Sleep Disruption in the Menopausal Transition and Postmenopause: A Narrative Review.

Abstract

The objective of this narrative review is to provide a comprehensive overview of sleep disruptions during menopause by examining primary sleep disorders and secondary disruptors, the biopsychosocial etiology of these disruptions, and approaches to clinical diagnosis. Literature published between January 2015 and March 2026 was searched using PubMed and MEDLINE, Embase, and Google Scholar databases. Findings are summarized into a narrative review that addresses primary sleep disorders that commonly occur during menopause, specifically insomnia, obstructive sleep apnea, restless legs syndrome, and periodic limb movement disorder, as well as the biopsychosocial etiology of sleep pathophysiology. Prevalence of sleep disruption varies by menopausal stage (perimenopause or postmenopause), the presence of vasomotor symptoms, and the definition and measurement of sleep disruptions (self-report questionnaires or objective measures), and can be influenced by a variety of modifiable and nonmodifiable factors. Compared with premenopausal women, prevalence is higher in women during perimenopause and postmenopause, highlighting an increased burden and effect on quality of life in this population. Individual biological, psychological, and social disruptors and their contributions to and effects on sleep are described, as well as practical clinical considerations in the assessment of sleep disruption symptoms. Finally, salient points are discussed.