes and Night Sweats, collectively called vasomotor symptoms (VMS), are maximal (79%) in late perimenopause. The evidence describing whether VMS are associated with loss of areal bone mineral density (BMD) is mixed. We examined baseline and 2-year data for 1570 randomly selected women aged 43–63 in the Canadian Multicentre Osteoporosis Study (CaMos), a prospective Canada-wide study; we used linear regression to assess the relationship of Night Sweats (VMSn) with BMD and its changes. Clinically important VMSn occurred for 12.2%. Women with VMSn were slightly younger (54.5 vs. 55.3 years, p = 0.02) and less likely to use sex steroid therapies (39.8% vs. 51.4%, p < 0.05). BMD at the lumbar spine (L1-4), femoral neck (FN) and total hip (TH) were similar between those with/without VMSn. In adjusted models, we did not find a significant association between VMSn and 2-year change in L1-4, FN and TH BMD. Age, reproductive status, weight, sex steroid therapy and smoking status were associated with 2-year change in BMD. Incident fractures over 2 years also did not differ by VMSn. Our analyses were restricted to VMSn and may not truly capture the relationship between VMS and BMD. Additional research involving VMS, bone loss and fracture incidence is needed.
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Women’s Mid-Life Night Sweats and 2-Year Bone Mineral Density Changes: A Prospective, Observational Population-Based Investigation from the Canadian Multicentre Osteoporosis Study (CaMos)
MDPI AG, 2018Co-Authors: Evelyn M. M. Wong, George Tomlinson, Marsha M. Pinto, Claudie Berger, Angela M. Cheung, Jerilynn C PriorAbstract:Women’s hot flushes and Night Sweats, collectively called vasomotor symptoms (VMS), are maximal (79%) in late perimenopause. The evidence describing whether VMS are associated with loss of areal bone mineral density (BMD) is mixed. We examined baseline and 2-year data for 1570 randomly selected women aged 43–63 in the Canadian Multicentre Osteoporosis Study (CaMos), a prospective Canada-wide study; we used linear regression to assess the relationship of Night Sweats (VMSn) with BMD and its changes. Clinically important VMSn occurred for 12.2%. Women with VMSn were slightly younger (54.5 vs. 55.3 years, p = 0.02) and less likely to use sex steroid therapies (39.8% vs. 51.4%, p < 0.05). BMD at the lumbar spine (L1-4), femoral neck (FN) and total hip (TH) were similar between those with/without VMSn. In adjusted models, we did not find a significant association between VMSn and 2-year change in L1-4, FN and TH BMD. Age, reproductive status, weight, sex steroid therapy and smoking status were associated with 2-year change in BMD. Incident fractures over 2 years also did not differ by VMSn. Our analyses were restricted to VMSn and may not truly capture the relationship between VMS and BMD. Additional research involving VMS, bone loss and fracture incidence is needed
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hot flushes and Night Sweats differ in associations with cardiovascular markers in healthy early postmenopausal women
Menopause, 2012Co-Authors: Christine L Hitchcock, Tom Elliott, Eric G Norman, Vesna Stajic, Helena J Teede, Jerilynn C PriorAbstract:Objective The aim of this study was to evaluate the associations between vasomotor symptoms ([VMS] hot flushes or flashes and Night Sweats) and markers of cardiovascular risk. Methods Healthy postmenopausal women in a randomized controlled trial of progesterone for VMS recorded VMS frequency in the Daily Menopause Diary for 28 days at baseline. Accepted risks for cardiovascular disease were measured: body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), blood pressure (BP), endothelial function by venous occlusion plethysmography, fasting lipids, glucose, high-sensitivity C-reactive protein, albumin, and D-dimer. Relationships between risk variables and VMS frequency (24 h, day and Night) were assessed by univariate and multivariate robust regressions with adjustment for age and WHtR. Results Data were available for 145 healthy, nonsmoking women without heart disease, hypertension, or diabetes who were 1 to 11 years past their final menstruation and were aged 43 to 65 years, with a mean (SD) BMI of 25.0 (2.9) kg/m and WC of 79.1 (7.1) cm. Anthropometric variables (BMI, WC, and WHtR) were significantly negatively associated with total (24-h day) VMS frequency and with day VMS but not with Night VMS frequency. Systolic BP decreased with greater 24-hour VMS frequency, and both systolic and diastolic BPs were inversely related to day but not Night VMS frequency. Albumin was positively associated with Night VMS frequency but not with day or 24-hour VMS frequency. Other variables showed little association with VMS frequency. Conclusions Hot flushes, but not Night Sweats, were associated with lower cardiovascular risk factors in these healthy postmenopausal women. Future research should differentiate Night Sweats from hot flushes.
