Peri- and postmenopausal women frequently complain of insomnia or poor sleep quality. Sleep disturbance is often attributed to nocturnal hot flashes. While nocturnal hot flushes may be the cause of sleep disruption in many peri- and postmenopausal women, many of these women have an underlying primary sleep disorder, like restless leg syndrome or sleep apnea. Various pharmacologic and non-pharmacologic interventions may be used to manage sleep disturbance in this population
The MENOS 2 study, which included peri- and postmenopausal women with problematic vasomotor symptoms, demonstrated that group cognitive behavioral therapy (CBT) or self-help CBT experienced a significant reduction in hot flash and night sweat symptom ratings and also noted improvements in mood, sleep and quality of life.
Given the efficacy and safety of this intervention, CBT should be offered to all women who are suffering from vasomotor symptoms and sleep problems related to menopause. The problem, however, is finding treaters who are familiar with CBT and its use for menopausal symptoms. In order to address these issues related to access to treatment, a recent study has explored the use of telephone-guided CBT to manage menopausal sleep problems.
In this randomized controlled trial, telephone-guided CBT was delivered by non-sleep in peri- and postmenopausal women. According to the results published online in the May 24 issue of JAMA Internal Medicine, women in the CBT group were more than 5 times as likely to achieve good sleep quality after 8 weeks (odds ratio, 5.6; 95% CI, 2.3 – 14.8; P < .001) than women in the control group who received menopause education.
Ruta Nonacs, MD
Telephone-Based CBT Improves Menopause-Related Insomnia (Medscape – free subscription)
McCurry SM, Guthrie KA, Morin CM, Woods NF, et al. Telephone-Based Cognitive Behavioral Therapy for Insomnia in Perimenopausal and Postmenopausal Women With Vasomotor Symptoms: A MsFLASH Randomized Clinical Trial. JAMA Intern Med. 2016 May 23.