Menopause and Sleep: Why Researchers Are Finally Taking Women's Restless Nights Seriously

A groundbreaking five-year study is finally addressing what millions of women have long known: menopause wreaks havoc on sleep. Researchers from the University of Utah are part of a landmark initiative comparing three different treatments for menopause-related insomnia, tackling sleep problems that affect 16% to 47% of women during perimenopause and up to 60% during menopause.

What Sleep Problems Do Women Face During Menopause?

The transition into menopause brings a constellation of sleep issues that can begin as early as the mid-30s and persist for years. Women experience frequent nighttime awakenings, difficulty falling asleep, and consistently interrupted rest that leaves them exhausted during the day. These aren't minor inconveniences—they're significant health concerns that have been overlooked for far too long.

"Sleep concerns during perimenopause and menopause are very common yet often overlooked," said Kelly Baron, PhD, a clinical psychologist in the Division of Public Health who studies how sleep problems affect women during this transition.

What Treatments Are Being Studied?

The study, funded by the Patient-Centered Outcomes Research Institute and led by Brigham and Women's Hospital, will enroll 891 participants experiencing perimenopausal and early menopausal insomnia symptoms. Researchers are comparing three existing treatment approaches to determine which works best for real-world effectiveness and safety.

• Cognitive Behavioral Therapy for Insomnia (CBT-I): A self-guided, internet-based therapy that teaches women techniques to improve sleep habits and address the thoughts and behaviors that interfere with rest
• Trazodone: An antidepressant medication that's commonly prescribed off-label for sleep problems, helping women fall asleep and stay asleep longer
• Daridorexant: A newer medication specifically designed to treat insomnia by blocking the brain's wakefulness-promoting signals, essentially turning down the body's natural alertness system

The research team, led by Baron and Benjamin Brown, MD, a family medicine physician, will evaluate sleep quality using standardized patient questionnaires that measure difficulty falling asleep, staying asleep, and overall satisfaction with sleep. They'll also assess how each treatment impacts mood and general well-being.

Why Does This Research Matter for Women's Health?

This study represents a significant shift toward patient-centered research that prioritizes what women actually experience. The Patient-Centered Outcomes Research Institute emphasizes involving patients, caregivers, and clinicians in shaping study priorities—ensuring the research focuses on treatments that are accessible, scalable, and grounded in evidence-based findings.

Community partner and advisory board member Maria Jensen shared her personal experience with the research. "As someone who has struggled with sleep during menopause, I know how frustrating it can be to feel like your concerns aren't taken seriously," said Jensen. "Being part of this study means helping shape research that listens to women. It's empowering to know our voices are guiding the science."

Beyond measuring sleep improvement, researchers will examine safety outcomes including side effects like drowsiness and fall risk. They'll also investigate how individual factors such as demographics, health status, and sleep history may influence how well each treatment works for different women.

"We're excited to contribute to research that prioritizes patient-reported outcomes and real-world effectiveness," said Baron, highlighting how this approach differs from traditional clinical trials that may not reflect how treatments work in everyday life.