Perimenopause library · Symptoms
Sleep in perimenopause
Broken sleep is one of the most common complaints of the transition, and one of the easiest to over-explain.
SWAN found that frequent vasomotor symptoms last a median 7.4 years, and 4.5 years after the final period among those with an observed final period (Avis et al., 2015). Night sweats are part of that vasomotor story. Onset earlier in the transition predicted a longer course. Tepper and colleagues (2016) described four vasomotor trajectories — including persistently high and late-onset — so “my nights were fine and then they were not” is a pattern cohorts actually saw.
Sleep is not only flashes. Bromberger and Kravitz’s SWAN mood synthesis notes that depressive symptoms, stressors, and health all travel with the transition. Sleep apnea, pain, alcohol, caregiving, and shift work can look the same in a diary.
A useful log records: time to bed, awakenings, whether heat or sweating woke you, and how the next day felt. That is description.
This article cannot tell you that you have insomnia disorder, apnea, or “hormone insomnia.” It cannot prescribe melatonin, an antidepressant, or hormone therapy. If you stop breathing, gasp, or fall asleep while driving, that is clinical, promptly.
What this article cannot tell you
- Why you woke last night.
- Whether you have apnea or insomnia disorder.
- Which treatment would restore your sleep.
Questions worth taking to a clinician
- I am waking at night. How would you separate night sweats from other sleep problems?
- What would make you want a sleep study rather than attributing this to the transition?
Sources
- Avis NE, Crawford SL, Greendale G, Bromberger JT, Everson-Rose SA, Gold EB, Hess R, Joffe H, Kravitz HM, Tepper PG, Thurston RC. Duration of Menopausal Vasomotor Symptoms Over the Menopause Transition. JAMA Internal Medicine. 2015. doi:10.1001/jamainternmed.2014.8063
- Tepper PG, Brooks MM, Randolph JF, Crawford SL, El Khoudary SR, Gold EB, Lasley BL, Jones B, Joffe H, Hess R, Avis NE, Harlow S, McConnell DS, Bromberger JT, Zheng H, Ruppert K, Thurston RC. Characterizing the trajectories of vasomotor symptoms across the menopausal transition. Menopause. 2016.
- Bromberger JT, Kravitz HM. Mood and Menopause: Findings from the Study of Women's Health Across the Nation (SWAN) over ten years. Obstetrics and Gynecology Clinics of North America. 2011.