Sleep, Menopause, and Depression

Mild Depression in Women who have Nighttime Hot Flashes

The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism published a study that found menopausal women suffer mild symptoms of depression, which are likely triggered by an irregularly high number of hot flashes at night, or at least her perception of hot flashes.

According to the Hormone Health Network, women go through menopause when their ovaries no longer make hormones like estrogen, leading to a cessation of menstrual periods.  This transition into menopause is usually gradual, over about four or five years.  In the United States, the average age for menopause is 51.  There is a Menopause Map™, developed by the Hormone Health Network, which is available to women who want to learn more about the menopause stages and determine where they are in the process.

In this recent research, scientists gave menopausal women a medication that decreased their estrogen levels.  This led to sleep interruptions, as well as a perception of having more nighttime hot flashes, leading to mood disturbance.

Essentially, when the women were interviewed about their sleep, and when they were awake for long enough to recall nighttime hot flashes during the time they should have been sleeping, they reported a mood disturbance.  All of these women had decreased estrogen levels at the time.

First author of the study, Dr. Hadine Joffe, MD, MSc from Harvard Medical School’s Dana Farber Cancer Institute and Brigham and Women’s Hospital in Boston, MA stated there was a notable link between middle-of-the-night hot flashes, mood disturbances, and sleep interruption in these women.

This study included 29 premenopausal, otherwise healthy women between the ages of 18 and 45.  All of the women were given a medication that decreased the production of estrogen in the ovaries, which essentially resembles menopause, inducing symptoms with different degrees of intensity for each woman.  This drug was taken for four weeks.  Before and after that four-week timeframe, the scientists kept an eye on hormone levels and sleep.  All participants completed a mental health questionnaire both before and after the study.

In this study and the reports given by the women, those who reported experiencing hot flashes through the night were more likely to have mild depression symptoms than those who reported no or fewer hot flashes at night.  Interestingly, it was only the women’s perception of hot flashes and frequency that was associated with their mood disturbance.  The researchers made sure to pay close attention to physiological signs of hot flashes on the sleep studies, and there was no link to actual hot flashes and mood changes.

Sleep interruption was another component that was linked to symptoms of depression in the participants.  Those who reported sleep interruption were more likely to have mild symptoms than those who got more sleep.  Of note, there was no link to daytime hot flashes and mood disturbance.

Dr. Joffe and colleagues note that menopausal women who are reporting sleep disruption and nighttime hot flashes should be screened for mood changes.  Their treatment for mood disturbances should include all efforts to address the nighttime hot flashes and sleep interruption as well.


Author: Rachael Herman is a professional writer with an extensive background in medical writing, research, and language development. Her hobbies include hiking in the Rockies, cooking, and reading.


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