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Insomnia During Menopause

  • Helena Hachul
  • Daniel Ninello Polesel
  • Sergio Tufik
Chapter
  • 48 Downloads
Part of the Current Clinical Neurology book series (CCNEU)

Abstract

Menopause is a period in a woman’s life that starts from a year after the date of the last menstrual cycle. It can only be confirmed after 12 consecutive months of amenorrhea, associated with changes in luteinizing hormone and follicle-stimulating hormone levels. Global life expectancy has increased and now women spend nearly one third of their lives in the climacteric period, and therefore experience the consequences of hypoestrogenism for longer than before. The hypoestrogenism, resulting from ovarian failure promotes a series of negative consequences in relation to women’s health, like insomnia, anxiety, irritability, hot flashes, sleep-disordered breathing, qualitative alterations in the skin and hair. In addition, there is a modification in fat distribution, with more abdominal after menopause. Vasomotor symptoms, as hot flashes and excessive sweating, which affect and impair sleep quality, are frequently associated with anxiety, irritability and depressive symptoms. Some evidence suggests that there is a bidirectional interaction between psychological distress and decreased estrogen levels. Hormonal therapy can be an effective treatment; however, the potential side effects of hormone therapy (especially thromboembolic events) must be taken in account before it is prescribed. In older women, the risks associated with oral hormone therapy exceed the benefits. Cognitive-behavioral therapy for insomnia has been shown to be the main non-pharmacological treatment, particularly for chronic insomnia. There is strong evidence that multidisciplinary teams can provide an individualized evaluation of the patient as a whole. The best therapeutic approach is a holistic one taking into consideration both the body and the mind and putting the therapy in both pharmacological and biopsychological contexts in order to promote better health and a better quality of life.

Keywords

Insomnia Menopause Quality of life Sleep Women 

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Helena Hachul
    • 1
    • 2
    • 3
  • Daniel Ninello Polesel
    • 4
  • Sergio Tufik
    • 4
  1. 1.Departamento de Ginecologia e Psicobiologia, Head of the Women’s Sleep DivisionUniversidade Federal de São PauloSão PauloBrazil
  2. 2.Departamento de GinecologiaCasa de Saude Santa MarcelinaSão PauloBrazil
  3. 3.School of Medicine at Faculdade de Ciências da Saúde Albert EinsteinSão PauloBrazil
  4. 4.Departamento de PsicobiologiaUniversidade Federal de São PauloSão PauloBrazil

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