Oct. 6, 2010 -- Both pain and the hot flashes that occur with menopause can prevent older women from getting a good night's sleep, a study shows.

"More than one thing contributes to sleep difficulties in middle-aged women and those going through menopause," explains study researcher Howard M. Kravitz, DO, the Stanley G. Harris Family Professor of Psychiatry and a professor of preventive medicine at Rush University Medical Center in Chicago. "Menopause symptoms and pain both act together and must be taken into account."

The new findings, part of the Study of Women's Health Across the Nation (SWAN) Sleep Study, are slated to be presented at the North American Menopause Society's annual meeting in Chicago.

In the study, 314 women completed sleep diaries and wore a wristwatch to detect nighttime motion. Menopausal symptoms did play a role in sleep difficulty, but pain had an independent effect on wakefulness and sleep efficiency or the amount of time spent fast asleep in bed, the study shows.

Slideshow: Menopause and Perimenopause Overview
Treating Sleep Problems

Better “sleep hygiene” is the first step toward troubleshooting sleep issues in all people, including women going through menopause, Kravitz says. This means making sure that the bedroom is quiet and dark and not exercising right before bedtime, he says.

"Keep a regular bed and wake time, and use the bed as place to sleep, not to do other things," he tells WebMD. He also cautions against daytime napping or lying down to rest during the day.

For women in or approaching menopause who are experiencing symptoms such as hot flashes that interfere with sleep, a brief course of hormone replacement therapy may be warranted -- assuming there are no contraindications to its use, he says.

Pain, too, should be addressed, he says. "The first step is to identify the cause of the pain and then treat it," he says.

"Women in menopause don't sleep well and almost everybody assumed it was due to hot flashes. And while that is a factor, pain is another factor," says Michael Breus, PhD, author of Beauty Sleep and the clinical director of the sleep division for Arrowhead Health in Glendale, Ariz. "This study says it's not just hot flashes, it's pain, too."

"When you speak to your doctor about sleep, mention pain if you have it," he says.

This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.