Sleep challenges in menopause highlight gaps in education and care

In an interview with Contemporary OB/GYN, Carleara Weiss, MD, PhD, MSH, RN, sleep scientist at Aeroflow Sleep, outlined key sleep trends commonly experienced by menopausal and perimenopausal women, highlighting both insomnia-related symptoms and an increased prevalence of sleep disorders.

Weiss explained that difficulty falling asleep, frequent nighttime awakenings, early morning waking, and non-restorative sleep are often linked to hot flashes and night sweats driven by declining estrogen and progesterone levels. These hormonal changes disrupt thermoregulation, contributing significantly to sleep fragmentation and distress.

Weiss also described a second category of sleep-related issues: obstructive sleep apnea (OSA) and restless legs syndrome (RLS). Reduced estrogen and progesterone can alter the structure and function of upper airway muscles, increasing the likelihood of OSA. Similarly, menopausal women may experience new muscle stiffness or arthritis-like symptoms that make them more susceptible to limb movements associated with RLS. These physiological shifts frequently intersect with increased stress and anxiety during midlife, further amplifying sleep difficulties.

Discussing findings from Aeroflow Sleep’s recent survey, Weiss noted that 81% of respondents reported struggling with sleep, and nearly half failed to achieve the recommended 7 hours per night. Unexpectedly, the survey revealed a gender gap. Men were more likely than women to seek information about sleep disorders on social media and to pursue medical evaluation.

Additionally, younger women showed higher engagement with sleep-related content online, but this trend dropped markedly after the age of 30 years. Weiss suggested this may reflect a lack of accessible sleep-health resources tailored to perimenopausal and menopausal women.

Weiss expressed concern that women aged over 30 years may not be seeking appropriate guidance or care despite facing increased physiological sleep changes. Reliance on social media over medical evaluation also poses risks, as self-directed information may be incomplete or inaccurate. Without proper assessment, sleep disorders may go undiagnosed and untreated, negatively impacting long-term health.

To address these gaps, Weiss emphasized the need for sleep scientists, clinicians, and health educators to expand accessible, evidence-based information targeted to midlife women. Providing clear explanations of expected hormonal changes, early signs of sleep disorders, and indicators for specialist referral could empower women to seek timely care. She concluded on a hopeful note, underscoring the opportunity to improve awareness and support for women navigating sleep disturbances during menopause and challenging outdated assumptions that these issues are inevitable and untreatable.

No relevant disclosures.

Reference

Wake up call. Aeroflow Sleep. Accessed November 24, 2025. https://shop.aeroflowsleep.com/wake-up-call.