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The integration of migraine and sleep disturbance in perimenopause: a narrative review

Roberta Heale, Christie Tait

Menopause The Journal of The North American Menopause Society, 2026

Abstract

IMPORTANCE AND OBJECTIVE: This narrative review examines the intersection of migraine and sleep disturbances during perimenopause. Although hormone fluctuations exacerbate both conditions, clinical guidelines for their coordinated management are lacking. This review explores the impact of perimenopause on these comorbidities, evaluates how treatments for one affect the other, and provides evidence-based recommendations for integrated care. METHODS: A search for full-text studies and clinical guidelines written in English was undertaken. The search included PubMed, CINAHL (EBSCOhost), Google Scholar, and ProQuest Nursing and Allied Health from 2015 to 2025. Manual extraction of research articles from review articles and foundational physiology was also undertaken expanding the years from 2003. DISCUSSION AND CONCLUSION: An integrated approach to assessment and monitoring of migraine and sleep disorders during perimenopause, and treatment considerations impacting both conditions can reduce the burden of migraine and improve sleep. Coordination of treatment across both has the potential to improve quality of life of women in perimenopause. Further research is needed to better understand coordinated approaches to this complex interplay.

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