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medroxyprogesterone and conjugated oestrogen are equivalent for hot flushes a 1 year randomized double blind trial following premenopausal ovariectomy
Clinical Science, 2007Co-Authors: Jerilynn C Prior, Christine L Hitchcock, Jason D Nielsen, Lucy A Williams, Yvette M Vigna, C B DeanAbstract:Oestrogen therapy is the gold standard treatment for hot flushes/Night Sweats, but it and oestrogen/progestin are not suitable for all women. MPA (medroxyprogesterone acetate) reduces hot flushes, but its effectiveness compared with oestrogen is unknown. In the present study, oral oestrogen [CEE (conjugated equine oestrogen)] and MPA were compared for their effects on hot flushes in a planned analysis of a secondary outcome for a 1-year randomized double-blind parallel group controlled trial in an urban academic medical centre. Participants were healthy menstruating women prior to hysterectomy/ovariectomy for benign disease. A total of 41 women {age, 45 (5) years [value is mean (S.D.)]} were enrolled; 38 women were included in this analysis of daily identical capsules containing CEE (0.6 mg/day) or MPA (10 mg/day). Demographic variables did not differ at baseline. Daily data provided the number of Night and day flushes compared by group. The vasomotor symptom day-to-day intensity change was assessed by therapy assignment. Hot flushes/Night Sweats were well controlled in both groups, one occurred on average every third day and every fourth Night. Mean/day daytime occurrences were 0.363 and 0.187 with CEE and MPA respectively, but were not significantly different ( P =0.156). Night Sweats also did not differ significantly ( P =0.766). Therapies were statistically equivalent (within one event/24 h) in the control of vasomotor symptoms. Day-to-day hot flush intensity decreased with MPA and tended to remain stable with CEE ( P <0.001). In conclusion, this analysis demonstrates that MPA and CEE are equivalent and effective in the control of the number of hot flushes/Night Sweats immediately following premenopausal ovariectomy. Abbreviations: BMI, body mass index; CEE, conjugated equine oestrogen; CI, confidence interval; HDL, high-density lipoprotein; MPA, medroxyprogesterone acetate; RR, relative risk
Myra S. Hunter - One of the best experts on this subject based on the ideXlab platform.
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The Hot Flush Beliefs Scale: A tool for assessing thoughts and beliefs associated with the experience of menopausal hot flushes and Night Sweats
2020Co-Authors: Melanie J. Rendall, Laura M. Simonds, Myra S. HunterAbstract:Abstract Objectives: Approximately 15-20 per cent of women experience their hot flushes and Night Sweats as problematic. There is some evidence that cognitive appraisals may help explain individual variation, and that cognitive behaviour therapy can alleviate related distress. This paper describes the development of the Hot Flush Beliefs Scale (HFBS), a questionnaire to assess women's appraisals, and reports on the reliability, validity and factor structure of the scale. Methods: An initial pool of 63 items was generated from several sources: empirical literature, clinicians' views, and in-depth interviews, with the aim of reflecting common thoughts and beliefs about flushes and Sweats. A total of 103 women, aged 41-64 years completed the initial measure. Principal components analysis and principal axis factoring were applied to the data, with both orthogonal and oblique rotation to determine the most coherent and interpretable solution. Conclusions: Preliminary analysis of the HFBS reveals it to be a psychometrically sound instrument. The HFBS has the benefit of being grounded in women's 2 experiences and shows initial promise as a tool to aid further clinical and theoretical understanding of the impact of hot flushes and Night Sweats
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cognitive behavior therapy for menopausal symptoms hot flushes and Night Sweats moderators and mediators of treatment effects
Menopause, 2014Co-Authors: Sam Norton, Joseph Chilcot, Myra S. HunterAbstract:Objective: Cognitive-behavior therapy (CBT) has been found in recent randomized controlled trials (MENOS1 and MENOS2) to reduce the impact of hot flushes and Night Sweats (HFNS). In the MENOS2 trial, group CBT was found to be as effective as self-help CBT in reducing the impact of HFNS. This study investigates for whom and how CBT works for women in the MENOS2 trial. Methods: This study performed a secondary analysis of 140 women with problematic HFNS who were recruited to the MENOS2 trial: 48 were randomly assigned to group CBT, 47 were randomly assigned to self-help CBT, and 45 were randomly assigned to usual care. Self-report questionnaires were completed at baseline, 6 weeks postrandomization, and 