Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
Maturitas. 2019 Oct;128:1-3. doi: 10.1016/j.maturitas.2019.06.008. Epub 2019 Jun 28.
Sleep disorders increase in prevalence during the menopausal transition and they constitute a complex phenomenon. Insomnia, the main sleep disorder, can be a primary disorder or it can be secondary to hot flushes (HF), mood disorders, psychosocial factors, medical conditions, and other sleep disturbances, such as obstructive sleep apnoea (OSA) or restless legs syndrome (RLS). Menopausal women complaining of persistent sleep disorders should be referred to a sleep specialist for comprehensive sleep management because unrecognized and untreated sleep disorders can have dramatic health-related consequences. Women suffering from insomnia related to vasomotor symptoms (VMS) can be treated with hormone replacement therapy (HRT). Primary insomnia will be preferentially improved with cognitive behavioural therapy (CBT-I) or with non-benzodiazepine hypnotics or melatonin. CBT-I is a highly efficacious treatment for postmenopausal women with insomnia. Using antidepressants to treat sleep disruption in the absence of depression is not recommended; instead, the United States Food and Drug Administration (FDA) approved paroxetine as the first non-hormonal treatment for HF. Sleep disorders in menopausal women should not be underestimated. It is necessary to diagnose the specific causal disorder and then to provide treatment to improve sleep quality and quality of life.
在更年期过渡期间，睡眠障碍的患病率增加，且其构成了一种复杂的现象。失眠是主要的睡眠障碍，它既可以是原发性疾病，也可以继发于热潮红（HF）、情绪障碍、社会心理因素、医疗状况和其他睡眠紊乱，如阻塞性睡眠呼吸暂停（OSA）或不宁腿综合征（RLS）。因持续睡眠障碍而前来就诊的更年期女性应转介给睡眠专家进行全面的睡眠管理，因为未被识别和未被治疗的睡眠障碍可能会产生严重的健康相关后果。因血管舒缩症状（VMS）相关失眠的女性可以接受激素替代疗法（HRT）治疗。原发性失眠将优先通过认知行为疗法（CBT-I）或非苯二氮䓬类催眠药或褪黑素进行改善。CBT-I 是治疗绝经后失眠女性的一种非常有效的方法。不建议在没有抑郁的情况下使用抗抑郁药来治疗睡眠障碍；相反，美国食品和药物管理局（FDA）批准帕罗西汀为治疗 HF 的第一种非激素治疗方法。更年期女性的睡眠障碍不应被低估。有必要诊断出特定的病因性疾病，然后提供治疗以改善睡眠质量和生活质量。
