***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: This study examined the relationship between objective ly measured nocturnal hot flashes and objective ly measured sleep in breast cancer survivors with insomnia . Twenty-four women who had completed treatment for non-metastatic breast cancer participated . All were enrolled in a study of cognitive-behavioral treatment for chronic insomnia .  Nocturnal hot flashes and sleep  were measured by skin conductance and polysomnography  , respectively . The 10-minute periods around hot flashes were found to have significantly more wake time , and more stage changes to lighter sleep , than other 10-minute periods during the night . Nights with hot flashes had a significantly higher percentage of wake time , a lower percentage of Stage 2 sleep , and a longer REM latency compared to nights without hot flashes . Overall , hot flashes were found to be associated with less efficient , more disrupted sleep . Nocturnal hot flashes , or their underlying mechanisms , should be considered as potential contributors to sleep disruption in women with breast cancer who report poor sleep PURPOSE / OBJECTIVES To compare the hot flash symptom experience and related outcomes between breast cancer survivors and healthy women . DESIGN Descriptive , cross-sectional , comparative study . SETTING Southeastern university medical center . SAMPLE 69 of 207 breast cancer survivors contacted via a tumor registry and 63 age-matched healthy female volunteers . Survivors were a mean of 57 years and a mean of 39 months postdiagnosis . METHODS Mailed survey included a demographic , disease , and treatment information form ; a gynecologic history form ; a two-day , prospect i ve , hot flash diary ; a detailed hot flash question naire ; mood and affect scales ; and the Hot Flash-Related Daily Interference Scale . MAIN RESEARCH VARIABLES Hot flashes , mood , affect , interference with daily activities , and overall quality of life . FINDINGS Breast cancer survivors had hot flashes that were significantly more frequent , severe , distressing , and of greater duration . Breast cancer survivors were less likely to be using hormone replacement and more likely to have tried nonhormonal prescription interventions in the past , but reported significantly less effectiveness from hot flash treatments . Breast cancer survivors with severe hot flashes reported significantly greater mood disturbance ; higher negative affect ; more interference with daily activities , including sleep , concentration , and sexuality ; and poorer overall quality of life in comparison to breast cancer survivors with no hot flashes to mild hot flashes . Hot flash quality and triggers were not significantly different between groups . No clear temporal pattern of hot flashes emerged . CONCLUSIONS Hot flashes are a significant problem for breast cancer survivors , even for those who are naturally postmenopausal ( i.e. , did not undergo menopause as a result of surgery or the effects of chemotherapy ) . Hot flashes remained fairly stable over time and did not diminish in frequency , severity , or associated distress . IMPLICATION S FOR NURSING The findings guide the assessment of the uniqueness of the problem of hot flashes experienced by breast cancer survivors and help define outcomes to address in clinical practice or include in future hot flash intervention research Objective : Hot flashes are valuable indicators of physiological condition and drug effect ; however , subjective and objective measures do not always agree . No study has examined both subjective and objective hot flashes in women prescribed aromatase inhibitors .  The study ( 1 ) compared subjective and objective hot flash measures , ( 2 ) examined changes in subjective and objective hot flashes over time , and ( 3 ) evaluated predictors of change in hot flashes in aromatase inhibitor-treated women . Methods : Participants ( n = 135 ) were enrolled in a r and omized clinical trial comparing exemestane and letrozole for the treatment of breast cancer .  Hot flashes were assessed before the start of the drug therapy and 1 , 3 , and 6 months later . Participants wore a sternal skin conductance monitor for 24 hours or longer at each time point . With each perceived hot flash , women pressed an event button and rated intensity and bother in a paper diary . Results : Participants had a mean age of 60 years and were mainly white ( 92 % ) . Across time points , monitor hot flashes were ( 1 ) significantly more frequent than diary and /or event button flashes ( P < 0.05 ) and ( 2 ) moderately correlated with subjective measures ( 0.35 < r < 0.56 ) . Monitor hot flashes did not significantly change over time with aromatase inhibitor therapy , whereas both diary and event button frequencies significantly varied but in dissimilar patterns ( 51 % nonlinear ) . No consistent predictors of hot flashes across measures or time points were identified . Conclusions : Findings indicated dissimilarities between subjective and objective measures of hot