Estrogen Treatment Restores Normal Sleep Patterns in Menopausal Women
The authors noted changes in deep sleep that mimicked the deep sleep patterns seen in younger, healthy individuals. People with sleep difficulties and depressed people do not have such patterns. They also found evidence that ERT appeared to play a role in the improvement of cognitive functioning, according to Antonijevic.
Without ERT, 10 of the 11 women rated their sleep as dissatisfying and reported three to five awakenings per night. That ratio changed dramatically after ERT, as 10 of the 11 women rated the quality of their sleep as very or quite satisfying, with only one or two awakenings per night.
"The improvement of sleep with ERT in menopausal women was documented in the late 1970s in England and we documented it in 1980," Quentin Regestein, MD, of the psychiatry department at Harvard Medical School, tells WebMD. "We also found the women got to sleep faster and had more REM -- but we didn't show some of the details, like the decrease in [deep] sleep these people have found." Regestein, however, was quite impressed with the reported change in sleep satisfaction after ERT, a finding he says is "extremely telling."
Menopausal patients with sleep problems should keep track of their sleep with a sleep diary, Trupin says. Then "they should have a general evaluation with a health care provider to rule out other medical causes of insomnia. If the patient is postmenopausal and a candidate for estrogen, most physicians would then probably recommend ERT as the next step."
If patients are menopausal and not having symptoms like hot flashes and are not that interested in hormone replacement therapy, Trupin would "probably prescribe a nonaddicting, short-acting sleep medicine. However, I find my patients do better by placing them on estrogen than going with strictly traditional sleeping medications. I believe that if a patient's sleep disruption is due to [hot flashes], 95% to 98% ... can be cured with ERT," she says.