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This article is from the WebMD Feature Archive
How Menopause Affects Sleep
A new area of research in sleep medicine focuses on women's health and how menopause affects sleep. Menopause, regardless of age, is associated with poor sleep quality. These sleep problems are thought to be associated with hormonal function and also with psychological factors.
One study shows shows an association of hot flashes with a shorter amount of time sleeping and a higher incidence of arousals from sleep. Hot flashes that occur during sleep have the ability to affect the quality of sleep adversely by bringing women from a deeper, more restful stage of sleep to a lighter, less restful and restorative stage.
Hot flashes before bed may also cause insomnia. However, often cases of insomnia related to menopause are due to increased depression or anxiety, which may affect the time it takes to fall asleep. One study that factored in sleep disorders, including obstructive sleep apnea and periodic limb movement, and medications showed no differences in sleep patterns of postmenopausal women with hot flashes.
Researchers have also found that the frequency of nighttime urination may be a good predictor of disturbed sleep quality.
Some studies have reported that estrogen replacement therapy (ERT) is associated with better sleep quality, while others have shown no difference or poor sleep quality.
In premenopausal women, the incidence of sleep-disordered breathing (including snoring and apnea, a condition in which breathing starts and stops while asleep) is quite small, but it appears to increase dramatically (to 9% of the population) after menopause. Interestingly, recent research shows the effects of menopause on snoring or sleep apnea are due to advancing age (specifically changes in the tone of the muscles in the neck) and increased weight rather than directly from the hormonal changes of menopause itself.
The clinical consequences of untreated sleep disorders are quite large. Sleep-related breathing disorders are associated with high blood pressure, heart attack, heart failure, stroke, obesity, neuro-psychiatric problems including depression and other mood disorders, mental impairment, excessive daytime sleepiness, injury from accidents, disruption of bed-partner's sleep quality and poor quality of life. Recent studies also show a decrease in women's sex hormones with sleep-disordered breathing.
If you have trouble sleeping for more than a few weeks, or if
sleep problems interfere with daily functioning, speak with your doctor.
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VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.
Ob-Gyn Laura Corio talks about the importance of exercise during menopause.
