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The Effect of Selective Serotonin Reuptake Inhibitors (SSRIs) on Sleep among Midlife Women with Depression: A SWAN Study

Garritano, Samantha S (2023) The Effect of Selective Serotonin Reuptake Inhibitors (SSRIs) on Sleep among Midlife Women with Depression: A SWAN Study. Master's Thesis, University of Pittsburgh. (Unpublished)

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Background/Objective: The objective of this study was to determine the effects of SSRI use on self-reported sleep disturbances among midlife women with depression. During the menopause transition, women are more likely to experience health conditions like depression and sleep disturbances that impact many aspects of health. SSRIs are the most frequently prescribed class of antidepressant medication and information on the relationship between SSRI medications and sleep disturbances has primarily been investigated cross-sectionally or over a short follow up.
Methods: A subcohort from the Study of Women’s Health Across the Nation (SWAN) was used to assess the relationship between SSRIs and sleep disturbances using a retrospective cohort design. Women who initiated an SSRI during the SWAN study were propensity score matched to women who never used an SSRI medication. Women reported on the frequency of self-reported sleep disturbances, including trouble falling asleep, difficulty staying asleep, and early morning awakening. The change in sleep disturbances was assessed 1 year after report of SSRI initiation using generalized estimating equations (GEE).
Results: A cohort of 146 SSRI users and 666 non-users were frequency matched by SSRI initiation visit. Propensity score matching was carried out to achieve better balance between the groups. The final matched set consisted of 133 users and 133 non-users. The proportion of women experiencing sleep disturbances was greatest at the SSRI initiation visit for frequent awakening, early morning awakening, and any sleep disturbance for SSRI users before returning near baseline levels. Changes in sleep disturbances at SSRI initiation and 1 year post-initiation from baseline did not differ significantly between SSRI users and non-users for any sleep disturbances.
Conclusion: The interaction between SSRI use and time was not significant at SSRI initiation and 1 year post-initiation, meaning SSRI users and non-users did not differ in the change in sleep disturbances at various timepoints. SSRI users and non-user groups did not see a significant change from baseline for any type of sleep disturbance.
Public Health Significance: As long term use of SSRIs continues in midlife women, the medication does not appear to adversely impact sleep in the menopause transition.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Garritano, Samantha Sssg47@pitt.edussg47
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Thesis AdvisorBrooks, Maria Morimbrooks@pitt.edumbrooks
Committee MemberSuh, Kanghokas551@pitt.edukas551
Committee MemberRuppert, Kristineruppertk@pitt.eduruppertk
Date: 3 January 2023
Date Type: Publication
Defense Date: 15 November 2022
Approval Date: 3 January 2023
Submission Date: 8 December 2022
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 79
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: SWAN, Pharmacoepidemiology, Propensity Score Matching
Date Deposited: 03 Jan 2023 13:55
Last Modified: 03 Jan 2023 13:55


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