A small new study suggests that a type of talk therapy called cognitive behavioral therapy (CBT) may help reduce insomnia and nighttime hot flashes during menopause. It may help women who want a nonhormonal approach to managing sleep problems and nighttime hot flashes.

In the pilot trial, researchers found that women who received CBT designed for menopause-related insomnia had greater improvements in insomnia severity and how much hot flashes affected their daily lives compared with women who received menopause education.

Earlier research suggests that CBT may help reduce how much menopause symptoms, including hot flashes and night sweats, get in the way of sleep and quality of life. This study tested a version of CBT designed specifically for women with insomnia and nighttime hot flashes.

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Why Sleep Problems and Hot Flashes Are Common in Menopause

During perimenopause and postmenopause, changing hormone levels can affect the body’s temperature control system. This can lead to vasomotor symptoms, the medical term for hot flashes and night sweats.

Night sweats can wake people up or make it harder to fall back asleep. Over time, poor sleep may affect mood, energy, concentration, and quality of life.

Current treatments for hot flashes and night sweats may include hormone therapy.

Nonhormonal options may include:

• Certain antidepressants
• Gabapentin
• Other prescription medicines
• Lifestyle changes, such as dressing in layers, avoiding foods that trigger hot flashes, and trying mind-body practices

What Is CBT?

CBT is a structured form of talk therapy. It helps people notice and change thoughts and habits that may worsen symptoms.

For insomnia, CBT often focuses on sleep routines, beliefs about sleep, relaxation skills, and behaviors that may make sleep harder.

CBT doesn’t involve taking medication, although it can sometimes be used along with medication or other treatments.

What the Study Found

The study included 43 perimenopausal and postmenopausal women. Their average age was 53.6 years. All had insomnia and reported at least one hot flash per night.

Participants were randomly assigned to one of two groups:

• One group received CBT for menopausal insomnia, adapted to address both insomnia and vasomotor symptoms. They had four 50-minute sessions over eight weeks.
• The other group received one 50-minute menopause education session.

Researchers found that women who received CBT had bigger improvements in insomnia and fewer problems from hot flashes after treatment and one month later, compared with women who had the education session.

The study also reported that 69 percent of women in the CBT group no longer had insomnia symptoms severe enough to be considered insomnia after treatment, compared with 30 percent in the education group.

This was a small pilot study, so larger studies are needed to confirm the results.

Why This Matters for Women in Menopause

For women with menopause-related insomnia and night sweats, CBT may offer another option to discuss with a healthcare provider. It may also be useful for women who want to manage poor sleep and nighttime hot flashes without hormone therapy.

If hot flashes or poor sleep are affecting daily life, talk with a healthcare provider. They can review treatment options and lifestyle steps to help you feel better.