26 weeks postrandomization. Potential moderators and mediators of treatment effects on the primary outcomeVhot flush problem ratingVwere examined using linear mixed-effects models and path analysis, respectively. Results: CBT was effective at reducing HFNS problem rating regardless of age, body mass index, menopause status, or psychological factors at baseline. Fully reading the manual in the self-help CBT arm and completing most homework assignments in the group CBT arm were related to greater improvement in problem rating at 6 weeks. The effect of CBT on HFNS problem rating was mediated by changes in cognitions (beliefs about coping/control of hot flushes, beliefs about Night Sweats and sleep) but not by changes in mood. Conclusions: These findings suggest that CBT is widely applicable for women having problematic HFNS, regardless of sociodemographic or health-related factors, and that CBT works mainly by changing the cognitive appraisal of HFNS.
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you know i ve joined your club i m the hot flush boy a qualitative exploration of hot flushes and Night Sweats in men undergoing androgen deprivation therapy for prostate cancer
Psycho-oncology, 2013Co-Authors: C U Eziefula, Elizabeth A Grunfeld, Myra S. HunterAbstract:Objective Hot flushes and Night Sweats are common amongst menopausal women, and psychological interventions for managing these symptoms have recently been developed for women. However, flushes in men with prostate cancer, which commonly occur following androgen deprivation therapy (ADT), remain under-researched. This study is a qualitative exploration of flush-related cognitive appraisals and behavioural reactions reported by a sample of these men. Methods Semi-structured, in-depth interviews were conducted with 19 men who were experiencing flushes after receiving ADT for prostate cancer. Framework analysis was used to generate and categorise emergent themes and explore associations between themes. Results Five main cognitive appraisals included the following: changes in oneself, impact on masculinity, embarrassment/social-evaluative concerns, perceived control and acceptance/adjustment. There were men who held beliefs about the impact of flushes on their perceptions of traditional gender roles, who experienced shame and embarrassment due to concerns about the salience of flushes and perceptions by others and who experienced feelings of powerlessness over flushes. Powerlessness was associated with beliefs about the potentially fatal consequences of discontinuing treatment. Two other dominant themes included awareness/knowledge about flushes and management strategies. Experiences of flushes appeared to be influenced by upbringing and general experiences of prostate cancer and ADT. Conclusions The range of men's appraisals of, and reactions to, flushes generated from this qualitative exploration were broadly similar to those of menopausal women but differed in terms of the influence of masculinity beliefs. These findings could be used to inform future research and psychological interventions in this under-researched field. Copyright © 2013 John Wiley & Sons, Ltd.
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cognitive behaviour therapy for menopausal hot flushes and Night Sweats a qualitative analysis of women s experiences of group and self help cbt
Behavioural and Cognitive Psychotherapy, 2013Co-Authors: Janet Balabanovic, Beverley Ayers, Myra S. HunterAbstract:Background: There is a growing need for non-medical treatments for women experiencing problematic menopausal symptoms such as hot flushes and Night Sweats (HF/NS). A recent randomized control trial (RCT) (MENOS2) provides evidence of the effectiveness of Group CBT and Self-Help CBT for HF/NS. Aims: This study examines MENOS 2 participants’ experience of the CBT treatments. Method: Twenty women who had experienced CBT for HF/NS (10 Group CBT and 10 Self-Help CBT) were interviewed at the end of the trial to explore how they experienced the treatment and its effects. The interviews were analysed using interpretative phenomenological analysis. Results: Women experienced both treatment formats as positive and helpful, increasing their ability to cope and their sense of control over HF/NS. Four super-ordinate themes were identified: making sense of symptom change, new ways of coping and regaining control, acknowledging and challenging the menopause taboo, and social interaction and support versus individual learning. Conclusions: These qualitative results are consistent with those of the main trial in that women found both CBT formats helpful in reducing the impact of HF/NS. However, the results also suggest possible mechanisms of change and provide useful information on women's responses to the different treatment components and formats.
