Active temperature regulation improves nocturnal hot flashes and sleep in menopausal women

Abstract Menopausal hot flashes (HFs) frequently disrupt sleep, adversely affecting quality of life. Non-pharmacological interventions targeting temperature regulation during sleep remain underexplored. This study conducted a 14-night crossover trial with 98 peri- and post-menopausal women (1,219 nights; mean ± SD: 54.1 ± 6.7 y), comparing HF frequency when women slept for 7 nights with active temperature regulation (ATR) ON vs. 7 nights OFF. Core temperature was tracked for 24-hours and skin temperature was tracked overnight during each ATR condition. For both menopausal women taking and not taking hormone replacement therapy, ATR reduced nocturnal HFs by 56 ± 39%, and improved menopausal symptom severity by 9 ± 41% and reported sleep quality by 10 ± 39%. HF reduction via ATR likely occurred by keeping women within their thermoneutral zone, indicated by lower core and skin temperatures throughout the night, with ATR ON. These findings suggest that ATR helps stabilize overnight body temperatures in menopausal women, thus reducing HFs and improving sleep quality. Therefore, ATR may serve as a non-pharmacological intervention for managing menopausal symptoms and improving sleep quality.