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Daytime sleepiness in relation to gender and premenstrual symptoms in a sample of Japanese college students

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Abstract

Daytime sleepiness is common in college students. In women, daytime sleepiness increases in the late-luteal phase compared with the follicular phase. In addition, women with premenstrual dysphoric disorder (PMDD), the severest form of premenstrual syndrome (PMS), experience severer daytime sleepiness than healthy women do. To date, daytime sleepiness has not been compared between women with PMDD and those with moderate PMS, or between men and women. Hence, this study aims to explore daytime sleepiness in college students in correlation with gender and the severity of premenstrual symptoms. We enrolled 658 Japanese college students (383 females, 275 males; age: 18–27 years) and assessed PMS and PMDD using the PMDD scale. Using the Japanese version of the Epworth Sleepiness Scale (JESS), we evaluated daytime sleepiness. Furthermore, women were asked about the severity of premenstrual daytime sleepiness. In this study, 47 (12.3%), 79 (20.6%), and 257 women (67.1%) were with PMDD, moderate-to-severe PMS (PMS), and no or mild PMS (no/mild PMS), respectively. The JESS score was markedly higher in women than that in men. The JESS score was highest in those with PMDD, followed by those with PMS, and lowest in those with no/mild PMS. Furthermore, women with no/mild PMS exhibited higher JESS score than men. This study suggests that daytime sleepiness is severer in women before menstruation than in men. Furthermore, the severity of daytime sleepiness in women correlates with the severity of premenstrual symptoms. Hence, daytime sleepiness should be cautioned in women with PMS/PMDD.

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References

  1. American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien: American Academy of Sleep Medicine; 2014.

    Google Scholar 

  2. Steptoe A, Peacey V, Wardle J. Sleep duration and health in young adults. Arch Intern Med. 2006;166(16):1689–92.

    Article  Google Scholar 

  3. Fukuda K, Ishihara K. Age-related changes of sleeping pattern during adolescence. Psychiatry Clin Neurosci. 2001;55(3):231–2.

    Article  CAS  Google Scholar 

  4. Asaoka S, Fukuda K, Tsutsui Y, Yamazaki K. Does television viewing cause delayed and/or irregular sleep-wake patterns? Sleep Biol Rhythms. 2007;5(1):23–7.

    Article  Google Scholar 

  5. Van den Bulck J. Television viewing, computer game playing, and Internet use and self-reported time to bed and time out of bed in secondary-school children. Sleep. 2004;27(1):101–4.

    Article  Google Scholar 

  6. Asaoka S, Fukuda K, Yamazaki K. Effects of sleep–wake pattern and residential status on psychological distress in university students. Sleep Biol Rhythms. 2004;2(3):192–8.

    Article  Google Scholar 

  7. Takamoto M, Komura K. Part-time jobs, mental health, and earning university credit. Jpn J Educ Psychol. 2018;66:14–27.

    Article  Google Scholar 

  8. Wolfson AR, Carskadon MA. Understanding adolescents’ sleep patterns and school performance: a critical appraisal. Sleep Med Rev. 2003;7(6):491–506.

    Article  Google Scholar 

  9. Rhie S, Lee S, Chae KY. Sleep patterns and school performance of Korean adolescents assessed using a Korean version of the pediatric daytime sleepiness scale. Korean J Pediatr. 2011;54(1):29–35.

    Article  Google Scholar 

  10. Shibui K, Uchiyama M, Okawa M, Kudo Y, Kim K, Liu X, Kamei Y, Hayakawa T, Akamatsu T, Ohta K, et al. Diurnal fluctuation of sleep propensity and hormonal secretion across the menstrual cycle. Biol Psychiatry. 2000;48(11):1062–8.

    Article  CAS  Google Scholar 

  11. Manber R, Bootzin RR. Sleep and the menstrual cycle. Health Psychol. 1997;16(3):209–14.

    Article  CAS  Google Scholar 

  12. Merryman W, Boiman R, Barnes L, Rothchild I. Progesterone anesthesia in human subjects. J Clin Endocrinol Metab. 1954;14(12):1567–9.

    Article  CAS  Google Scholar 

  13. Eisenhofer G, Peitzsch M, Kaden D, Langton K, Pamporaki C, Masjkur J, Tsatsaronis G, Mangelis A, Williams TA, Reincke M, et al. Reference intervals for plasma concentrations of adrenal steroids measured by LC–MS/MS: impact of gender, age, oral contraceptives, body mass index and blood pressure status. Clin Chim Acta. 2017;470:115–24.

    Article  CAS  Google Scholar 

  14. Deutsch SI, Mastropaolo J, Hitri A. GABA-active steroids: endogenous modulators of GABA-gated chloride ion conductance. Clin Neuropharmacol. 1992;15(5):352–64.

    Article  CAS  Google Scholar 

  15. Israel S, Schneller O. The thermogenic property of progesterone. Fertil Steril. 1950;1:53–65.

    Article  Google Scholar 

  16. World Health Organization. Mental, behavioral and developmental disorders Tenth Revision of the International Classification of Diseases (ICD-10). Geneva: World Health Organization; 1996.

    Google Scholar 

  17. American Psychiatric Association: Diagnostic and statistical manual of mental disorders fifth edition (DSM-5) Arlington; 2013.

  18. Baker FC, Colrain IM. Daytime sleepiness, psychomotor performance, waking EEG spectra and evoked potentials in women with severe premenstrual syndrome. J Sleep Res. 2010;19(1 Pt 2):214–27.

