Best Ways to Fix Insomnia Caused by Menopausal Hot Flashes
Martin Reed | Nov 24, 2015
It is possible to improve your sleep when going through menopause. If you find that hot flashes are disrupting your sleep, hormone therapy and even herbal and nutritional products may help. In this slideshow, we’ll look at ways you can improve your sleep when living with hot flashes, according to a 2018 study published in the journal Sleep.
How the study worked
The study recruited 546 perimenopausal and postmenopausal women with insomnia who experienced at least 14 hot flashes per week. Participants had not taken any medication for hot flashes in the previous 30 days or used hormonal contraceptives, hormone replacement therapy (HRT), or hormonal birth control in the previous two months. The women were divided into groups and underwent different treatments, outlined in the following slides.
Measuring insomnia severity
Insomnia severity was measured using the Insomnia Severity Index. This is a questionnaire that asks seven questions related to sleep. Higher scores suggest more severe insomnia symptoms. A score of 0-7 indicates no insomnia, a score of 8-14 indicates subthreshold or mild insomnia, a score of 15-21 indicates moderate insomnia, while a score of 22-28 indicates severe insomnia.
Insomnia treatment #1: Escitalopram (Lexapro)
A total of 51 women took 10-20 mg of escitalopram every day for eight weeks. Average insomnia severity scores were roughly two points lower at the end of treatment compared to the control group.
Insomnia treatment #2: Exercise
A total of 58 women participated in moderate-intensity aerobic exercise training three times every week for 12 weeks. For each training session, participants could choose whether to use a treadmill, elliptical trainer, or stationary bicycle. At the end of 12 weeks, insomnia severity scores in this group were two points lower compared to the control group.
Insomnia treatment #3: Yoga
A total of 54 women participated in weekly 90-minute yoga classes and practiced yoga at home for 20 minutes every day for 12 weeks. Average insomnia severity scores were only one point lower at the end of treatment compared to the control group.
Insomnia treatment #4: Omega-3 supplements
A total of 95 women took 1.8 grams of omega-3 fish oil capsules three times per day for 12 weeks. Omega-3 was found to have little effect on insomnia severity scores at the end of the treatment period compared to the control group.
Insomnia treatment #5: Estrogen
A total of 45 women took 0.5 mg of estradiol for eight weeks. Average insomnia severity scores were only one point lower at the end of treatment compared to the control group.
Insomnia treatment #6: Venlafaxine (Effexor XR)
A total of 47 women took 37.5 mg of venlafaxine per day for one week followed by 75 mg per day for seven weeks. At the end of the eight-week period, insomnia severity scores in this group were two points lower compared to the control group.
Insomnia treatment #7: Cognitive behavioral therapy for insomnia (CBT-I)
A total of 53 women received six telephone sessions of CBT-I over an eight-week period. CBT-I was found to provide substantially more relief from insomnia symptoms than any of the other treatment options. Average insomnia severity scores dropped by five points compared to a control group that received menopause education instead of CBT-I.
Although omega-3 supplements had no effect on the sleep of menopausal women suffering from hot flashes, all other treatment options were found to improve sleep symptoms to some degree. With that being said, cognitive behavioral therapy for insomnia was found to be far more effective at treating moderate-to-severe insomnia symptoms out of all the options evaluated. If CBT-I is not available, researchers suggested that exercise and venlafaxine were the next-best options.