Highlights
- •Sleep disorders increase in prevalence during the menopausal transition and they are related with vasomotor symptoms.
- •Women, suffering from sleep disturbances related to vasomotor symptoms, can be treated with Hormone Replacement Therapy.
- •Cognitive-behavioral therapy is the most commonly administered non-pharmacological insomnia treatment among sleep specialists.
- •Menopausal women complaining of persisting sleep disorders should be referred to a sleep specialist.
- •Future studies are needed to identify more standardized interventions and to conduct wide-scale randomized trials.
Abstract
Sleep disorders increase in prevalence during the menopausal transition and they constitute
a complex phenomenon. Insomnia, the main sleep disorder, can be a primary disorder
or it can be secondary to hot flushes (HF), mood disorders, psychosocial factors,
medical conditions, and other sleep disturbances, such as obstructive sleep apnoea
(OSA) or restless legs syndrome (RLS). Menopausal women complaining of persistent
sleep disorders should be referred to a sleep specialist for comprehensive sleep management
because unrecognized and untreated sleep disorders can have dramatic health-related
consequences. Women suffering from insomnia related to vasomotor symptoms (VMS) can
be treated with hormone replacement therapy (HRT). Primary insomnia will be preferentially
improved with cognitive behavioural therapy (CBT-I) or with non-benzodiazepine hypnotics
or melatonin. CBT-I is a highly efficacious treatment for postmenopausal women with
insomnia. Using antidepressants to treat sleep disruption in the absence of depression
is not recommended; instead, the United States Food and Drug Administration (FDA)
approved paroxetine as the first non-hormonal treatment for HF. Sleep disorders in
menopausal women should not be underestimated. It is necessary to diagnose the specific
causal disorder and then to provide treatment to improve sleep quality and quality
of life.
Keywords
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Article info
Publication history
Published online: June 28, 2019
Accepted:
June 27,
2019
Received in revised form:
June 22,
2019
Received:
May 8,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
