Sleep Screening May Be Key in Menopause Care, National Poll Suggests

Women aged 50 to 80 years who reported menopausal-related symptoms were significantly more likely to report sleep problems than those without menopausal symptoms, according to findings from the National Poll on Healthy Aging presented at the 2026 American College of Obstetricians and Gynecologists (ACOG) Annual Clinical and Scientific Meeting in Washington, DC.¹

In a cross-sectional analysis of 1202 US women, investigators found that 56.4% of respondents reported sleep problems overall. Sleep problems were reported by 75.0% of women with any menopausal-related symptoms compared with 49.8% of those without menopausal-related symptoms (P<.001).¹

The findings add to existing evidence that sleep disturbances are common during the menopause transition and may be closely tied to active symptom burden. The Menopause Society has noted that women with vasomotor symptoms during the menopause transition are more likely to report disrupted sleep, and its 2022 hormone therapy position statement states that hormone therapy improves sleep in women with bothersome night sweats and hot flashes that disrupt sleep.²

Sleep problems in midlife and older women are clinically important because they may affect quality of life, daytime function, cardiometabolic health, and long-term well-being. Reviews of sleep disorders during menopause have identified multiple potential contributors, including vasomotor symptoms, ovarian hormone changes, restless legs syndrome, periodic limb movement disorder, and obstructive sleep apnea.³

The findings underscore the importance of asking about sleep when evaluating menopausal symptoms and, conversely, considering menopause-related symptom burden when women in midlife and older adulthood present with insomnia, fragmented sleep, or poor sleep quality.

“Integrating screening and evidence-based interventions for sleep disturbances into menopause management may improve overall health, quality of life, and long-term outcomes,” Joseph R. White, MD, MS, and colleagues wrote in the study abstract.

White and colleagues analyzed survey data from Wave 10 of the National Poll on Healthy Aging, a nationally representative household survey of US adults aged 50 years and older conducted from January 21 to February 7, 2022 designed to assess timely issues related to health, health care, and health policy.

Respondents in the current analysis were stratified and weighted to reflect the US Census. Investigators used chi-square testing to evaluate associations between sleep problems and menopausal symptoms.

Among the 1202 respondents, 65 women were premenopausal with no symptoms, accounting for 7.3% of the weighted sample. Thirty-seven women were perimenopausal with some symptoms, accounting for 3.0%; 40 were menopausal within the past year with regular symptoms, accounting for 3.3%; and 35 were menopausal within the past year without regular symptoms, also accounting for 3.3%.

Most respondents were postmenopausal. A total of 243 women were postmenopausal with symptoms, accounting for 20.8% of the weighted sample, and 765 were postmenopausal without symptoms, accounting for 61.2%.

Overall, 677 respondents reported sleep problems. Women with any menopausal-related symptoms were significantly more likely to report sleep problems than women without menopausal-related symptoms.

The current findings suggest that sleep assessment may be an important component of that individualized approach. In primary care, screening may include questions about sleep duration, sleep latency, nighttime awakenings, early-morning awakening, daytime impairment, snoring or witnessed apneas, restless legs symptoms, mood symptoms, medication use, alcohol use, and the timing and severity of hot flashes or night sweats.

Investigators did not identify which specific menopausal symptoms were most strongly associated with sleep problems. However, prior research has shown that greater vasomotor symptom severity is associated with more sleep disturbance, greater sleep-related impairment, worse sleep quality, and greater impairment in daytime activities and work productivity.

Limitations to the current study include the fact that the analysis was cross-sectional, sleep problems and menopausal symptoms were self-reported, and the analysis does not specify whether respondents had diagnosed sleep disorders or whether other contributors, such as depression, anxiety, chronic pain, cardiometabolic disease, or medication use, were assessed.

Still, the large, nationally representative sample provides clinically relevant insight into the overlap between menopause-related symptoms and sleep complaints among US women aged 50 to 80 years. For primary care clinicians, the findings support routine sleep screening as part of menopause evaluation and follow-up, particularly among women reporting active symptoms.

References:

1. White JR, Dakroub A, Lenze N, et al. Sleep disturbances and menopausal symptoms: findings from the National Poll on Healthy Aging. Presented at: ACOG 2026 Annual Clinical & Scientific Meeting.
2. The North American Menopause Society. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022;29(7):767-794.
3. Lee J, Han Y, Cho HH, Kim MR. Sleep disorders and menopause. J Menopausal Med. 2019;25(2):83-87.
4. National Poll on Healthy Aging. National Poll on Healthy Aging, United States. OpenICPSR. Published June 7, 2024. Accessed May 1, 2026.