Keywords
menopausal transition
menopause
perimenopause
sleep disorders
sleep quality
How to Cite
Abstract
Sleep, defined as a reversible neurobehavioral state regulated by circadian rhythms, is essential for health. Sleep disorders, especially during the perimenopausal period (age 45– 55), are a significant health problem, affecting up to 60% of women during this period. These women often report a deterioration in sleep quality, frequent awakenings, and chronic feelings of sleep deprivation. This narrative literature review synthesizes current scientific reports on the biological, physical, and psychosocial mechanisms underlying these complaints. The etiopathogenesis of sleep disorders is multifactorial, with hormonal changes considered to be the main cause. Fluctuations and decreases in estrogen and progesterone (and its metabolite allopregnanolone) are directly associated with a deterioration in sleep structure, a decrease in sleep efficiency, and disruption of the circadian rhythm, including the action of melatonin. Estrogen deficiency may also increase the risk of sleep-disordered breathing. The clinical picture is dominated by insomnia, the main symptoms of which are difficulty staying asleep and prolonged wakefulness after falling asleep. The review lists vasomotor symptoms, mood disorders (anxiety and depression), and nocturia resulting from hormonal dysregulation affecting bladder capacity and urine production at night as secondary factors of insomnia. In addition, an increase in the frequency of primary disorders, including obstructive sleep apnea and restless legs syndrome, is observed during the perimenopausal period. Sleep disorders are often underestimated and undiagnosed, which contributes to the deterioration of mental health and professional functioning and increases the risk of chronic diseases and injuries (e.g., falls). The level of knowledge about proper sleep hygiene among women is generally low. The conclusions of the review point to the multidimensional nature of the problem and the need for a holistic, interprofessional, team-based approach to improve the quality of life for women during the menopausal transition.
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