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Cited by 37

The DOI matches its Crossref record; 16 of the 16 references it cites were found in a registry or an index.

Behavioral interventions for improving sleep outcomes in menopausal women: a systematic review and meta-analysis

Lam, Christine M., Hernandez-Galan, Leticia, Mbuagbaw, Lawrence, Ewusie, Joycelyne Efua, Thabane, Lehana, Shea, Alison K.·2022·Menopause
DOI 10.1097/gme.0000000000002051
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Abstract

Importance: Perimenopausal and postmenopausal women commonly report sleep disruption and insomnia. Behavioral interventions may be safe alternatives for patients who are unwilling to begin pharmacological treatments because of adverse effects, contraindications, or personal preference. Objective: The primary objective is to assess the efficacy of behavioral interventions on sleep outcomes among perimenopausal and postmenopausal women, as measured using standardized scales and objective methods (polysomnography, actigraphy). The secondary objective is to evaluate the safety of these methods through occurrence of adverse events. Evidence Review: Searches were performed within MEDLINE (OVID interface, 1946 onward), Embase (OVID interface, 1974 onward), Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Web of Science (Core collection) using a search strategy developed in consultation with a health sciences librarian. Title/abstract and full-text screenings were performed in duplicate, and relevant studies were selected based on inclusion and exclusion criteria set to identify randomized controlled trials evaluating the effects of behavioral interventions on sleep quality. Risk of bias assessments were done using the Cochrane Risk of Bias 2 tool, and the Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the certainty of the body of evidence. Data were pooled in a meta-analysis using a random-effects model. Findings: Nineteen articles reporting results from 16 randomized controlled trials were included, representing a total of 2,108 perimenopausal and postmenopausal women. Overall, behavioral interventions showed a statistically significant effect on sleep outcomes (standardized mean difference [SMD], −0.62; 95% confidence interval [CI], −0.88 to −0.35; I 2 = 93.4%). Subgroup analyses revealed that cognitive behavioral therapy (SMD, −0.40; 95% CI, −0.70 to −0.11; I 2 = 72.7%), physical exercise (SMD, −0.57; 95% CI, −0.94 to −0.21; I 2 = 94.0%), and mindfulness/relaxation (SMD, −1.28; 95% CI, −2.20 to −0.37; I 2 = 96.0%) improved sleep, as measured using both subjective (eg, Pittsburg Sleep Quality Index) and objective measures. Low-intensity (SMD, −0.91; 95% CI, −1.59 to −0.24; I 2 = 96.8) and moderate-intensity exercise (SMD, −0.21; 95% CI, −0.34 to −0.08; I 2 = 0.0%) also improved sleep outcomes. No serious adverse events were reported. Overall risk of bias ranged from some concern to serious, and the certainty of the body of evidence was assessed to be of very low quality. Conclusions and Relevance: This meta-analysis provides evidence that behavioral interventions, specifically, cognitive behavioral therapy, physical exercise, and mindfulness/relaxation, are effective treatments for improving sleep outcomes among perimenopausal and postmenopausal women.

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Research works printed but not linked: 39

