0279 Ovarian Hormone Suppression With Or Without Exercise Training And Subjective Sleep Quality

Abstract

Introduction: Midlife sleep complaints are highly prevalent in women and this may be related to the loss of ovarian hormones. We used a pharmacological approach (GnRH agonist) to suppress ovarian function and assess resultant changes in subjective sleep quality in women approaching the menopause. As an exploratory aim, we evaluated whether programmed exercise could mitigate changes in subjective sleep quality with the loss of ovarian function. Methods: Women nearing the menopause with normal menstrual cycle function (n=42, age= 40‐53y) were randomized to receive monthly injections of placebo (n=10) or gonadotropin releasing hormone agonist (GnRHag; leuprolide acetate, 3.75 mg/month) for 6 months to suppress ovarian function. The GnRHag arm involved additional randomization to no exercise (GnRHag+NoEx, n=14) or supervised endurance exercise (GnRHag+Ex, n=18; 3d/wk). Subjective sleep was assessed at baseline and 6 months using the Pittsburgh Sleep Quality Index (PSQI). A maximum likelihood repeated measures model was used to evaluate change in global PSQI within each group and whether changes differed among the GnRHag+Ex, GnRHag+NoEx, and PBO groups. Positive change scores indicate worse sleep quality. Results: Sleep quality at 6 months tended to be reduced in the hormone suppression groups (ΔPSQI global score: GnRHag+NoEx=+1.7 ± 1.0, P=0.08; GnRH+Ex, +1.1 ± 0.8, P=0.16), whereas subjective sleep quality improved in the PBO group (ΔPSQI global score = ‐2.6 ± 1.2, P=0.04). The 6 month change in sleep quality was not different between the GnRH+Ex and GnRH+NoEx groups (P=0.65), but changes in both suppression groups were different from PBO (both comparisons had P≤0.01). Conclusion: Compared to placebo, 6 months of chronic suppression of sex hormones reduced subjective sleep quality but responses were variable. Exercise was not effective in improving sleep during ovarian suppression, but further research is warranted given the exploratory nature of this aspect of the study.