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Menopause – Improves Sleep

Evidence Summary
The evidence from both a systematic review and a literature review suggests a moderate improvement in sleep quality when undertaking increased levels of physical activity (1,2). The systematic review by Rubio-Arias et al examined 5 randomised-controlled trials with a 12–16-week course of physical activity and found menopausal women had improved sleep quality but no change in insomnia symptoms (1).
There have been multiple further randomised control trials and cross-sectional studies which further support the use of physical activity to improve sleep quality in both menopausal and peri-menopausal women (3,4,5,6,7,8,9) .
Of note, the options for the types of physical activity that may improve sleep quality include yoga undertake two-three times a week, walking or stretching (3,5,6). Encouragingly, just 10 minutes daily of stretching led to a significant decrease in insomnia in a trial for peri and post-menopausal women (3). This is thus an option for those women who are particularly time pressured or have not previously undertaken much physical activity.

Quality of Evidence
Quality of Evidence: Grade A – a good quality systematic review and several RCTs support the evidence that increased levels of physical activity led to less sleep problems and possibly reduced insomnia symptoms.

Strength of Recommendation
Strength of Recommendation: Grade 1 – Strong – systematic review and good amount of RCTs support the recommendation.

Regular physical activity in menopausal and peri-menopausal women has been shown to improve sleep quality in these patients. There is more inconsistent evidence that physical activity helps with insomnia however.


  1. Rubio-Arias, J. A., Marin-Cascales, E., Ramos-Campo, D. J., Hernandez, A. V. and Perez-Lopez, F. R. (2017) ‘Effect of exercise on sleep quality and insomnia in middle-aged women: A systematic review and meta-analysis of randomized controlled trials’, Maturitas, 100, pp. 49-56.
  2. Pettee Gabriel, K., Mason, J. and Sternfeld, B., 2015. Recent evidence exploring the associations between physical activity and menopausal symptoms in midlife women: perceived risks and possible health benefits. Women’s Midlife Health, 1(1).
  3. Kai, Y., Nagamatsu, T., Kitabatake, Y. and Sensui, H. (2016) ‘Effects of stretching on menopausal and depressive symptoms in middle-aged women: a randomized controlled trial’, 1(8), pp. 827-32.
  4. Javadivala, Z., Allahverdipour, H., Jafarabadi, M. A. and Emami, A. (2020) ‘An Interventional strategy of physical activity promotion for reduction of menopause symptoms’, Health Promotion Perspectives, 10(4), pp. 383-392.
  5. Lu, X., Liu, L. and Yuan, R. ‘Effect of the Information Support Method Combined with Yoga Exercise on the Depression, Anxiety, and Sleep Quality of Menopausal Women’.
  6. Noh, E., Kim, J., Kim, M. and Yi, E. (2020) ‘Effectiveness of SaBang-DolGi Walking Exercise Program on Physical and Mental Health of Menopausal Women’, International Journal of Environmental Research and Public Health, 17(18).
  7. Courneya, K. S., McNeil, J., O’Reilly, R., Morielli, A. R. and Friedenreich, C. M. ‘Dose-Response Effects of Aerobic Exercise on Quality of Life in Postmenopausal Women: results from the Breast Cancer and Exercise Trial in Alberta (BETA)’.
  8. El Hajj, A., Wardy, N., Haidar, S., Bourgi, D., El Haddad, M., El Chammas, D., El Osta, N., Khabbaz, L. R. and Papazian, T. (2020) ‘Menopausal symptoms, physical activity level and quality of life of women living in the Mediterranean region’, Plos One, 15(3).
  9. Tan, M. N., Kartal, M. and Guldal, D. ‘The effect of physical activity and body mass index on menopausal symptoms in Turkish women: a cross-sectional study in primary care’.
  10. Wilbur, J., Miller, A. M., McDevitt, J., Wang, E. and Miller, J. ‘Menopausal status, moderate-intensity walking, and symptoms in midlife women’