Section 4: Vasomotor Symptoms and Sleep

Sleeplessness due to menopause is often associated with Vasomotor Symptoms (VMS) or, as they’re more commonly referred to, hot flashes or night sweats. Hot flashes are triggered by a decline in estrogen and affects more than 75% of women during menopause transition.  

Defined as a disturbance of the temperature-regulating system in the brain, specifically the hypothalamus, these sensations of extreme heat are often associated with profuse sweating and can come on during the day or at night.

Nighttime hot flashes or “night sweats” often cause unexpected awakenings and can profoundly disrupt sleep, leading to a challenging cycle of sleep disturbances. When night sweats are moderate-to-severe, women are three times more likely to report frequent nightly awakenings compared to women without hot flashes. 

Characterized by intense periods of sweating during sleep, night sweats are essentially severe hot flashes that occur at night. These episodes can dramatically elevate the body temperature and heart rate, causing sudden and uncomfortable awakenings. As the body struggles to regulate its temperature, women may find themselves tossing and turning, struggling to return to sleep.

This can disrupt the sleep cycle, reducing the amount of deep, healing sleep. The result is often waking up feeling unrefreshed and fatigued, which can affect cognitive functions, mood stability, and overall quality of life during the daytime. Moreover, the anxiety about experiencing night sweats can itself become a source of sleep disruption, as the anticipation of discomfort may make it harder to fall asleep.

Although they are a common cause of poor sleep quality during menopause transition, not all women who experience menopause-related sleep problems experience hot flashes or night sweats. 

Vasomotor Symptoms:

• Are associated with sweating and affect more than 75% of women during menopause transition
• Defined as a disturbance of the temperature-regulating system in the brain (hypothalamus)
• Triggered by a decline in estrogen
• When moderate-severe, women are three times more likely to report frequent nightly awakenings compared to women without hot flashes
• Can be absent in some women who suffer from menopause-related sleep problems