Effectiveness of Cognitive Behavioral Therapy for Insomnia in Women Experiencing Menopausal Insomnia: A Scoping Review

Abstract

Decreased quality and duration of sleep can impact both physical and mental health in addition to quality of life, well-being, quality of social relationships, productivity, and performance. With insomnia as a leading sleep disorder among menopausal-aged women, identifying low-cost and low-risk interventions is important for maintaining physical and mental health. One promising intervention is cognitive behavioral therapy for insomnia (CBT-I). The objective of this review was to describe the effectiveness of CBT-I in decreasing insomnia symptoms in menopausal-aged women. Electronic databases were searched using terms encompassing insomnia, CBT-I, and menopausal age. Seven articles met the inclusion criteria of using a CBT-I strategy in women of menopausal or post-menopausal age and measuring at least one sleep-related outcome. Studies primarily used sleep restriction, stimulus control, and sleep hygiene education techniques. Interventions were delivered in both face-to-face and telehealth formats. Across studies, insomnia symptoms and sleep quality improved with moderate to large effect sizes and clinically significant changes were achieved in most studies. Quality of life and mental health were improved in studies measuring those outcomes. Effectiveness did not appear to vary between delivery methods. Based on this review, we can state that CBT-I is a practical and effective intervention for menopausal-aged women experiencing insomnia, providing clinically meaningful reductions in insomnia symptoms and improvements in sleep quality, quality of life, and mental health. Future research would benefit from more detailed analyses of the different techniques and dosing. Additionally, new technology, including sleep trackers and personalized care using AI-driven programming, should be investigated.