The relationship between hot flash beliefs and insomnia symptoms in menopausal women

Hot flashes are a hallmark symptom of menopause and are often implicated in sleep disturbance. Although hot flash severity has been linked to insomnia, the cognitive model of hot flashes suggests that negative beliefs about hot flashes may also influence symptom perception and distress. However, the relationship between hot flash beliefs and insomnia remains understudied. We examined whether hot flash beliefs are uniquely associated with insomnia symptom severity.

This study is a cross-sectional design utilizing secondary data from participants recruited for a longitudinal study. A total of 102 perimenopausal and postmenopausal women were included in this study. Participants completed measures assessing hot flash severity, hot flash beliefs, and insomnia symptom severity. Hierarchical linear regression was used to examine whether hot flash beliefs were associated with insomnia symptoms above and beyond hot flash severity.

Hot flash beliefs were positively associated with insomnia symptom severity (β=0.12, P< 0.05), accounting for 24% of the variance. When hot flash severity was added to the model, both hot flash severity (β=0.80, P< 0.05) and hot flash beliefs (β=0.10, P< 0.05) were significantly positively associated with insomnia symptoms. Together, hot flash severity and hot flash beliefs explained 27% of the variance in insomnia symptom severity.

Cognitive appraisals of hot flashes are associated with greater insomnia symptom severity in perimenopausal and postmenopausal women. It is possible that negative beliefs about hot flashes may heighten arousal and interfere with sleep, independent of hot flash severity. These findings have implications for cognitive-behavioral interventions targeting insomnia and vasomotor symptoms in this population.