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Updated: Jun 18, 2026

Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder

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Published on: April 26, 2024

Sleep disturbances during perimenopause and later-life cognitive function.

Bangyan Hu¹, Joyce Jy Lin², Xinye Qiu^2,3,4

¹Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.

Menopause (New York, N.Y.)

|June 16, 2026

Summary

Sleep disturbances during perimenopause are linked to poorer cognitive function later in life, especially for women frequently woken by menopausal symptoms. Midlife sleep and menopausal symptoms may indicate future cognitive health.

Keywords:

Cognitive function Hormonal fluctuations Menopausal symptoms Perimenopause Sleep disturbances

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Published on: September 22, 2020

Area of Science:

Neuroscience
Gerontology
Sleep Medicine

Background:

Perimenopause is a transitional phase characterized by hormonal fluctuations and often accompanied by sleep disturbances.
Sleep quality during midlife may impact long-term cognitive health.
Understanding the link between perimenopausal sleep and later cognitive function is crucial for women's health.

Purpose of the Study:

To investigate the association between self-reported sleep disturbances during perimenopause and cognitive function in postmenopausal women.
To determine if the frequency of being woken by menopausal symptoms modifies this association.
To identify potential midlife markers for later-life cognitive decline.

Main Methods:

Analysis of 2,097 postmenopausal women from the St. Louis Baby Tooth-Later Life Health Study.
Retrospective reporting of perimenopausal sleep quality and current sleep using the Neuro-QoL Sleep Disturbance scale.
Cognitive function assessed via a composite Z-score from the TestMyBrain battery.
Multiple linear regression used to analyze associations, stratified by menopausal symptom-related awakenings.

Main Results:

Perimenopausal sleep disturbances were associated with lower cognitive scores decades later.
The association was more pronounced in women frequently woken by menopausal symptoms.
Cognitive deficits were observed even after adjusting for hormone therapy or concurrent sleep issues.

Conclusions:

Perimenopausal sleep disturbances are a significant predictor of poorer cognitive function in later life.
Frequent awakenings due to menopausal symptoms exacerbate the negative impact on cognition.
Sleep quality and menopausal symptom experience in midlife may serve as important indicators of cognitive aging.