Impact of sleep disturbances on health-related quality of life in postmenopausal women: a systematic review

IMPORTANCE: Sleep disturbances are common during and after the menopause transition, with potential effects on morbidity and quality of life; however, they may be underdiagnosed and undertreated. OBJECTIVE: We carried out a systematic literature review to investigate the prevalence and impact of sleep disturbances associated with menopause on women's health-related quality of life across the stages of menopause. EVIDENCE REVIEW: Searches were conducted in PubMed and Excerpta Medica Database to identify articles published between 2013 and 2023 containing evidence for the impact of sleep quality on health-related quality of life and the epidemiology of sleep disturbances in women in menopause. FINDINGS: In total, 29 publications focusing on epidemiological outcomes of sleep disturbances and 28 studies focusing on the impact of sleep quality on health-related quality of life were identified. Overall, these studies confirmed the high prevalence of sleep disturbances in postmenopausal women. Risk factors for sleep disturbances included menopausal status, depression, vasomotor symptoms, high glycemic index diets, and age. Notably, sleep disturbances were identified even in the absence of vasomotor symptoms. Sleep disturbances were significantly associated with impaired menopause-specific and general health-related quality of life, including depression, anxiety, and musculoskeletal pain. Sleep disturbances were also associated with reduced work productivity and the ability to perform daily activities. CONCLUSIONS AND RELEVANCE: Healthy sleep is important at all life stages, including during menopause. Our review indicates that sleep disturbances are highly prevalent during postmenopausal years, even among women without vasomotor symptoms, and can severely impact women's well-being and quality of life. This study highlights the importance of promoting increased awareness and developing tailored treatment strategies for sleep disturbances in midlife and beyond.