Complementary and Alternative Medicine in the Management of Perimenopausal Sleep Disturbances: A Scoping Review

Perimenopause is a natural midlife transition characterized by hormonal and neurological changes that disrupt thermoregulation and circadian sleep-wake regulation, thereby contributing to sleep disturbances. These disturbances are associated with poorer mental health, increased cardiometabolic risk, reduced work productivity, and lower quality of life (QoL). Treatment options include hormonal and nonhormonal therapies, with complementary and alternative medicine (CAM) representing a commonly used nonhormonal approach. However, the evidence supporting CAM for perimenopausal sleep disturbances remains unclear. This scoping review mapped the available literature on CAM interventions for sleep disturbances in healthy perimenopausal women. The Joanna Briggs Institute (JBI) methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines were followed. Comprehensive searches were performed in PubMed, CINAHL, Scopus, Cochrane Library, and Web of Science for English-language studies published between 2014 and 2024. Four reviewers independently screened records and full texts using Covidence, with disagreements resolved by consensus. Data from eligible studies were charted and synthesized descriptively by CAM modality, study design, and the direction of sleep-related outcomes. Thirty-two studies, primarily randomized controlled trials (RCTs), were included, with most reporting improvements in sleep quality. However, substantial heterogeneity in interventions, outcome measures, and study quality limits the strength of recommendations. Larger, standardized trials with objective sleep assessments, more rigorous study designs, greater population diversity, and longer follow-up periods are needed.