Insomnia in peri-menopausal and post-menopausal women and in some somatic diseases

Insomnia is becoming increasingly common in modern society and leads to significant issues for people’s health and well-being. Sex differences in sleep begin at an early age and continue throughout life. At the same time, women report poorer sleep quality and have higher risk for insomnia than men. Some studies show that men and women differ in their neurohormonal secretion, biological processes, and brain morphology. A significant number of women experience sleep difficulties in the approach to menopause and beyond, with the most common symptoms being difficulty in initiating sleep, short sleep duration, and poor sleep quality. The aetiology of sleep disorders in postmenopausal women isn’t yet still clear and seems to be different according to the specific symptoms of sleep disorder. However, potential factors include menopause itself, ageing, vasomotor symptoms, depression, anxiety, and many other diseases such as cardiovascular, endocrine, and psychosocial factors. Insomnia may occur alone or with other medical or mental health conditions. If left untreated, it may increase the risk for developing and worsening any of these conditions. Menopause is often associated with elevated risks of cardiovascular diseases. Insomnia is considered as an established risk factor for myocardial infarction, including in women. Sex differences have been detected in studies of sleep problems, with significant associations in women with regard to hypertension, the prevalence of dyslipidaemia, obesity, and diabetes. Diagnosis of insomnia is largely based on skilled history taking. Insomnia treatment is based on two strategies that may be used isolatedly or in combination: cognitive behavioural therapy for insomnia and pharmacological treatment.

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