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testing a cognitive model of menopausal hot flushes and Night Sweats
Journal of Psychosomatic Research, 2013Co-Authors: Myra S. Hunter, Joseph ChilcotAbstract:Abstract Objective Hot flushes and Night Sweats (HFNS) are commonly experienced by women during the menopause transition and are particularly problematic for approximately 25% having negative impact on their quality of life. We previously developed a cognitive model of HFNS, which outlines potential predictors of HFNS. This study aims to test the model by investigating the relationships between personality characteristics, perceived stress, mood, HFNS beliefs and subjective and physiological measures of menopausal HFNS. Methods 140 women (menopause transition or postmenopausal) who were experiencing at least 10 HFNS per week for at least a month, completed assessment interviews, including questionnaires assessing optimism, somatic amplification, perceived stress, depressed mood, anxiety, HFNS beliefs and HFNS frequency, problem-rating and 24-hour sternal skin conductance monitoring. Structural equation models (SEM) were used to investigate the optimum predictive model for HFNS Frequency and HFNS Problem-Rating. Results On average 63 HFNS per week and moderately problematic HFNS were reported. The physiological measure of HFNS frequency was not associated with socio-demographic variables, personality or mood. The final SEM explained 53.2% of the variance in problem rating. Stress, anxiety and somatic amplification predicted HFNS problem rating but only via their impact on HFNS beliefs; HFNS frequency, smoking and alcohol intake also predicted HFNS problem rating. Conclusions Findings support the influence of psychological factors on experience of HFNS at the level of symptom perception and cognitive appraisal of HFNS.
Carolyn J Crandall - One of the best experts on this subject based on the ideXlab platform.
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association of genetic variation in the tachykinin receptor 3 locus with hot flashes and Night Sweats in the women s health initiative study
Menopause, 2017Co-Authors: Carolyn J Crandall, Joann E Manson, Chancellor Hohensee, Steve Horvath, Jean Wactawskiwende, Erin Leblanc, Mara Z Vitolins, Rami Nassir, Janet S SinsheimerAbstract:AbstractObjective:Vasomotor symptoms (VMS, ie, hot flashes or Night Sweats) are reported by many, but not all, women. The extent to which VMS are genetically determined is unknown. We evaluated the relationship of genetic variation and VMS.Methods:In this observational study, we accessed data from t
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association of genetic variation in the tachykinin receptor 3 locus with hot flashes and Night Sweats in the women s health initiative study
Menopause, 2017Co-Authors: Carolyn J Crandall, Joann E Manson, Chancellor Hohensee, Steve Horvath, Jean Wactawskiwende, Erin Leblanc, Mara Z Vitolins, Rami Nassir, Janet S SinsheimerAbstract:Vasomotor symptoms (VMS, ie, hot flashes or Night Sweats) are reported by many, but not all, women. The extent to which VMS are genetically determined is unknown. We evaluated the relationship of genetic variation and VMS.In this observational study, we accessed data from three genome-wide association studies (GWAS) (SNP Health Association Resource cohort [SHARe], WHI Memory Study cohort [WHIMS+], and Genome-Wide Association Studies of Treatment Response in Randomized Clinical Trials [GARNET] studies, total n = 17,695) of European American, African American, and Hispanic American postmenopausal women aged 50 to 79 years at baseline in the Women's Health Initiative Study. We examined genetic variation in relation to VMS (yes/no) in each study and using trans-ethnic inverse variance fixed-effects meta-analysis. A total of 11,078,977 single-nucleotide polymorphisms (SNPs) met the quality criteria.After adjustment for covariates and population structure, three SNPs (on chromosomes 3 and 11) were associated with VMS at the genome-wide threshold of 5 × 10 in the African American SHARe GWAS, but were not associated in the other cohorts. In the meta-analysis, 14 SNPs, all located on chromosome 4 in the tachykinin receptor 3 (TACR3) locus, however, had P < 5 × 10. These SNPs' effect sizes were similar across studies/participants' ancestry (odds ratio ∼1.5).Genetic variation in TACR3 may contribute to the risk of VMS. To our knowledge, this is the first GWAS to examine SNPs associated with VMS. These results support the biological hypothesis of a role for TACR3 in VMS, which was previously hypothesized from animal and human studies. Further study of these variants may lead to new insights into the biological pathways involved in VMS, which are poorly understood.
