Sleep problems during the menopausal transition: prevalence, impact, and management challenges

Fiona C Baker,1,2 Massimiliano de Zambotti,1 Ian M Colrain,1,3 Bei Bei4,5 1Center for Health Sciences, SRI International, Menlo Park, CA, USA; 2Brain Function Research Group, University of the Witwatersrand, Johannesburg, South Africa; 3Melbourne School of Psychological Sciences, University of Melbo...

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Autores principales:	Baker FC, de Zambotti M, Colrain IM, Bei B
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	insomnia midlife women hormone therapy estradiol hot flashes vasomotor symptoms Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/42e07f62cc2a45feb42a4230fdd959ce
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spelling	oai:doaj.org-article:42e07f62cc2a45feb42a4230fdd959ce2021-12-02T06:18:57ZSleep problems during the menopausal transition: prevalence, impact, and management challenges1179-1608https://doaj.org/article/42e07f62cc2a45feb42a4230fdd959ce2018-02-01T00:00:00Zhttps://www.dovepress.com/sleep-problems-during-the-menopausal-transition-prevalence-impact-and--peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Fiona C Baker,1,2 Massimiliano de Zambotti,1 Ian M Colrain,1,3 Bei Bei4,5 1Center for Health Sciences, SRI International, Menlo Park, CA, USA; 2Brain Function Research Group, University of the Witwatersrand, Johannesburg, South Africa; 3Melbourne School of Psychological Sciences, University of Melbourne, 4Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 5Centre for Women’s Mental Health, Department of Psychiatry, University of Melbourne, Royal Women’s Hospital, Melbourne, VIC, Australia Abstract: A substantial number of women experience sleep difficulties in the approach to menopause and beyond, with 26% experiencing severe symptoms that impact daytime functioning, qualifying them for a diagnosis of insomnia. Here, we review both self-report and polysomnographic evidence for sleep difficulties in the context of the menopausal transition, considering severity of sleep complaints and links between hot flashes (HFs) and depression with poor sleep. Longitudinal population-based studies show that sleep difficulties are uniquely linked with menopausal stage and changes in follicle-stimulating hormone and estradiol, over and above the effects of age. A major contributor to sleep complaints in the context of the menopausal transition is HFs, and many, although not all, HFs are linked with polysomnographic-defined awakenings, with HF-associated wake time contributing significantly to overall wakefulness after sleep onset. Some sleep complaints may be comorbid with depressive disorders or attributed to sleep-related breathing or movement disorders, which increase in prevalence especially after menopause, and for some women, menopause, age, and environmental/behavioral factors may interact to disrupt sleep. Considering the unique and multifactorial basis for sleep difficulties in women transitioning menopause, we describe clinical assessment approaches and management options, including combination treatments, ranging from cognitive behavioral therapy for insomnia to hormonal and nonhormonal pharmacological options. Emerging studies suggest that the impact of severe insomnia symptoms could extend beyond immediate health care usage and quality of life issues to long-term mental and physical health, if left untreated in midlife women. Appropriate treatment, therefore, has immediate benefit as well as advantages for maintaining optimal health in the postmenopausal years. Keywords: insomnia, midlife women, hormone therapy, estradiol, hot flashes, vasomotor symptomsBaker FCde Zambotti MColrain IMBei BDove Medical Pressarticleinsomniamidlife womenhormone therapyestradiolhot flashesvasomotor symptomsPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 10, Pp 73-95 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	insomnia midlife women hormone therapy estradiol hot flashes vasomotor symptoms Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	insomnia midlife women hormone therapy estradiol hot flashes vasomotor symptoms Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Baker FC de Zambotti M Colrain IM Bei B Sleep problems during the menopausal transition: prevalence, impact, and management challenges
description	Fiona C Baker,1,2 Massimiliano de Zambotti,1 Ian M Colrain,1,3 Bei Bei4,5 1Center for Health Sciences, SRI International, Menlo Park, CA, USA; 2Brain Function Research Group, University of the Witwatersrand, Johannesburg, South Africa; 3Melbourne School of Psychological Sciences, University of Melbourne, 4Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 5Centre for Women’s Mental Health, Department of Psychiatry, University of Melbourne, Royal Women’s Hospital, Melbourne, VIC, Australia Abstract: A substantial number of women experience sleep difficulties in the approach to menopause and beyond, with 26% experiencing severe symptoms that impact daytime functioning, qualifying them for a diagnosis of insomnia. Here, we review both self-report and polysomnographic evidence for sleep difficulties in the context of the menopausal transition, considering severity of sleep complaints and links between hot flashes (HFs) and depression with poor sleep. Longitudinal population-based studies show that sleep difficulties are uniquely linked with menopausal stage and changes in follicle-stimulating hormone and estradiol, over and above the effects of age. A major contributor to sleep complaints in the context of the menopausal transition is HFs, and many, although not all, HFs are linked with polysomnographic-defined awakenings, with HF-associated wake time contributing significantly to overall wakefulness after sleep onset. Some sleep complaints may be comorbid with depressive disorders or attributed to sleep-related breathing or movement disorders, which increase in prevalence especially after menopause, and for some women, menopause, age, and environmental/behavioral factors may interact to disrupt sleep. Considering the unique and multifactorial basis for sleep difficulties in women transitioning menopause, we describe clinical assessment approaches and management options, including combination treatments, ranging from cognitive behavioral therapy for insomnia to hormonal and nonhormonal pharmacological options. Emerging studies suggest that the impact of severe insomnia symptoms could extend beyond immediate health care usage and quality of life issues to long-term mental and physical health, if left untreated in midlife women. Appropriate treatment, therefore, has immediate benefit as well as advantages for maintaining optimal health in the postmenopausal years. Keywords: insomnia, midlife women, hormone therapy, estradiol, hot flashes, vasomotor symptoms
format	article
author	Baker FC de Zambotti M Colrain IM Bei B
author_facet	Baker FC de Zambotti M Colrain IM Bei B
author_sort	Baker FC
title	Sleep problems during the menopausal transition: prevalence, impact, and management challenges
title_short	Sleep problems during the menopausal transition: prevalence, impact, and management challenges
title_full	Sleep problems during the menopausal transition: prevalence, impact, and management challenges
title_fullStr	Sleep problems during the menopausal transition: prevalence, impact, and management challenges
title_full_unstemmed	Sleep problems during the menopausal transition: prevalence, impact, and management challenges
title_sort	sleep problems during the menopausal transition: prevalence, impact, and management challenges
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/42e07f62cc2a45feb42a4230fdd959ce
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_version_	1718399986724503552

Sleep problems during the menopausal transition: prevalence, impact, and management challenges

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