  1. 2008, Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women, Sleep, 31, 979
  2. 2014, A systematic review of the longitudinal relationships between subjective sleep disturbance and menopausal stage, Maturitas, 79, 401, 10.1016/j.maturitas.2014.09.011 · DOI
  3. 2018, Sleep problems during the menopausal transition: prevalence, impact, and management challenges, Nat Sci Sleep, 10, 73, 10.2147/NSS.S125807 · DOI · Paper page
  4. 2015, Longitudinal changes in insomnia status and incidence of physical, emotional, or mixed impairment in postmenopausal women participating in the Women's Health Initiative (WHI) study, Sleep Med, 16, 364, 10.1016/j.sleep.2014.11.008 · DOI
  5. 2017, Sleep characteristics and carotid atherosclerosis among midlife women, Sleep, 40, zsw052
  6. 2020, Effects of menopause on sleep quality and sleep disorders: Canadian longitudinal study on aging, Menopause, 27, 295, 10.1097/GME.0000000000001462 · DOI
  7. 2015, Treatment of chronic insomnia disorder in menopause: evaluation of literature, Menopause, 22, 674, 10.1097/GME.0000000000000348 · DOI
  8. 2010, Cognitive behavioral therapy for sleep disorders, Psychiatr Clin North Am, 33, 629, 10.1016/j.psc.2010.04.011 · DOI
  9. 1999, Nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine review, Sleep, 22, 1134, 10.1093/sleep/22.8.1134 · DOI · Paper page
  10. 2017, Qualitative studies of insomnia: current state of knowledge in the field, Sleep Med Rev, 31, 58, 10.1016/j.smrv.2016.01.003 · DOI
  11. 2006, Severe hot flashes are associated with chronic insomnia, Arch Intern Med, 166, 1262, 10.1001/archinte.166.12.1262 · DOI · Paper page
  12. 2009, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement, PLoS Med, 6, e1000097, 10.1371/journal.pmed.1000097 · DOI · Paper page
  13. 1997, Bias in meta-analysis detected by a simple, graphical test, BMJ, 315, 629, 10.1136/bmj.315.7109.629 · DOI · Paper page
  14. 2017, Comparison of the effect of acupressure and Pilates-based exercises on sleep quality of postmenopausal women: a randomized controlled trial, Iran J Nurs Midwifery Res, 22, 140, 10.4103/1735-9066.205954 · DOI
  15. 2019, Effects of Pilates training on sleep quality, anxiety, depression and fatigue in postmenopausal women: a randomized controlled trial, Maturitas, 124, 62, 10.1016/j.maturitas.2019.03.019 · DOI
  16. 2017, Effects of yoga and aerobic exercise on actigraphic sleep parameters in menopausal women with hot flashes, J Clin Sleep Med, 13, 11, 10.5664/jcsm.6376 · DOI
  17. 2014, Efficacy of yoga for vasomotor symptoms: a randomized controlled trial, Menopause, 21, 339, 10.1097/GME.0b013e31829e4baa · DOI
  18. 2013, Paced respiration for vasomotor and other menopausal symptoms: a randomized, controlled trial, J Gen Intern Med, 28, 193, 10.1007/s11606-012-2202-6 · DOI
  19. 2019, Treating chronic insomnia in postmenopausal women: a randomized clinical trial comparing cognitive-behavioral therapy for insomnia, sleep restriction therapy, and sleep hygiene education, Sleep, 42, zsy217
  20. 2020, Objective sleep disturbance is associated with poor response to cognitive and behavioral treatments for insomnia in postmenopausal women, Sleep Med, 73, 82, 10.1016/j.sleep.2020.04.024 · DOI
  21. 2018, The effect of sleep hygiene education and relaxation exercises on insomnia among postmenopausal women: a randomized clinical trial, Int J Nurs Pract, 24, e12650, 10.1111/ijn.12650 · DOI
  22. 2019, Cognitive behavior therapy for menopausal symptoms (CBT-Meno): a randomized controlled trial, Menopause, 26, 972, 10.1097/GME.0000000000001363 · DOI
  23. 2016, Comparing the influence of relaxation training and consumption of valerian on insomnia of menopause women: a randomized clinical trial, Afr J Tradit Complement Altern Med, 13, 40, 10.4314/ajtcam.v13i1.6 · DOI
  24. 2020, Effect of the information support method combined with yoga exercise on the depression, anxiety, and sleep quality of menopausal women, Psychiatr Danub, 32, 380, 10.24869/psyd.2020.380 · DOI
  25. 2016, Telephone-based cognitive behavioral therapy for insomnia in perimenopausal and postmenopausal women with vasomotor symptoms: a MsFLASH randomized clinical trial, JAMA Intern Med, 176, 913, 10.1001/jamainternmed.2016.1795 · DOI
  26. 2015, Inflammation and psychosocial factors mediate exercise effects on sleep quality in breast cancer survivors: pilot randomized controlled trial, Psychooncology, 24, 302, 10.1002/pon.3594 · DOI
  27. 2016, Impact of pedometer-based walking on menopausal women’s sleep quality: a randomized controlled trial, Climacteric, 19, 364, 10.3109/13697137.2015.1123240 · DOI
  28. 2010, Exercise as a treatment to enhance sleep, Am J Lifestyle Med, 4, 500, 10.1177/1559827610375532 · DOI
  29. 2005, Effects of exercise on sleep, Clin Sports Med, 24, 355, 10.1016/j.csm.2004.12.003 · DOI · Paper page
  30. 2014, The North American Menopause Society recommendations for clinical care of midlife women, Menopause, 21, 1038, 10.1097/GME.0000000000000319 · DOI · Paper page
  31. 2019, Italian Association of Sleep Medicine (AIMS) position statement and guideline on the treatment of menopausal sleep disorders, Maturitas, 129, 30, 10.1016/j.maturitas.2019.08.006 · DOI
  32. 2021, The clinical effects of sleep restriction therapy for insomnia: a meta-analysis of randomised controlled trials, Sleep Med Rev, 58, 101493, 10.1016/j.smrv.2021.101493 · DOI
  33. 2019, Delivering cognitive behavioral therapy for insomnia in the real world: considerations and controversies, Sleep Med Clin, 14, 275, 10.1016/j.jsmc.2019.01.008 · DOI
  34. 2001, Validation of the Insomnia Severity Index as an outcome measure for insomnia research, Sleep Med, 2, 297, 10.1016/S1389-9457(00)00065-4 · DOI · Paper page
  35. 2003, Reliability and validity of the Women's Health Initiative Insomnia Rating Scale, Psychol Assess, 15, 137, 10.1037/1040-3590.15.2.137 · DOI · Paper page
  36. 2002, Test-retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia, J Psychosom Res, 53, 737, 10.1016/S0022-3999(02)00330-6 · DOI · Paper page
  37. 2011, Comparison of subjective and objective sleep quality in menopausal and non-menopausal women with insomnia, Sleep Med, 12, 65, 10.1016/j.sleep.2010.09.003 · DOI
  38. 2004, Self-reported sleep in postmenopausal women, Menopause, 11, 198, 10.1097/01.GME.0000097741.18446.3E · DOI
  39. 1999, Climacteric symptoms and sleep quality, Obstet Gynecol, 94, 219

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Metadata

Authors
Lam, C. M., Hernandez-Galan, L., Mbuagbaw, L., Ewusie, J. E., Thabane, L., & Shea, A. K.
Affiliations
  • Department of Biology, McMaster University, Hamilton, Ontario, Canada
  • Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada
Venue
Menopause
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2022-09-06
Volume
29
Issue
10
Pages
1210-1221
ISSN
1072-3714
DOI
10.1097/gme.0000000000002051
Cited by
37
References
16
Language
en

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CoChat. (2026). Citation check: Behavioral interventions for improving sleep outcomes in menopausal women: a systematic review and meta-analysis. https://app.cochat.ai/papers/10.1097/gme.0000000000002051
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Lam, C. M., Hernandez-Galan, L., Mbuagbaw, L., Ewusie, J. E., Thabane, L., & Shea, A. K. (2022). Behavioral interventions for improving sleep outcomes in menopausal women: a systematic review and meta-analysis. Menopause. https://doi.org/10.1097/gme.0000000000002051

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