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vasomotor symptoms and insulin resistance in the study of women s health across the nation
The Journal of Clinical Endocrinology and Metabolism, 2012Co-Authors: Rebecca C Thurston, Hadine Joffe, Carolyn J Crandall, Samar El R Khoudary, Kim Suttontyrrell, Barbara Sternfeld, Ellen B Gold, Faith Selzer, Karen A MatthewsAbstract:Context: Emerging research suggests links between menopausal hot flashes and cardiovascular disease risk. The mechanisms underlying these associations are unclear, due to the incomplete understanding of the physiology of hot flashes. Objective and Main Outcome Measures: We examined the associations between hot flashes/Night Sweats and glucose and insulin resistance over 8 yr, controlling for cardiovascular risk factors and reproductive hormones. Design, Setting, and Participants: Participants in the Study of Women's Health Across the Nation (SWAN) (n = 3075), a longitudinal cohort study, were ages 42–52 yr at entry. Women completed questionnaires (hot flashes, Night Sweats: none, 1–5 d, ≥6 d, past 2 wk), physical measures (blood pressure, height, weight), and a fasting blood draw [serum glucose, insulin, estradiol (E2), FSH] annually for 8 yr. Hot flashes/Night Sweats were examined in relation to glucose and the homeostasis model assessment (HOMA) in mixed models, adjusting for demographics, cardiovascula...
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beyond frequency who is most bothered by vasomotor symptoms
Menopause, 2008Co-Authors: Rebecca C Thurston, Joyce T Bromberger, Yuefang Chang, Hadine Joffe, Carolyn J Crandall, Nancy E Avis, Rachel Hess, Robin Green, Karen A MatthewsAbstract:Objective: Most menopausal women report vasomotor symptoms (hot flashes, Night Sweats). However, not all women with vasomotor symptoms, including frequent symptoms, are bothered by them. The primary aim was to identify correlates of vasomotor symptom bother beyond symptom frequency. Design: The Study of Women's Health Across the Nation participants reporting vasomotor symptoms at annual visit 7 comprised the sample (N = 1,042). Assessments included hot flash and Night Sweats frequency (number per week) and bother (1, not at all- 4, very much). Negative affect (index of depressive symptoms, anxiety, perceived stress, negative mood), symptom sensitivity, sleep problems, and vasomotor symptom duration (number of years) were examined cross-sectionally in relation to bother in ordinal logistic regression models with symptom frequency and covariates. Hot flashes and Night Sweats were considered separately. Results: In multivariable models controlling for hot flash frequency, negative affect (odds ratio [OR] = 1.27, 95% CI: 1.08-1.51), symptom sensitivity (OR = 1.18, 95% CI: 1.03-1.37), sleep problems (OR = 1.38, 95% CI: 1.04-1.85), poorer health (OR = 1.24, 95% CI: 1.03-1.48), duration of hot flashes (OR = 1.14, 95% CI: 1.06-1.23), younger age (OR = 0.94, 95% CI: 0.89-0.99), and African American race (vs white, OR = 1.59, 95% CI: 1.12-2.26) were associated with hot flash bother. After controlling for Night Sweats frequency and covariates, sleep problems (OR = 1.84, 95% CI:1.33-2.55) and Night Sweats duration (OR = 1.10, 95% CI: 1.02-1.20) were associated with Night Sweats bother. Conclusions: Beyond frequency, factors associated with bothersome hot flashes include mood, symptom sensitivity, symptom duration, sleep problems, age, and race. Correlates of bothersome Night Sweats include sleep problems and symptom duration. In addition to reducing frequency, interventions for vasomotor symptoms might consider addressing modifiable factors related to symptom bother.
