Table 1.

Etiology of sleep disorders in menopause.

Physiologic/Physical
Age  Circadian rhythm modifications  Decreased melatonin secretion Female sexual hormone changes  Decreased estrogen and progesterone, increased FSH Menopausal symptoms  Hot flushes, night sweats Others  Bladder problems,  Ill health, chronic pain—musculoskeletal disorders, osteoarthritis, fibromyalgia, cancer, etc.  Poor sleep hygiene/circumstances  Medication, coffee, smoking
Psychiatric/Psycho-social
Mood disorder—depression Anxiety Illegal drugs, alcohol intake Others—familial/economic/social problem: stress, bereavement, divorce, unemployment, finances, etc.
Comorbid diseases with sleep disorders
Obstructive sleep apnea Restless legs syndrome Periodic limb movement syndrome
Others
Circadian rhythm sleep–wake disorder Narcolepsy, idiopathic hypersomnia Parasomnias

FSH: follicle-stimulating hormone.