title: Eszopiclone improves insomnia and depressive and anxious symptoms in perimenopausal and postmenopausal women with hot flashes: a randomized, double-blinded, placebo-controlled crossover trial.
abstract: OBJECTIVE
  Menopause-associated insomnia is commonly associated with other symptoms (hot flashes, depression, anxiety). Given frequent symptom cooccurrence, therapies targeting sleep may provide an important approach to treatment during midlife.
  
  
  METHODS
  Peri/postmenopausal women (40-65 years old) with sleep-onset and/or sleep-maintenance insomnia cooccurring with hot flashes and depressive and/or anxiety symptoms were randomized to eszopiclone 3 mg orally or placebo in a double-blinded, crossover 11 week trial. Changes in the Insomnia Severity Index (ISI) scale and secondary outcomes (diary-based sleep parameters, depression/anxiety, hot flashes, quality of life) were analyzed using repeated-measure linear models.
  
  
  RESULTS
  Of 59 women, 46 (78%) completed the study. Eszopiclone reduced ISI scores by 8.7 + or - 1.4 more points than placebo (P < .0001). Eszopiclone improved (P < .05) all sleep parameters, depressive symptoms, anxiety symptoms, quality of life, and nighttime but not daytime hot flashes.
  
  
  CONCLUSIONS
  Eszopiclone treats insomnia and cooccurring menopause-related symptoms. Our results provide evidence that hypnotic therapies may improve multiple domains of well-being during midlife.
authors.affiliation: Perinatal and Reproductive Psychiatry Clinical Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. hjoffe@partners.org
authors.forename: Hadine
authors.initials: H
authors.lastname: Joffe
authors.forename: Laura
authors.initials: L
authors.lastname: Petrillo
authors.forename: Adele
authors.initials: A
authors.lastname: Viguera
authors.forename: Alexia
authors.initials: A
authors.lastname: Koukopoulos
authors.forename: Kate
authors.initials: K
authors.lastname: Silver-Heilman
authors.forename: Adriann
authors.initials: A
authors.lastname: Farrell
authors.forename: Gary
authors.initials: G
authors.lastname: Yu
authors.forename: Michael
authors.initials: M
authors.lastname: Silver
authors.forename: Lee S
authors.initials: LS
authors.lastname: Cohen
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000188:drug therapy*; D053961:Azabicyclo Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003863:Depression / Q000188:drug therapy*; D004311:Double-Blind Method; D000069582:Eszopiclone; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008875:Middle Aged; D047648:Perimenopause / Q000523:psychology*; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D017698:Postmenopause / Q000523:psychology*; D011788:Quality of Life; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy* / Q000523:psychology
chemical_list: D053961:Azabicyclo Compounds; D006993:Hypnotics and Sedatives; D010879:Piperazines; D000069582:Eszopiclone