Italian Association of Sleep Medicine (AIMS) position statement and guideline on the treatment of menopausal sleep disorders

R. Silvestri, I. Aricò, E. Bonanni, M. Bonsignore, M. Caretto, D. Caruso, M. C. Di Perri, S. Galletta, R. M. Lecca, C. Lombardi, M. Maestri, M. Miccoli, L. Palagini, F. Provini, M. Puligheddu, M. Savarese, M. C. Spaggiari, T. Simoncini

Research output: Contribution to journalReview article

Abstract

Insomnia, vasomotor symptoms (VMS) and depression often co-occur after the menopause, with consequent health problems and reductions in quality of life. The aim of this position statement is to provide evidence-based advice on the management of postmenopausal sleep disorders derived from a systematic review of the literature. The latter yielded results on VMS, insomnia, circadian rhythm disorders, obstructive sleep apnea (OSA) and restless leg syndrome (RLS). Overall, the studies show that menopausal hormone therapy (MHT) improves VMS, insomnia, and mood. Several antidepressants can improve insomnia, either on their own or in association with MHT; these include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and mirtazapine. Long-term benefits for postmenopausal insomnia may also be achieved with non-drug strategies such as cognitive behavioral therapy (CBT) and aerobic exercise. Continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) both reduce blood pressure and cortisol levels in postmenopausal women suffering from OSA. However, the data regarding MHT on postmenopausal restless legs syndrome are conflicting.

Original languageEnglish
Pages (from-to)30-39
Number of pages10
JournalMaturitas
Volume129
DOIs
Publication statusPublished - Nov 2019

Keywords

  • Cognitive behavioral therapy for insomnia (CBT-I)
  • Hormone replacement therapy (HRT)
  • Menopause
  • Position statement
  • Sleep disorders
  • Vasomotor symptoms (VMS)

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Obstetrics and Gynaecology

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  • Cite this

    Silvestri, R., Aricò, I., Bonanni, E., Bonsignore, M., Caretto, M., Caruso, D., Di Perri, M. C., Galletta, S., Lecca, R. M., Lombardi, C., Maestri, M., Miccoli, M., Palagini, L., Provini, F., Puligheddu, M., Savarese, M., Spaggiari, M. C., & Simoncini, T. (2019). Italian Association of Sleep Medicine (AIMS) position statement and guideline on the treatment of menopausal sleep disorders. Maturitas, 129, 30-39. https://doi.org/10.1016/j.maturitas.2019.08.006