Recognizing Sleep Disturbances in Menopause

Welcome back to another Contemporary Ob/Gyn Peer Exchange series. In "Recognizing Sleep Disturbances in Menopause," moderator Mary Rosser, MD, PhD is joined by JoAnn Pinkerton, MD, Genevieve Hofmann, DNP, WHNP, and Suzanne Bertisch, MD to open the series on sleep disturbances in postmenopausal women.The discussion establishes why sleep deserves a central place in menopause care. The panel describes how sleep disturbances present across the menopausal transition, from difficulty falling or staying asleep to early waking and sleep that feels unrefreshing. Dr. Pinkerton frames sleep disruption as one of the most bothersome symptoms women experience, often rivaling hot flashes in its effect on quality of life. She also stresses the importance of distinguishing hormonally driven sleep changes from other medical causes.

Dr. Bertisch then turns to the clinical burden, explaining that sleep disturbance affects a large share of women during the transition and early postmenopause. The consequences extend into the day, affecting concentration, mood, productivity, and pain, and insomnia carries a recognized link to depression. The panel agrees that the resulting fatigue often surfaces in the clinic as what patients describe as brain fog.

Dr. Hofmann closes the episode by focusing on recognition. Because women rarely raise sleep on their own, especially when visits center on hot flashes, she encourages clinicians to ask directly about sleep and daytime fatigue. Together, the panelists make the case that sleep is a symptom worth screening for proactively, not a complaint to address only when patients bring it up. The discussion sets the foundation for the rest of the series by framing sleep as both highly prevalent and frequently overlooked in midlife women. It also positions sleep as a meaningful target for treatment, rather than a side effect that will resolve on its own.

The next episode in this series, "Vasomotor Symptoms and Sleep Fragmentation in Menopause," features Dr. Pinkerton and Dr. Bertisch examining how much menopausal sleep disruption occurs independently of hot flashes.