Sleep during transition to and after menopause (or sleep and menopause)

Women approaching or in early menopause are prone to reporting deteriorated sleep quality, particularly multiple awakenings most often clustered with highly bothersome vasomotor symptoms (hot flashes/sweats). For some this is accompanied by depressed/anxious mood and of concern are pre-existing or emerging sleep-related disorders, especially breathing and movement disorders. Awakenings and vasomotor events coincide with monitored indications of sleep fragmentation but not necessarily evidence of extensive sleep loss or radically altered sleep architecture. Relevant clinical considerations are (1) joint assessment of especially sleep, vasomotor and mood symptoms; (2) screening for pre-existing sleep disturbance, sleep-related disorders, and prior hyper-sensitivity to mood disorders with menstrual cycles or surrounding pregnancy; and (3) combined pharmacological, behavioral and complementary therapies.