Treatment of chronic insomnia disorder in menopause: evaluation of literature

Treatment of chronic insomnia disorder in menopause: evaluation of literature

Author Attarian, Hrayr Google Scholar
Hachul, Helena Autor UNIFESP Google Scholar
Guttuso, Thomas Google Scholar
Phillips, Barbara Google Scholar
Institution Northwestern Univ Feinberg Sch Med
Universidade Federal de São Paulo (UNIFESP)
SUNY Buffalo
Univ Kentucky Coll Med
Abstract Objective: Insomnia both as a symptom and as part of chronic insomnia disorder is quite common in menopause. Comorbid conditions, such as restless legs syndrome and obstructive sleep apnea, occur with high prevalence among perimenopausal women with insomnia. Insomnia in this population group is associated with adverse health outcomes, and there are no clear standards on how to treat it.Methods: Based on extensive literature search, 76 articles were identified. Two authors independently graded evidence according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence.Results: Evaluation and treatment of other comorbid sleep disorders are recommended, as is cognitive-behavioral therapy for insomnia. Hormone therapy, eszopiclone, escitalopram, gabapentin, isoflavones, valerian, exercise, and hypnosis are suggested. Zolpidem, quiteiapine XL, citalopram, mirtazapine followed by long-acting melatonin, ramelteon, Pycnogenol, Phyto-Female Complex, yoga, and massage may be considered. Kampo formulas are not recommended. Acupuncture may not be suggested, and cognitive-behavioral therapy that is not tailored for insomnia probably should not be considered.Conclusions: Although a variety of interventions are shown to be helpful in improving sleep in menopause, there is a need for well-designed head-to-head trials with uniform outcome measures.
Keywords Menopause
Hot flashes
Night sweats
Insomnia
Treatment
Vasomotor symptoms
Language English
Sponsor Teva Pharmaceuticals
Date 2015-06-01
Published in Menopause-the Journal of the North American Menopause Society. Philadelphia: Lippincott Williams & Wilkins, v. 22, n. 6, p. 674-684, 2015.
ISSN 1072-3714 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 674-684
Origin http://dx.doi.org/10.1097/gme.0000000000000348
Access rights Closed access
Type Review
Web of Science ID WOS:000355238100015
URI http://repositorio.unifesp.br/handle/11600/39134

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