Sleep problems in midlife and beyond

Good sleep quality is important for good health, both physical and mental, and indeed for quality of life, performance and productivity. Sleep problems increase with age in both sexes, but women are more susceptible to them at all ages. Although menopause is considered an important milestone (the decrease in both oestrogen and progesterone has been shown to reduce sleep quality), an increase in sleep problems is already evident in midlife, as there is an increased incidence of other diseases as well as mood symptoms, which may exert an effect on sleep quality either directly or via the side-effects of the associated medications. Weight changes at midlife and the menopause may also affect sleep quality. In addition to reductions in sleep quality, specific sleep disorders, like sleep-disordered breathing and restless legs syndrome, become more prevalent in midlife and especially after menopause. Because sleep problems are commonly present in association with other conditions, rather than as isolated, independent disorders, treatment is often complex and patients generally need multiprofessional appraisal.