Insomnia is common right before or shortly after menopause. In fact, 15% to 60% of women may experience sleep disturbances during menopause. Potential causes include hot flushes, menopause-related mood and anxiety issues, and social stresses linked to middle age. From a biology point-of-view, declining estrogen levels are the likely culprit. But, the effects of estrogen replacement therapy on sleep have been mixed.
Some doctors and researchers propose that non-hormonal insomnia treatment may be an option for some menopausal women. Lunesta (eszopiclone) is a non-benzodiazepine prescription sleep medication approved by the FDA for adults and the elderly. A 2006 study investigated Lunesta (eszopiclone) for women with menopause-related insomnia.
Insomnia Treatment With Lunesta (Eszopiclone) During Menopause
Whom did they study?
Women with insomnia caused by menopause. The criteria for insomnia were: (1) sleeping less than 6 hours a day and (2) requiring at least 45 minutes to fall asleep. The women has these insomnia symptoms more than three times per week for one month. Women who may have had insomnia caused by non-menopausal factors were not allowed to participate. So, women with mood disorders or a history of substance abuse were excluded. The use of insomnia-causing drugs was another exclusion factor.
The majority of women were white. On average, the women were 49 years old.
What did they study?
The study created two groups: women who received Lunesta (eszopiclone) 3mg once daily and women who received a placebo pill. The study authors wanted to know if Lunesta (eszopiclone) decreased the time needed to fall asleep (“sleep latency”).
What were the results?
Lunesta (eszopiclone) reduced the time needed to fall asleep by 26 minutes; the placebo pill reduced the time needed to sleep by 10 minutes. Importantly, users of Lunesta (eszopiclone) noted better quality of life.
Patients who took Lunesta (eszopiclone) were more likely to experience side effects (5.5% versus 1.4%). The side effects included: back pain, nausea, joint pain, headache, and bitter taste.
The authors made the following conclusions:
…women treated with eszopiclone fell asleep quickly, stayed asleep longer (with reduction in awakenings and awakenings due to nocturnal hot flushes), reported improved sleep quality, and had additional benefits in mood, daytime well-being and ability to function, and quality of life compared with placebo.
- Lunesta may be an option for treating your menopausal insomnia if you closely match characteristics of the women who took part in this study
- Lunesta does not improve hot flushes. So, if you’re insomnia is due primarily to hot flushes or night sweats, hormone replacement therapy (or antidepressants like Effexor or Pristiq) remain good options.
- The authors studied Lunesta for a short-time (only 4 weeks). The longer term effects (good or bad) are not known.
- Non-prescription options include melatonin for sleep
- Eszopiclone in patients with insomnia during perimenopause and early postmenopause. Obstet Gynecol. 2006 Dec;108(6):1402-10.