Menopause

The prevalence of sleep disorders in premenopausal women range between 16-42%, from 39-47% in perimenopausal women and 35-60% in postmenopausal women (Journal of Menopausal Medicine 2019).

Sleep disorders experienced include difficulty falling asleep, frequent awakenings during the night and waking up before the desired alarm clock time. Insomnia becomes chronic when these symptoms are experienced for at least three nights a week and for three months or more. Insomnia is one of the main causes of depression.

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Vasomotor symptoms (VMS) hot flashes lasting 7-10 years, caused by the reduction in estrogen and progesterone, are the most common symptoms reported by perimenopausal, menopausal and post-menopausal women. Lasting between 30 seconds to 5 minutes, raising the body temperature, causing awakenings throughout the night and early in the morning. Melatonin production (that regulates the sleep/wake cycle) also declines during menopause affecting sleep maintenance.

HRT is shown to be effective in treating vasomotor symptoms, improving sleep quality and is one of the main therapies for Osteoporosis.

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CBT-I is very effective in resolving insomnia by re-aligning your sleep/wake cycles to your circadian rhythm. We work to increase your body’s natural sleep drive, helping you to fall asleep quicker, wake up less and have better daytime functioning. We teach effective coping strategies for when VMS wakes you during the night and educate you in effective sleep hygiene and stimulus control. Our aim is for you to recognise your bedroom as an environment for restorative sleep and not nocturnal anxiety.

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A centre for women’s mental health indicates “CBT-I should be considered a first line treatment in healthy midlife women who present with insomnia symptoms in the setting of moderately bothersome VMS”.