ArticleMenopause (New York, N.Y.)2026
Cognitive behavioral therapy for menopausal insomnia in perimenopausal and postmenopausal women with insomnia and nocturnal hot flashes: a randomized-controlled pilot trial.
Article in Menopause (New York, N.Y.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThe objective of this randomized-controlled pilot trial was to develop and test a cognitive behavioral therapy intervention for both insomnia and vasomotor symptoms (VMS) in perimenopausal and postmenopausal women with insomnia disorder experiencing nocturnal vasomotor symptoms.
methodsForty-three participants (mean age = 53.6 y) self-described as perimenopausal or postmenopausal who reported at minimum ≥ 1 nocturnal hot flash/night and met diagnostic criteria for insomnia disorder were randomized to cognitive behavioral therapy for menopausal insomnia (CBT-MI) or menopause education control (MEC). The CBT-I intervention was adapted for the study population by incorporating elements of CBT for menopausal symptoms. Primary outcomes measured at baseline, post-treatment measures, 1-month follow-up, and 3-month follow-up included: Insomnia Severity Index (ISI), Sleep Self-Efficacy Scale (SES), and Hot Flash Daily Interference Scale (HFDIS).
resultsCBT-MI compared with MEC significantly reduced ISI (CBT-MI vs. MEC: -10.2±1.15 vs. -6.2±0.99; P=0.007), HFDIS (CBT-MI vs. MEC: -1.3±0.29 vs. -0.5±0.17; P=0.01), and increased SES (10.2±1.46 vs. 5.9±1.24, P=0.03) post-treatment and 1-month after the end of treatment (ISI: CBT-MI vs. MEC, -10.9±1.19 vs. -6.5±0.98; P=0.003, HFRDIS: CBT-MI vs. MEC, -1.1±0.28 vs. -0.4±0.18, P=0.047, SES: CBT-MI vs. MEC, 11.9±2.06 vs. 5.6±1.25; P=0.003). Analysis of the ISI factors showed that CBT-MI significantly decreased night-time sleep symptoms and patient perception of insomnia at post-treatment and 1-month follow-up compared with MEC. Night-time sleep symptoms remained improved at 3-month follow-up compared with MEC.
conclusionsIn this pilot study, a CBT intervention targeting both insomnia and VMS showed promising improvements in sleep and hot flash interference in midlife women.
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