Sleep Solutions for Midlife and Menopause - Could CBT-I Help?

Sleep difficulties are common during menopause and midlife, and effective, evidence-based solutions are available. In this national webinar, Dr. Andrea Murphy, a pharmacist and professor at Dalhousie University in Halifax, Canada and co-lead of the Sleepwell research and knowledge mobilization program, discusses the role of menopause hormone therapy and cognitive behavioural therapy for insomnia (CBT-I) in sleep management during menopause. She explores how menopause-related changes affect sleep, the development of chronic insomnia, and treatment benefits. The session covers the fundamentals of menopause and sleep and introduces practical strategies to improve sleep without medication. This live webinar, held on March 10, 2026, was attended by over 450 participants across Canada. 00:00 Introduction 00:09 Agenda 00:31 (Peri)Menopause: Key Terminology 06:04 Hormones 101: Brain-Ovary Connection 08:19 Hormonal Changes in the Menopause Transition 12:57 Sleep Changes in Midlife 14:36 Common Sleep Issues 15:23 What Is Insomnia? 16:21 The 3P Model of Insomnia 19:30 Vicious Cycle of Insomnia 21:02 Arousal Spectrum of Sleep & Wakefulness 22:31 Circadian Rhythm & Sleep Drive 24:39 What Can Cause Sleep Disturbance in Menopause? 25:07 Medical & Lifestyle Contributors 27:02 Aging & Sleep Changes 27:35 Nocturia & Nighttime Awakenings 28:16 Mood Changes & Mental Health 29:21 Vasomotor Symptoms (Hot Flashes & Night Sweats) 30:29 Hormonal Changes: How Estrogen & Progesterone Affect Sleep 32:55 Prevalence of Sleep Disturbance in Menopause 34:38 Sleep Disordered Breathing 36:33 Restless Legs Syndrome 37:27 Genitourinary Syndrome of Menopause 38:21 Impact of Insomnia on Overall Health 38:52 Treatment Options: CBT-I vs. Sleeping Pills 39:53 CBT-I: First-Line Treatment for Chronic Insomnia 42:43 Does CBT-I Work in Menopause? 44:06 Formats of CBT-I (Self-help, Therapist-Guided, Hybrid) 44:50 Most Effective Components of CBT-I 45:11 How to Get Started: Sleep Diary 45:54 Sleep Diary Walkthrough (Ginny's Example) 51:28 Stimulus Control Techniques 53:30 How to Adjust Bedtime Based on Sleep Efficiency 54:14 More Stimulus Control Techniques 55:25 Sleep Medications: What to Expect 56:12 Sedative Use: Differences by Sex, Age, and Region 57:08 Risks of Sleeping Pills 57:57 Faye's Story: From Pills to Healthy Habits