Sleep during perimenopause (menopause transition)

During aging of reproductive function, women pass through several stages of transition to menopause (MT), commonly recognized by menstrual bleeding patterns and cardinal symptoms (e.g., hot flashes/sweats plus sleep quality difficulties). Compared to women in reproductive phase, more than twice as many in MT self-report poor sleep quality. Evidence that physically monitored sleep is uniquely impacted remains equivocal, mainly with indications of sleep fragmentation and without indications of striking sleep stage changes or sleep loss. Perceived poor sleep is seemingly more a function of excess waking aligned with vasomotor activity instigating hot flash/sweats, and often in concert with depressed mood changes.