HRT and sleep quality

Sleep problems are common in older people, and especially during the menopause. I have had many posts over the years on insomnia and how to manage it. (search Ïnsomnia”on my web-site.)
Endocrine. 2016 Aug 11. [Epub ahead of print]

Efficacy of menopausal hormone therapy on sleep quality: systematic review and meta-analysis.

Author information

  • 1Mayo Graduate School, Mayo Clinic, Rochester, MN, USA.
  • 2Center for Sleep Medicine, Mayo Clinic, Rochester, MN, USA.
  • 3Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.
  • 4Evidence-Based Practice Center, Mayo Clinic, Rochester, MN, USA.
  • 5Mayo Medical Library, Mayo Clinic, Rochester, MN, USA.
  • 6Departments of Surgery and Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA.
  • 7Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA. murad.mohammad@mayo.edu.
  • 8Evidence-Based Practice Center, Mayo Clinic, Rochester, MN, USA. murad.mohammad@mayo.edu.
  • 9Division of Preventive Medicine, Mayo Clinic, Rochester, MN, USA. murad.mohammad@mayo.edu.

Abstract

Sleep complaints are reported by 40-60 % of menopausal women. Poor sleep is a risk factor for cardiovascular disease, diabetes, and obesity. The effect of menopausal hormone therapy on sleep quality is unclear. A systematic review and meta-analysis were conducted to summarize the efficacy of menopausal hormone therapy on self-reported sleep quality. Electronic databases (PubMed, Scopus, Ovid MEDLINE, EMBASE, EBM Reviews CENTRAL, and PsycInfo) were searched from 2002 to October 2015. Randomized trials assessing the effect of menopausal hormone therapy with a minimum follow up of 8 weeks were included. Titles, abstracts, and full texts were screened independently and in duplicate. Primary outcome included sleep items within a questionnaire, scale or diary. Standardized mean differences across trials were pooled using random-effects models. The search identified 424 articles, from which 42 trials were included. Seven trials at a moderate to high risk of bias enrolling 15,468 women were pooled in meta-analysis. Menopausal hormone therapy improved sleep quality in women who had vasomotor symptoms at baseline [standardized mean difference -0.54 (-0.91 to -0.18), moderate quality evidence]. No difference was noted when women without such symptoms were analyzed separately or combined. Across 31 sleep quality questionnaires, daytime dysfunction was the most evaluated sleep domain

. Menopausal hormone therapy improves sleep in women with concomitant vasomotor symptoms.

Heterogeneity of trials regarding study population, formulations, and sleep scales; limit overall certainty in the evidence. Future menopausal hormone therapy trials should include assessment of self-reported sleep quality using standardized scales and adhere to reporting guidelines.

About Dr Colin Holloway

Gp interested in natural hormone treatment for men and women of all ages

Posted on March 6, 2017, in Uncategorized. Bookmark the permalink. 1 Comment.

  1. Interesting article. I can honestly say that I have had no improvement to my very poor sleep habits since taking bio identical progesterone and estrogen therapy but then I wasn’t expecting miracles in that regard. It’s certainly been great for other uncomfortable symptoms of menopause though. Perhaps it would be even worse sleep without taking them! No problems falling asleep but waking at 2 am every night and can’t get back to sleep for sometimes a few hours. Consequently I get very fatigued through the day but long-term Hashimotos and fibromyalgia won’t be helping this either. Poor sleep is something Ive just learned to live with over the last 13 years.

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