James W Mold - One of the best experts on this subject based on the ideXlab platform.
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selective serotonin reuptake inhibitors and Night Sweats in a primary care population
Drugs - real world outcomes, 2015Co-Authors: James W Mold, Barbara J HoltzclawAbstract:Objective Several small published case reports have suggested that selective serotonin reuptake inhibitors (SSRIs) can cause Night Sweats. The purpose of this study was to investigate this possibility further and to explore possible associations between Night Sweats and other commonly prescribed medications.
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Night Sweats a systematic review of the literature
Journal of the American Board of Family Medicine, 2012Co-Authors: James W Mold, Barbara J Holtzclaw, Laine H MccarthyAbstract:Background: Much of primary care involves helping patients manage symptoms. Nighttime sweating is a symptom linked to menopause, malignancies, autoimmune diseases, and infections. However, in primary care settings, Night Sweats are commonly reported by persons without these conditions. Methods: We conducted a literature review, focusing on questions about definition, mechanisms, incidence/prevalence, measurement, clinical causes, evaluation, treatment, and prognosis. We limited our search to English language studies of adult humans published since 1966. Because studies of estrogen and androgen deficiency states had been reviewed by others, we excluded them. Search criteria were developed for each question. Publications meeting criteria were reviewed by the first 2 authors and consensus was reached through discussion. Results: Prevalence estimates ranged from 10% among older primary care patients to 60% among women on an obstetrics inpatient unit. Life expectancy of primary care patients reporting Night Sweats did not appear to be reduced. Although many clinical causes have been suggested, most are not well supported. Algorithmic approaches to evaluation are not evidence-based. Alpha adrenergic blockers may reduce Night Sweats in patients taking serotonin reuptake inhibitors. Thalidomide and thioridazine may benefit some terminal cancer patients with Night Sweats. Conclusions: The symptom, Night Sweats, appears to be nonspecific. Many questions about causation, evaluation, and management remain unanswered.
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the prognostic implications of Night Sweats in two cohorts of older patients
Journal of the American Board of Family Medicine, 2010Co-Authors: James W Mold, Frank H LawlerAbstract:Background: When asked, a significant number of patients report having experienced Night Sweats. Those who do are more likely to report decreased physical health, mental health, and quality of life. In most cases the cause of Night Sweats is unknown. We therefore do not know how much to worry about patients with this symptom. The present study examined associations between Night Sweats and mortality. Methods: We used logistic regression and proportional hazards analyses to investigate potential predictors of mortality, including Night Sweats reported at baseline, among 2 different cohorts of people older than 65 years of age (n = 682 and n = 852) who were followed for an average of 7.3 and 7.5 years, respectively. Results: Patients who reported Night Sweats were not more likely to die or to die sooner than those who did not report Night Sweats after controlling for age, sex, body mass index, education, and income. This held true as well for patients who reported more severe Night Sweats among the cohort in which the severity of Night Sweats was quantified. Conclusions: Patients who report Night Sweats on a primary care health history questionnaire do not seem, on average, to be at increased risk for mortality.
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associations between subjective Night Sweats and sleep study findings
Journal of the American Board of Family Medicine, 2008Co-Authors: James W Mold, Suanne Goodrich, William C OrrAbstract:Background: In 2 previous studies, patients reporting Night Sweats were found to be more likely to have other sleep-related symptoms. Sleep apnea is often mentioned as a possible cause of Night Sweats, but there is little evidence to support this assertion. Methods: Retrospective review of data from 2 sleep laboratories in Oklahoma City, Oklahoma. Analyses included bivariate and multivariate tests of associations between reported Night Sweats and other sleep-related symptoms, scores on specific sleep inventories, and findings from polysomnography. Results: Patients who reported Night Sweats were more likely to report daytime fatigue (P = .001); creepy/crawly feelings in their legs (P = .003); kicking during sleep (P = .004); snoring (P = .03); Nighttime breathing trouble (P Conclusions: Subjective Night Sweats are associated with a variety of other sleep-related symptoms, but we could find no evidence for an association between subjective Night Sweats and objective evidence of specific sleep disorders.