    Article  Google Scholar 

  19. Lamarche LJ, Driver HS, Wiebe S, Crawford L. JM DEK: nocturnal sleep, daytime sleepiness, and napping among women with significant emotional/behavioral premenstrual symptoms. J Sleep Res. 2007;16(3):262–8.

    Article  Google Scholar 

  20. Mauri M, Reid RL, MacLean AW. Sleep in the premenstrual phase: a self-report study of PMS patients and normal controls. Acta Psychiatr Scand. 1988;78(1):82–6.

    Article  CAS  Google Scholar 

  21. Joo S, Shin C, Kim J, Yi H, Ahn Y, Park M, Kim J, Lee S. Prevalence and correlates of excessive daytime sleepiness in high school students in Korea. Psychiatry Clin Neurosci. 2005;59(4):433–40.

    Article  Google Scholar 

  22. Liu Y, Zhang J, Li SX, Chan NY, Yu MWM, Lam SP, Chan JWY, Li AM, Wing YK. Excessive daytime sleepiness among children and adolescents: prevalence, correlates, and pubertal effects. Sleep Med. 2019;53:1–8.

    Article  CAS  Google Scholar 

  23. Hara C, Lopes Rocha F, Lima-Costa MF. Prevalence of excessive daytime sleepiness and associated factors in a Brazilian community: the Bambui study. Sleep Med. 2004;5(1):31–6.

    Article  Google Scholar 

  24. Gaina A, Sekine M, Hamanishi S, Chen X, Wang H, Yamagami T, Kagamimori S. Daytime sleepiness and associated factors in Japanese school children. J Pediatr. 2007;151(5):518–22 (522 e511–514).

    Article  Google Scholar 

  25. Akerstedt T, Hallvig D, Kecklund G. Normative data on the diurnal pattern of the Karolinska Sleepiness Scale ratings and its relation to age, sex, work, stress, sleep quality and sickness absence/illness in a large sample of daytime workers. J Sleep Res. 2017;26(5):559–66.

    Article  Google Scholar 

  26. Gau SF, Soong WT. Sleep problems of junior high school students in Taipei. Sleep. 1995;18(8):667–73.

    Article  CAS  Google Scholar 

  27. Takegami M, Suzukamo Y, Wakita T, Noguchi H, Chin K, Kadotani H, Inoue Y, Oka Y, Nakamura T, Green J, et al. Development of a Japanese version of the Epworth Sleepiness Scale (JESS) based on item response theory. Sleep Med. 2009;10(5):556–65.

    Article  Google Scholar 

  28. Miyaoka Y, Akimoto Y, Ueda K, Ujiie Y, Kametani M, Uchiide Y, Kamo T. Fulfillment of the premenstrual dysphoric disorder criteria confirmed using a self-rating questionnaire among Japanese women with depressive disorders. Biopsychosoc Med. 2011;5(1):5.

    Article  Google Scholar 

  29. Steiner M, Macdougall M, Brown E. The premenstrual symptoms screening tool (PSST) for clinicians. Arch Womens Ment Health. 2003;6(3):203–9.

    Article  CAS  Google Scholar 

  30. Yama K, Minami E, Machida M, Hayase N, Miura J. Relation between premenstrual syndrome, oxidative stress and depression. Pharmacometrics (Oyo Yakuri). 2018;95(1/2):19–24.

    Google Scholar 

  31. Johns M, Hocking B. Daytime sleepiness and sleep habits of Australian workers. Sleep. 1997;20(10):844–9.

    Article  CAS  Google Scholar 

  32. Owens J. Adolescent Sleep Working G, Committee on A: insufficient sleep in adolescents and young adults: an update on causes and consequences. Pediatrics. 2014;134(3):e921–32.

    Article  Google Scholar 

  33. Takeda T, Tasaka K, Sakata M, Murata Y. Prevalence of premenstrual syndrome and premenstrual dysphoric disorder in Japanese women. Arch Womens Ment Health. 2006;9(4):209–12.

    Article  CAS  Google Scholar 

  34. Owashi T, Otsubo T, Tanaka K, Yoshida Y, Ishii Y, Koda R, Kobayashi R, Okajima Y, Kamijima K. Premenstrual dysphoric disorder in Japanese students of a nurse’s training schlool. Seishin Igaku (Clinical Psychiatry). 2001;43:1311–5.

    Google Scholar 

  35. Akimoto Y, Miyaoka Y, Kamo T. Clinical characteristics and stress coping behaviors in women with premenstrual syndrome or premenstrual dysphoric disorder. J Atomi Univ Fac Lit. 2009;43:45–60.

    Google Scholar 

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Acknowledgements

The authors thank all participants of this study for their time.

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Contributions

JM conceptualized and designed the study, drafted the manuscript and the figure, and was responsible for the whole study. RH assisted with data acquisition and statistical analyses.

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Correspondence to Jun Miura.

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The authors declare no conflict of interest.

Ethical approval

This study protocol was approved by the Ethics Committee of Hokkaido Pharmaceutical University (No. 15-03-022) and was conducted per the ethical principles of the Declaration of Helsinki (Fortaleza, Brazil, 2013).

Research involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Miura, J., Honma, R. Daytime sleepiness in relation to gender and premenstrual symptoms in a sample of Japanese college students. Sleep Biol. Rhythms 18, 3–8 (2020). https://doi.org/10.1007/s41105-019-00236-x

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  • DOI: https://doi.org/10.1007/s41105-019-00236-x

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