First-Night Effect on Sleep in Different Female Reproductive States

ABSTRACT

Objectives: In sleep laboratory studies, the new environment is generally considered to disturb sleep during the first night. However, older women have rarely been studied. Although menopause and hormone therapy affect sleep, their impact on the first-night effect is virtually unknown. Participants: Four groups of women with no sleep laboratory experience: young on hormonal contraceptives (n = 11, 23.1 [0.5] years), perimenopausal (n = 15, 48.0 [0.4] years), postmenopausal without hormone therapy (HT; off-HT, n = 22, 63.4 [0.8] years) and postmenopausal with HT (n = 16, 63.1 [0.9] years). Procedure: A cross-sectional study. Methods: Polysomnography was performed over two consecutive nights and the first-night effect and group differences were evaluated. Questionnaire-based insomnia and sleepiness scores were correlated to sleep variables and their between-night changes. Results: Although sleep in young women was deeper and less fragmented than in the other groups, first-night effect was similar in all study groups. Total sleep time, sleep efficiency, and S1 and S2 sleep increased, and wake after sleep onset, awakenings per hour of sleep, S2 and REM latencies, and percentage of SWS decreased from the first to the second night. Perimenopausal women had more insomnia complaints than other women. Insomnia complaints were associated with more disturbed sleep but not with the first-night effect. Conclusions: A first night in a sleep laboratory elicits a marked interference of sleep architecture in women of all ages, with a carryover effect of lighter sleep on the second study night. Menopausal state, HT use, or insomnia complaints do not modify this effect.

Acknowledgments

We are grateful to Dr. Tarja Porkka-Heiskanen for the general arrangements of the study and the support of the data collection in Helsinki.

Additional information

Funding

The study was financially supported by a European Commission Grant (QLK6-CT-2000-00499), and grants from the Väinö and Laina Kivi Foundation (P.P-K.), The Finnish Menopause Society Foundation (P.P-K.), The Finnish Medical Foundation (P.P-K. and N.K.), The Turku University Foundation (P.P-K., N.K. and I.V.), The Finnish Academy (A.S.U.), and by a Finnish Government grant (N.K.).