Treatment of chronic insomnia disorder in menopause: Evaluation of literature

Hrayr Pierre Attarian*, Helena Hachul, Thomas Guttuso, Barbara Phillips

*Corresponding author for this work

Research output: Contribution to journalReview article

27 Scopus citations

Abstract

Insomnia both as a symptom and as part of chronic insomnia disorder is quite common in menopause. Comorbid conditions, such as restless legs syndrome and obstructive sleep apnea, occur with high prevalence among perimenopausal women with insomnia. Insomnia in this population group is associated with adverse health outcomes, and there are no clear standards on how to treat it. Methods Based on extensive literature search, 76 articles were identified. Two authors independently graded evidence according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence. Results Evaluation and treatment of other comorbid sleep disorders are recommended, as is cognitive-behavioral therapy for insomnia. Hormone therapy, eszopiclone, escitalopram, gabapentin, isoflavones, valerian, exercise, and hypnosis are suggested. Zolpidem, quiteiapine XL, citalopram, mirtazapine followed by long-acting melatonin, ramelteon, Pycnogenol, Phyto-Female Complex, yoga, and massage may be considered. Kampo formulas are not recommended. Acupuncture may not be suggested, and cognitive-behavioral therapy that is not tailored for insomnia probably should not be considered. Conclusions Although a variety of interventions are shown to be helpful in improving sleep in menopause, there is a need for well-designed head-to-head trials with uniform outcome measures.

Original languageEnglish (US)
Pages (from-to)674-684
Number of pages11
JournalMenopause
Volume22
Issue number6
DOIs
StatePublished - Jun 6 2015

Keywords

  • Hot flashes
  • Insomnia
  • Menopause
  • Night sweats
  • Treatment
  • Vasomotor symptoms

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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