Sleep and Sleep Disorders in the Menopausal Transition

Abstract

The menopausal transition is associated with an increase in insomnia symptoms, especially difficulty staying asleep, which negatively impacts quality of life. Vasomotor symptoms are a key component of sleep disruption. Findings from polysomnographic studies are less consistent in showing disrupted sleep in menopausal transition independent of aging; further prospective studies are needed. Hormone therapy alleviates subjective sleep disturbances, particularly if vasomotor symptoms are present. However, because of contraindications, other options should be considered. Further work is needed to develop preventive and treatment strategies for alleviating sleep disturbances to ensure better health, quality of life, and productivity in midlife women.

Keywords: Climacteric; Depressive symptoms; Menopause; Polysomnography; Sleep architecture; Subjective sleep quality; Vasomotor symptoms.

Copyright © 2018 Elsevier Inc. All rights reserved.

Figures

Figure 1:

Hypnograms derived from the polysomnograms of one representative participant during her premenopausal baseline visit (A) and at a follow-up visit 6 years later (B), when she was peri-menopausal. Data from Lampio L, Polo-Kantola P, Himanen SL, et al. Sleep during menopausal transition: A six-year follow-up. Sleep. 2017.

Figure 2.

Many factors are associated with sleep disturbances in the context of the menopausal transition. Some factors may also interact to worsen sleep quality. SDB, sleep-disordered breathing; PLMD, periodic limb movement disorder; RLS, restless legs syndrome.