Telephone Delivered Cognitive Behavioral Therapy Improved Insomnia and Hot Flashes in Menopausal Women Interview with:

Dr. Susan McCurry Principal Investigator Clinical psychologist and research professor School of Nursing University of Washington

Dr. Susan McCurry

Dr. Susan McCurry
Principal Investigator
Clinical psychologist and research professor
School of Nursing
University of Washington What is the background for this study?

Dr. McCurry: Every woman goes through menopause.  Most women experience nighttime hot flashes/sweats and problems sleeping at some point during the menopause transition.  Poor sleep leads to daytime fatigue, negative mood, and reduced daytime productivity.  When sleep problems become chronic – as they often do – there are also a host of negative physical consequences including increased risk for weight gain, diabetes, and cardiovascular disease.  Many women do not want to use sleeping medications or hormonal therapies to treat their sleep problems because of concerns about side effect risks.  For these reasons, having effective non-pharmacological options to offer them is important. What are the main findings?
Dr. McCurry: The study was a randomized, controlled clinical trial of a novel telephone-delivered cognitive-behavioral therapy intervention for insomnia (CBT-I).  One hundred six peri- and post-menopausal women in Seattle between 40 and 65 years of age with moderate insomnia who experienced at least two hot flashes a day were enrolled.

The main outcomes of the study were that women in the cognitive behavioral therapy group experienced statistically significant, clinically meaningful, and sustained improvements in sleep as compared to the women in an menopause education control group. The women who received cognitive behavioral therapy also reported that their hot flashes interfered less with their daily functioning after treatment. What should readers take away from your report?

Dr. McCurry: This study demonstrates that it is possible to significantly improve the sleep of many women going through the menopausal transition, without use of sleeping medications or hormone therapies, even if hot flashes are waking them up at night.  This is good news for millions of women who are suffering from poor sleep at this time of life. What recommendations do you have for future research as a result of this study?

Dr. McCurry: Telephone-based CBT-I potentially allows upscaling to reach large populations of menopausal women seeking treatment for sleep problems. Results support further development and testing of centralized CBT-I programs in primary and women’s health care settings for treatment of midlife insomnia in women. Another logical next step would be direct comparison of sleep and hot flash outcomes and cost-effectiveness of telephone CBT-I versus pharmacotherapy in this population. Is there anything else you would like to add?

Dr. McCurry: To our knowledge, this is the first, and the largest, study to show that  cognitive-behavioral therapy intervention helps healthy women with hot flashes sleep better. Thank you for your contribution to the community.


McCurry SM, Guthrie KA, Morin CM, et al. Telephone-Based Cognitive Behavioral Therapy for Insomnia in Perimenopausal and Postmenopausal Women With Vasomotor Symptoms: A MsFLASH Randomized Clinical Trial. JAMA Intern Med. Published online May 23, 2016. doi:10.1001/jamainternmed.2016.1795

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and

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