Perimenopausal- and postmenopausal sleep disorders: Perspectives of sleep medicine

Insomnia is a common disabling problem during the menopause. Up to 50% of women suffer from problems with initiating or maintaining sleep. Chronic insomnia is a proven risk factor for cardiovascular diseases which underlines the necessity to recognize and treat insomnia. The pathophysiology of sleep disorders during the perimenopause is multifactorial, which is a challenge for the treating physician. Besides insomnia, depression and subjective impairment of cognition play an important role. Also, vasomotor changes, such as hot flashes, perspiration, menstruation irregularities and sexual dysfunction have to be overcome. All of these play a possible role in the development of sleep disorders. Polysomnography is rarely required for the diagnosis of insomnia. Diagnosis is mainly based on medical, psychological, psychiatric and sleep history. Cognitive behavioral therapy is the first line therapy in insomnia, but comorbidities play an important role to find the appropriate treatment. It is of importance that insomnia is emphasized as a distinct disorder and treated as such. Owing the complexity and burden of insomnia the presentation to a sleep specialist is often necessary. © 2018, Springer Medizin Verlag GmbH, ein Teil von Springer Nature.