flashes . Despite statistical significance , there was little clinical ly meaningful change in hot flashes after initiating aromatase inhibitor therapy OBJECTIVE To assess the feasibility and psychometric properties of a lightweight , automated , ambulatory sternal skin conductance monitor to measure frequency of hot flashes ( HFs ) among breast cancer survivors ( BCSs ) . DESIGN A total of 19 postmenopausal BCSs and 5 premenopausal healthy comparison women participated by wearing the monitor for 24 h during their normal daily activities , including sleep . HFs were assessed using subjective ( diaries , event markers ) and objective ( skin conductance ) methods . RESULTS Problems with subjective reporting of HFs were reported by 35 % of BCSs . Technological problems and discomfort related to wearing the monitor were minimal . A total of 243 HFs were recorded using the skin conductance monitor by 17 BCSs and 5 premenopausal women ( BCS group M = 13.4 ; range , 1 - 30 ) . Subjective reporting of HFs was associated with a 31 - 33 % false-positive rate . Skin conductance monitoring during waking hours was associated with a 30 % false-negative rate . CONCLUSIONS The monitor is a feasible method for objective ly assessing HFs in BCSs . Data support continued use of sternal skin conductance as an objective measure of HF frequency . This technology should prove useful as an objective measure of HFs in future intervention research aim ed at alleviating the symptom and improving quality of life among BCSs Although Unibase cream has been an effective medium for electrodermal recordings , its production has recently been discontinued . This study compared alternative media to Unibase for effectiveness . Three base creams similar to Unibase were initially compared for in vitro viscosity and effectiveness . Based upon this analysis one cream was eliminated . A volunteer sample of 6 postmenopausal women with hot flashes and 6 young women without flashes was recruited . Media were evaluated for viscosity and effectiveness of skin conductance . Results indicated that one electrolyte media produced readings within the normal range , identified true positive hot flashes , and produced few false negative readings whereas the second produced largely unreadable results with many false negative hot flashes . An appropriate substitute for Unibase as an effective electrolyte medium for measurement of electrodermal activity was identified OBJECTIVE To assess the feasibility and efficacy of a yoga treatment for menopausal symptoms . Both physiologic and self-reported measures of hot flashes were included . METHODS A prospect i ve within-group pilot study was conducted . Participants were 12 peri- and post-menopausal women experiencing at least 4 menopausal hot flashes per day , at least 4 days per week . Assessment s were administered before and after completion of a 10-week yoga program . Pre- and post-treatment measures included : Severity of question naire-rated menopausal symptoms ( Wiklund Symptom Check List ) , frequency , duration , and severity of hot flashes ( 24-h ambulatory skin-conductance monitoring ; hot-flash diary ) , interference of hot flashes with daily life ( Hot Flash Related Daily Interference Scale ) , and subjective sleep quality ( Pittsburgh Sleep Quality Index ) .  Yoga classes included breathing techniques , postures , and relaxation poses design ed specifically for menopausal symptoms . Participants were asked to practice at home 15 min each day in addition to weekly classes . RESULTS Eleven women completed the study and attended a mean of 7.45 ( S.D. 1.63 ) classes . Significant pre- to post-treatment improvements were found for severity of question naire-rated total menopausal symptoms , hot-flash daily interference ; and sleep efficiency , disturbances , and quality . Neither 24-h monitoring nor accompanying diaries yielded significant changes in hot flashes . CONCLUSIONS The yoga treatment and study procedures were feasible for midlife women . Improvement in symptom perceptions and well being warrant further study of yoga for menopausal symptoms , with a larger number of women and including a control group OBJECTIVE To design and test a miniature ambulatory hot flash recorder that uses neither electrodes nor gel . DESIGN In the first study , putative hot flashes recorded by using a relative humidity sensor were compared with patient event marks . In the second study , relative humidity recorded by using a complete prototype recorder was compared with sternal skin conductance recordings made on a Biolog recorder , as well as with event marks . SETTING University medical center . PATIENT(S ) Ten healthy postmenopausal women reporting frequent hot flashes and using no medication . INTERVENTION(S ) Body heating in laboratory . MAIN OUTCOME MEASURE(S ) Positive predictive value ( PPV ) , sensitivity , specificity . RESULT ( S ) In both laboratory studies , the PPV , sensitivity , and specificity among all three measures ( relative humidity , skin conductance level , event ) were 