CBT-I for perimenopause and postmenopause

A common complaint from women transitioning through menopause is sleep disturbance, which frequently continues into postmenopause. Sleep disturbance may be due to aging, lifestyle, and role transitions, as well as hormonal fluctuation occurring in midlife. The present chapter describes menopause and its effect on sleep while discussing specific case conceptualization considerations. We review empirical evidence for standard CBT-I, and CBT adapted for insomnia and hot flashes. Finally, we provide suggestions on how to adapt CBT-I for midlife women, including specific considerations for psychoeducation and treatment rationale, sleep hygiene education, and cognitive and relaxation strategies.