Can sleep disruption in midlife — seemingly not caused by anything in your life (i.e., young children, a new medication, too much caffeine)— be associated with perimenopause?
A recent review of many studies finally establishes that yes, it can be.
For a long time, it was believed that sleep disruption in perimenopause was always the result of nighttime vasomotor symptoms (aka hot flashes at night or night sweats).
In some cases, it is nighttime hot flashes that lead to awakening. But, in other cases, wake after sleep onset (called WASO) happens on its own during perimenopause.
Like many of you, I knew from my experience that this was true. I most certainly experienced disrupted sleep way before nighttime hot flashes arrived. This review of research is validating.
Repeated waking around 2 am was one of the first symptoms to show up for me. I was in my early 40s and still getting a monthly period. I couldn’t figure out what was going on. I was not expecting the impact of changing hormonal patterns to begin while I was getting a monthly period — and I was closer to 40 than 45.
Key highlights from the narrative review of research about sleep disruption during perimenopause.
- Disrupted sleep associated with perimenopause is inadequately studied.
- Disrupted sleep can happen in perimenopause without nighttime vasomotor symptoms (hot flashes and night sweats).
- There is a lack of pharmaceutical options for dealing with sleep disruption during perimenopause.
- Cognitive Behavioral Therapy for Insomnia (CBTi) works but isn’t widely used. It’s hard to find a therapist to work with. There are apps but those too require a time commitment that may be hard to make.
- Perimenopausal sleep disruption can impact mood and cognition and interfere with many aspects of life.
- A more recent understanding of the brain area that has led to non-hormonal treatments for hot flashes and night sweats may also lead to a better understanding of how sleep gets disrupted and ultimately new treatments.
Healio did a Q&A with Dr. Maki that offers a wonderful and more extensive summary.
You can find that here.
For those that want a deeper dive, read the article, Sleep disturbance associated with the menopause, in the most recent issue of Menopause, the journal of The Menopause Society.
Find more information on sleep disruption in perimenopause on the WLB Disrupted Sleep page.
