20 September 2022
Lam et al.  recently reported a systematic review and meta-analysis aimed at assessing the efficacy of behavioral interventions on sleep outcomes among peri- and postmenopausal women, as measured by standardized scales and objective methods (polysomnography, actigraphy). Secondarily they evaluated the safety of these methods through the occurrence of adverse events. The authors performed searches within MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PubMed, and Web of Science using an appropriate search strategy in order to retrieve relevant papers of randomized controlled trials (RCTs) evaluating the effects of behavioral interventions on sleep quality. Risk of bias was also assessed with classical tools used for this purpose. All data were pooled in a meta-analysis using a random-effects model. A total of nineteen articles reporting results from 16 RCTs were included, representing a total of 2,108 peri- and postmenopausal women. Overall, behavioral interventions showed a statistically significant effect on sleep outcomes. Subgroup analyses revealed that cognitive behavioral therapy (CBT), physical exercise and mindfulness/relaxation improved sleep, as measured using both subjective (i.e the Pittsburg Sleep Quality Index) and objective measures. Low- and moderate-intensity exercise also improved sleep outcomes. No serious adverse events were reported. Overall risk of bias ranged from some concern to serious, and the certainty of the body of evidence was assessed to be of very low quality. The investigators conclude that their meta-analysis provides evidence that behavioral interventions, specifically, CBT, physical exercise, and mindfulness/relaxation, are effective treatments to improving sleep outcomes among peri- and postmenopausal women.