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Management of sleep disorders in the menopausal transition.
Post Reprod Health. 2021 Dec; 27(4):209-214.PR

Abstract

The menopausal transition is associated with increasing sleep disorders including sleep apnoea and restless leg syndrome. Insomnia is the most common and is recognised as a core symptom of the menopause. Guidelines to support decision making for women with sleep problems during the menopausal transition are lacking. Sleep problems are associated with negative impacts on healthcare utilisation, quality of life and work productivity. Sleep deprivation is a risk factor for cardiovascular disease, diabetes, obesity and neurobehavioral dysfunction. Declining oestrogen is implicated as a cause of menopausal sleep disruption. Vasomotor symptoms (VMS) and menopausal mood disturbance are also factors in the complex aetiology. VMS commonly precipitate insomnia and, due to their prolonged duration, they often perpetuate the condition. Insomnia in the general population is most effectively treated with cognitive behavioural therapy (CBT) (also effective in the menopausal transition.) The associations of menopausal sleep disturbance with VMS and depression mean that other treatment options must be considered. Existing guidelines outline effectiveness of hormone replacement therapy (HRT), CBT and antidepressants. HRT may indirectly help with sleep disturbance by treating VMS and also via beneficial effect on mood symptoms. The evidence base underpinning menopausal insomnia often references risks associated with HRT that are not in line with current international menopause guidelines. This may influence clinicians managing sleep disorders, leading to hesitation in offering HRT, despite evidence of effectiveness. Viewing sleep symptoms on an axis of menopausal symptoms - towards vasomotor symptoms or towards mood symptoms may help tailor treatment options towards the symptom profile.

Authors+Show Affiliations

Beaconsfield Medical Practice, Brighton, UK.8945Guy's Hospital, London, UK.4616King's College London, London, UK.King's College London, London, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34748453

Citation

Schaedel, Zoe, et al. "Management of Sleep Disorders in the Menopausal Transition." Post Reproductive Health, vol. 27, no. 4, 2021, pp. 209-214.
Schaedel Z, Holloway D, Bruce D, et al. Management of sleep disorders in the menopausal transition. Post Reprod Health. 2021;27(4):209-214.
Schaedel, Z., Holloway, D., Bruce, D., & Rymer, J. (2021). Management of sleep disorders in the menopausal transition. Post Reproductive Health, 27(4), 209-214. https://doi.org/10.1177/20533691211039151
Schaedel Z, et al. Management of Sleep Disorders in the Menopausal Transition. Post Reprod Health. 2021;27(4):209-214. PubMed PMID: 34748453.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of sleep disorders in the menopausal transition. AU - Schaedel,Zoe, AU - Holloway,Debra, AU - Bruce,Deborah, AU - Rymer,Janice, Y1 - 2021/11/08/ PY - 2021/11/9/pubmed PY - 2021/11/9/medline PY - 2021/11/8/entrez KW - Sleep KW - cognitive behavioural therapy KW - hormone replacement therapy KW - insomnia KW - menopause KW - perimenopause SP - 209 EP - 214 JF - Post reproductive health JO - Post Reprod Health VL - 27 IS - 4 N2 - The menopausal transition is associated with increasing sleep disorders including sleep apnoea and restless leg syndrome. Insomnia is the most common and is recognised as a core symptom of the menopause. Guidelines to support decision making for women with sleep problems during the menopausal transition are lacking. Sleep problems are associated with negative impacts on healthcare utilisation, quality of life and work productivity. Sleep deprivation is a risk factor for cardiovascular disease, diabetes, obesity and neurobehavioral dysfunction. Declining oestrogen is implicated as a cause of menopausal sleep disruption. Vasomotor symptoms (VMS) and menopausal mood disturbance are also factors in the complex aetiology. VMS commonly precipitate insomnia and, due to their prolonged duration, they often perpetuate the condition. Insomnia in the general population is most effectively treated with cognitive behavioural therapy (CBT) (also effective in the menopausal transition.) The associations of menopausal sleep disturbance with VMS and depression mean that other treatment options must be considered. Existing guidelines outline effectiveness of hormone replacement therapy (HRT), CBT and antidepressants. HRT may indirectly help with sleep disturbance by treating VMS and also via beneficial effect on mood symptoms. The evidence base underpinning menopausal insomnia often references risks associated with HRT that are not in line with current international menopause guidelines. This may influence clinicians managing sleep disorders, leading to hesitation in offering HRT, despite evidence of effectiveness. Viewing sleep symptoms on an axis of menopausal symptoms - towards vasomotor symptoms or towards mood symptoms may help tailor treatment options towards the symptom profile. SN - 2053-3705 UR - https://www.unboundmedicine.com/medline/citation/34748453/Management_of_sleep_disorders_in_the_menopausal_transition_ L2 - https://journals.sagepub.com/doi/10.1177/20533691211039151?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -