Insomnia during menopause and perimenopause: clinical characteristics and therapeutic options

Abstract

Sleep disturbances and insomnia are more commonly observed in adult females than in adult males. It has been speculated that comorbid depression and anxiety among females may contribute to a higher incidence of insomnia. In addition, periods of intense hormonal variability (e.g.; pregnancy/postpartum, menopause transition) appear to be associated with higher incidence of sleep disturbances in females. Epidemiologic studies suggest that the menopausal transition constitutes a period of heightened risk for the occurrence of depressive symptoms and vasomotor complaints, as well as insomnia. This article reviews the clinical and hormone factors that may play a role for the development of insomnia during the menopausal transition and postmenopause. Treatment options are critically reviewed, including cognitive-behavioral techniques, hormonal treatments, hypnotics, antidepressants, and complimentary/alternative medicine.