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associations between Night Sweats and other sleep disturbances an okprn study
Annals of Family Medicine, 2006Co-Authors: James W Mold, Joseph H Woolley, Zsolt NagykaldiAbstract:PURPOSE Surprisingly little is known about the causes and implications of Night Sweats. This study was designed to clarify further the associations between Night Sweats and sleep-related symptoms. METHODS We undertook a cross-sectional study of consecutive adult patients seen in 10 primary care physicians’ offices. Data were collected and transmitted by a personal digital assistant. Information included demographic variables; height, weight, and blood pressure; occurrence of a variety of sleep-related symptoms; and occurrence and severity of Night Sweats, day Sweats, and hot flashes in the past month. For women, information about menstrual status was also obtained. RESULTS Thirty-four percent of the 363 patients interviewed reported Night Sweats, one half of whom reported saturating their bedclothes. In the multivariate model, Night Sweats were associated with daytime tiredness (OR = 1.99; 95% CI, 1.12–3.53), waking up with a bitter taste in the mouth (OR = 1.94; 95% CI, 1.19–3.18), legs jerking during sleep (OR = 1.78; 95% CI, 1.05–3.00), and awakening with pain in the Night (OR = 1.87; 95% CI, 1.16–2.99). CONCLUSIONS Night Sweats are associated with several sleep symptoms. Both Night Sweats and sleep disturbances are commonly experienced by adult primary care patients. When their patients report Night Sweats, clinicians should consider asking about sleep quality and sleep-related symptoms.
Janet S Sinsheimer - One of the best experts on this subject based on the ideXlab platform.
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association of genetic variation in the tachykinin receptor 3 locus with hot flashes and Night Sweats in the women s health initiative study
Menopause, 2017Co-Authors: Carolyn J Crandall, Joann E Manson, Chancellor Hohensee, Steve Horvath, Jean Wactawskiwende, Erin Leblanc, Mara Z Vitolins, Rami Nassir, Janet S SinsheimerAbstract:Vasomotor symptoms (VMS, ie, hot flashes or Night Sweats) are reported by many, but not all, women. The extent to which VMS are genetically determined is unknown. We evaluated the relationship of genetic variation and VMS.In this observational study, we accessed data from three genome-wide association studies (GWAS) (SNP Health Association Resource cohort [SHARe], WHI Memory Study cohort [WHIMS+], and Genome-Wide Association Studies of Treatment Response in Randomized Clinical Trials [GARNET] studies, total n = 17,695) of European American, African American, and Hispanic American postmenopausal women aged 50 to 79 years at baseline in the Women's Health Initiative Study. We examined genetic variation in relation to VMS (yes/no) in each study and using trans-ethnic inverse variance fixed-effects meta-analysis. A total of 11,078,977 single-nucleotide polymorphisms (SNPs) met the quality criteria.After adjustment for covariates and population structure, three SNPs (on chromosomes 3 and 11) were associated with VMS at the genome-wide threshold of 5 × 10 in the African American SHARe GWAS, but were not associated in the other cohorts. In the meta-analysis, 14 SNPs, all located on chromosome 4 in the tachykinin receptor 3 (TACR3) locus, however, had P < 5 × 10. These SNPs' effect sizes were similar across studies/participants' ancestry (odds ratio ∼1.5).Genetic variation in TACR3 may contribute to the risk of VMS. To our knowledge, this is the first GWAS to examine SNPs associated with VMS. These results support the biological hypothesis of a role for TACR3 in VMS, which was previously hypothesized from animal and human studies. Further study of these variants may lead to new insights into the biological pathways involved in VMS, which are poorly understood.
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association of genetic variation in the tachykinin receptor 3 locus with hot flashes and Night Sweats in the women s health initiative study
Menopause, 2017Co-Authors: Carolyn J Crandall, Joann E Manson, Chancellor Hohensee, Steve Horvath, Jean Wactawskiwende, Erin Leblanc, Mara Z Vitolins, Rami Nassir, Janet S SinsheimerAbstract:AbstractObjective:Vasomotor symptoms (VMS, ie, hot flashes or Night Sweats) are reported by many, but not all, women. The extent to which VMS are genetically determined is unknown. We evaluated the relationship of genetic variation and VMS.Methods:In this observational study, we accessed data from t
