TABLE 1.

Characteristics of included trials

	Y	Study design	Sample sizes	Participant characteristics	Details of HT (/d)	Control	Duration	Sleep outcomes
Brunner et al20	2005	RCT	10,739	postmenopausal women with hysterectomy, mean age 63.6 y	o-CEE 0.625 mg	placebo	12 mo	WHIIRS
Cintron et al16	2018	RCT	727	postmenopausal women, mean age 52.6 y	o-CEE 0.45 mg + micronized progesterone 200 mg, t-17β-E2 50 μg + micronized progesterone 200 mg	placebo	48 mo	PSQI
Ensrud et al25	2015	RCT	339	menopause, postmenopausal or undergone hysterectomy women, mean age 54.6 y	o-17β-E2 0.5 mg	placebo	8 wk	PSQI
Hachul et al26	2008	RCT	33	postmenopausal women, mean age 55.9 ± 4.5 y	o-CEE 0.625 mg	placebo	24 wk	polysomnography
Hays et al21	2003	RCT	8,506	postmenopausal women, mean age 63.2 y	o-CEE 0.625 mg + MPA 2.5 mg	placebo	12 mo	WHIIRS
Heinrich and Wolf17	2005	RCT	51	postmenopausal women with hysterectomy, mean age 64.1 ± 0.6 y	o-EV 2 mg, o-EV 2 mg + micro-micronized progesterone 200 mg	placebo	24 wk	Sleep item from ADSK and from Menopausal Index
Kagan et al27	2018	RCT	1,835	postmenopausal women, mean age 55 y	oral TX-001HR (1 mg E2/ 100 mg P4, 0.5 mg E2/ 100 mg P4, 0.5 mg E2/50 mg P4, 0.25 mg E2/50 mg P4)	placebo	12 mo	MOS-sleep questionnaire
Kalleinen et al28	2008	RCT	18	postmenopausal women, mean age 62.9 y	o-EV 2 mg + norethisterone 0.7 mg	placebo	6 mo	BNSQ and polysomno-graphy
LeBlanc et al29	2007	RCT	37	late menopausal or early postmenopause women, mean age 52.3 y	o-E2 2 mg	placebo	8 wk	OHSU SL sleep dairy
Leeangkoonsathian et al30	2017	RCT	100	perimenopause, early menopause or late menopause women, mean age 52.1 ± 4.1 y	o-EV 1 mg + micronized progesterone 10 mg, o-EV 1mg + dydrogesteron 100 mg	none	3 mo	PSQI
Meeuwsen et al31	2002	RCT	85	postmenopausal women, mean age 54.2 ± 4.7 y	o-tibolone 2.5 mg	placebo	12 mo	NHP questionnaire
Polisseni et al32	2013	RCT	130	postmenopausal women, mean age 52.6 ± 3.6 y	tibolone 2.5 mg, estradiol 1mg + norethindrone acetate 0.5 mg	calcium carbonate 50 mg + VitD3 200IU	12 wk	WHQ sleep item
Polo-Kantola et al33	1999	RCT	71	postmenopausal women, mean age 56.4 ± 4.4 y	estrogel 2.5 g, estrogen patch 50 ug	placebo	3 mo	polysomnography
Saletu-Zyhlarz et al22	2003	RCT	55	insomniac postmenopausal women, mean age 58 ± 5y	o-EV 2 mg + dienogest 3 mg, o-EV 2 mg	placebo	8 wk	PSQI and polysomnography
Savolainen-Peltonen et al23	2014	RCT	150	postmenopausal women, mean age 53.2 y	t-E2 1 mg, o-EV 2 mg, o-EV 2mg + MPA 5 mg	placebo	6 mo	WHQ sleep item
Shulman et al34	2002	RCT	845	postmenopausal women≥45 y	t-17β-E2/LNG (0.045 mg + 0.015 mg, 0.045 mg + 0.030 mg, 0.045 mg + 0.040 mg), t-17β-E2	none	1y	WHQ sleep item
Silva et al35	2011	RCT	12	postmenopausal women, mean age 49.7 ± 4.4 y	0.045 mg o-E2 1mg + trimegestone .125 mg	placebo	4 wk	polysomnography
Tansupswatdikil et al24	2015	RCT	40	insomniac postmenopausal women, mean age 54.4 y	t-17β-E2 50 μg	placebo	2 mo	ISI
Welton et al36	2008	RCT	3,721	postmenopausal women with or without subtotal hysterectomy, mean age 63.8 y	o-CEE 0.625 mg + MPA2.5 mg, o-CEE 0.625 mg + MPA 5mg	placebo	12 mo	WHQ sleep item

17β-E₂,17β-estradiol; ADSK, German short version of the Center for Epidemiological Studies Depression Scale; BNSQ, Basic Nordic Sleep Questionnaire; CEE, conjugated equine estrogens; E₂, estradiol; EV, estradiol valerate; HT, hormone therapy; ISI, Insomnia Severity Index; LNG, levonorgestrel; MOS, Medical Outcomes Study; MPA, medroxyprogesterone acetate; NHP, Nottingham Health Profile; o-, oral; o-CEE, oral conjugated equine estrogen; OHSU SL, Oregon Health and Science University Sleep Laboratory; P4, progesterone; PSQI, Pittsburgh Sleep Quality Index; RCT, randomized controlled trials; t-, transdermal; TX-001HR, a single, oral softgel capsule that contains hormones that are biologically identical to endogenous 17β-estradiol and progesterone; VitD3, vitamin D3; WHIIRS, Women's Health Initiative Insomnia Rating Scale; WHQ, Women's Health Questionnaire.