Sleep Disturbances in Perimenopause: Exploring Physiological and Ayurvedic Concepts

Abstract

At perimenopause, sleep disturbances occur due to hormone, neuro-endocrine and psychological changes, which leads to poor quality of life for women. Objective: The transition through menopause is often accompanied by various sleep disturbances, with the objective being to review how these sleep disturbances manifest physiologically and the potential for drug Guduchi (Tinospora cordifolia) to address them from biomedical and Ayurvedic perspectives. Methods: The literature search was made by applying the method of searching literature from PubMed, Scopus, Google Scholar and ScienceDirect based on the guideline of PRISMA 2020. The studies included in English-language human and animal studies, reviews, and clinical studies from 2015 to 2025. Results: Evidence indicates that symptoms of estrogen deficiency, vasomotor symptoms, oxidative stress, inflammation, and disruption of the circadian rhythm are factors that negatively impact sleep. Guduchi has been found to have Rasayana, antioxidant, anti-inflammatory, adaptogenic and immunomodulatory properties, all of which can help in reducing these. Evidence, however, is limited to direct clinical data concerning the effects of sleep in perimenopausal women. Conclusion: Guduchi has been found as a potential complementary management in women having sleep disturbances related to menopause. Additional well designed randomised clinical trials are required to validate its efficacy and safety.