Women’s pre-menopause sleep patterns give clues to future menopause sleep quality

In the largest study of its kind, research led by Nottingham Trent University with the University of Reading analysed the sleep quality and duration of more than 200,000 women aged 40 to 70, using data from the UK Biobank.

The study contrasted women’s sleep when menstruating compared with their sleep when they reached and passed menopause, using data reported on their first and final involvements in the Biobank – between two and 13 years later.

Findings showed that age, health and menopausal status all influence sleep, but a woman’s pre-menopause sleep quality is the strongest indicator of her future sleep during menopause.

The data showed that women who already struggled with sleep due to issues such as snoring, inability to get to sleep quickly, difficulty remaining asleep throughout the night, waking too early, daytime sleepiness and finding it hard to wake in the morning, were significantly more likely to continue experiencing poor sleep once they reached menopause.

Women with poorer overall health, or whose health deteriorated over the course of the study, also experienced worse sleep later on.

In contrast, women who considered themselves to be healthy and slept well before menopause tended to retain better sleep quality as they transitioned through it.

While menopause itself was linked with shorter and more disrupted sleep, the study found that these changes often amplified existing sleep patterns rather than creating new ones.

The study also found that women who had later natural menopause tended to maintain better sleep for longer, while the oldest study participants reported the poorest sleep overall.

Women who reached menopause during the study reported worse sleep than women of the same age, over the same time period, who had not reached menopause.

The exception was menopausal women who were prescribed Hormone Replacement Therapy (HRT). These women generally reported better sleep quality, even if they did not always sleep for longer.

HRT also appeared to support sleep in perimenopausal women, suggesting early intervention may offer benefits.

Lead author John Groeger, Professor of Psychology at NTU’s School of Social Sciences, said: “People often assume menopausal sleep problems appear suddenly, but what we see is a continuation or worsening of existing patterns.

“Intervening early and talking to a GP before sleep really deteriorates may give women the best chance of getting through menopause with fewer sleep-related problems. We often treat sleep once it has collapsed, this study suggests we should be acting long before that point.”

The study Sleep problems persist in middle-aged women and influence changes in health but are moderated by menopause and its treatment has been published in the journal Climacteric.