100 % . In the field , a relative humidity increase of 3 % per minute compared with skin conductance level-detected hot flashes yielded a PPV of 95.6 % , a specificity of 95.2 % , and a sensitivity of 90.9 % . CONCLUSION ( S ) This device should be useful as an endpoint in clinical trials of treatments for hot flashes Objective : To evaluate relationships among different measures of hot flashes , perceived hot flash interference , and associated outcomes ( positive affect , negative affect ) while controlling potential covariates . Design : Breast cancer survivors ( N = 236 ) provided demographic data , objective hot flash frequency data via sternal skin conductance monitoring , prospect i ve diary-based hot flash frequency and severity data , and question naire data via the Hot Flash Related Daily Interference Scale and the Positive and Negative Affect Scale . Results : Objective hot flash frequency and subjective hot flash severity emerged as separate factors in the structural equation model . Subjective hot flash frequency was associated with a high degree of unexplained variance ( error ) and seemed to be a potentially less accurate measure of either frequency or severity . Objective frequency was directly related to greater positive affect . In contrast , greater hot flash severity was ( 1 ) directly related to greater perceived hot flash interference and ( 2 ) indirectly related to more negative affect and lower positive affect through interference . Conclusions : Findings provide a theoretical basis for selecting among symptom measures and anticipating how interventions aim ed at different hot flash measures might affect perceived hot flash interference or associated outcomes . Because objective hot flash frequency and subjective hot flash severity seemed to measure different dimensions , measuring both may provide a more comprehensive picture of women 's symptom experiences To assess the psychometric properties of the  Hot Flash Related Daily Interference Scale ( HFRDIS ) , a sample of breast cancer survivors and an age-matched comparison group completed a question naire packet and 2-day prospect i ve hot flash diary at an initial time point and again 6 months later . There were 71 breast cancer survivors and 63 comparators at Time 1 , and 54 survivors and 46 comparators at Time 2 . The HFRDIS was internally consistent , with alphas of 0.96 at times 1 and 2 . Validity was supported through 1 ) correlations with other hot flash variables , 2 ) correlations with measures of affect and mood , 3 ) significant differences between women with hot flashes and those without , and 4 ) demonstrated sensitivity to change over time . The HFRDIS is a psychometrically sound measure for assessing the impact of hot flashes on daily activities and overall quality of life in clinical practice or research protocol OBJECTIVES A population -based study was used to describe healthcare seeking behavior for  menopausal  symptoms and treatment among women 40 - 65 years old in the United States . METHODS Participants were recruited into the Menopause Epidemiology Study from the KnowledgePanel(SM ) , which is selected by r and om digit dialing and probability sampling from the US population . From this source , 6201 women 40 - 65 years old were contacted and 4402 women participated . From the 3135 peri- and postmenopausal women , detailed information was obtained on menopausal symptoms , healthcare seeking , medication usage , and symptom relief from the medication . RESULTS Many women ( 60 % ) reported seeking health care for their menopausal symptoms . More than half of these women sought health care in the past 12 months . Vasomotor symptoms were the most frequently reported menopause symptoms across all races/ethnicities , and the most common symptoms discussed with a health care professional . One-third of the women ( 34 % ) used only hormone therapies , 12 % used complementary and /or alternative medicines , and 16 % used both for treatment of menopausal symptoms . CONCLUSIONS This study has shown that a large number of women consult healthcare providers for menopausal symptoms , indicating these symptoms are bothersome . Yet , in the United States , there is considerable variation in the symptomatology , healthcare seeking , and use of therapies for menopausal symptoms across cultures . To alleviate these symptoms women have tried alternative treatments as well as hormone therapies , yet many women did not get complete relief of specific symptoms Hot flushes and night sweats are one of the main symptoms accompanying the menopause , and are a main reason for seeking medical help at this time . This study of 61 women ( reporting hot flushes once a week or more ) investigates 
    Output:
    
Conclusions : Concordance rates were typically lower than early reports of sternal skin conductance measures but were highly variable between studies .
Use of both measures concurrently is likely to achieve more reliable and valid measurement of hot flushes and night sweats than either measure alone