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Active nighttime temperature regulation reduces nocturnal hot flashes by 57% and improves sleep quality in menopausal women, regardless of hormone therapy status.
For women dealing with nighttime hot flashes and disrupted sleep, a cooler sleep environment may offer a new way to ease symptoms, as per the findings of a novel study. About 1.3 million women enter menopause annually in the US; nearly 80% experience hot flashes (HFs), 40–60% report insomnia, and 83% report HF-related sleep interference with daytime productivity. Since HFs are linked to a narrowed hypothalamic thermoneutral zone and increased activity of temperature-sensitive neurons, researchers investigated whether actively regulating sleep temperature could reduce them.
The study, led by Megan Holm et al., included 98 peri- and postmenopausal women (54.1±6.7 years), including 35 HRT users and 51 non-HRT users. Volunteers completed 7 nights with an actively temperature-regulated mattress cover (ATR) switched OFF and 7 nights with ATR ON, producing 1,964 total nights. The order was randomized in 60 women and fixed in 38. In 60 postmenopausal women, core temperature (Tc) was measured using a gastrointestinal pill on Night 3, while foot and chest temperatures were recorded on Nights 2–4.
The distal-proximal gradient (DPG) was calculated as foot minus chest temperature and used as a marker of skin-temperature uniformity. Participants also reported nocturnal HF frequency and perceptual outcomes. Menopausal symptoms and sleep quality were assessed each week via the Menopause Rating Scale (MRS) and Pittsburgh Sleep Quality Index (PSQI).
HFs fall by more than half
ATR ON reduced nocturnal HFs by 57% on average:
Thus, the reduction was independent of HRT use. ATR ON also increased time spent with:
Both were significant. Furthermore, 23% (12/53) of women spent at least 50% more sleep time with DPG <−1°C, while 24% (14/59) spent at least 50% more time with Tc <36.5°C.
Sleep and menopausal symptoms improve
With ATR ON, overall menopausal symptom severity dropped by 2.8±5.0 points out of 44, while sleep quality improved by 1.4±2.5 points out of 21. These improvements were also observed regardless of HRT use. On nights with fewer HFs, women reported greater body-temperature comfort (r=−0.6) and higher sleep satisfaction (r=−0.5).
What may explain the effect?
The findings suggest that ATR may reduce HFs by increasing the time spent at a lower Tc while maintaining a wider temperature gradient between the feet and chest. The findings identify temperature regulation as a potential approach for tackling nighttime menopausal symptoms and provide evidence for two possible underlying thermal mechanisms.
Physiology
Active temperature regulation during sleep reduces nocturnal hot flashes and improves sleep quality and menopausal symptoms in menopausal women
Megan Holm et al.
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