TL;DR
Get health and wellness essentials delivered free with Prime
- Fast, free delivery on millions of items
- Prime Video, Amazon Music and more included
- Member-only deals all year
A meta-analysis of seven placebo-controlled trials found that neurokinin-receptor antagonists were associated with reduced sleep disturbance among menopausal women with moderate-to-severe vasomotor symptoms. Improvements were reported from four weeks and continued at 12 and 24 weeks, but the analysis cannot establish how much sleep improvement was independent of reduced hot flashes.
A meta-analysis of seven placebo-controlled trials found that non-hormonal neurokinin-receptor antagonists were associated with less sleep disturbance in menopausal women with moderate-to-severe hot flashes, with improvement reported as early as four weeks. The findings, presented by Maria Julia Lemos at the Menopause Society annual meeting and published in Menopause, add evidence about sleep outcomes for treatments used to reduce vasomotor symptoms.
The analysis covered 3,184 women: 949 received fezolinetant, 864 received elinzanetant, and 1,371 received placebo. Researchers searched PubMed, Embase and Cochrane through May 2026. The included trials were OASIS I, II and III; SWITCH-1; DAYLIGHT; pooled SKYLIGHT I and II data; and Depypere 2019. The authors assessed the trials as having a low risk of bias.
Five trials used the same sleep questionnaire, the PROMIS Sleep Disturbance-Short Form 8b, and were pooled for the primary analysis. On that scale, lower scores mean less sleep disturbance. Compared with placebo, the pooled results favored treatment at four weeks (standardized mean difference, or SMD, -3.94; 95% confidence interval -5.71 to -2.16), 12 weeks (SMD -3.11; 95% CI -4.60 to -1.61) and 24 weeks (SMD -2.04; 95% CI -3.93 to -0.15). The other two trials used different questionnaires and were analyzed separately.
In subgroup analyses, both drugs significantly improved sleep through 12 weeks. The reported effect was larger for elinzanetant than fezolinetant at four weeks and 12 weeks. These are comparisons across trial results, however, not findings from a direct head-to-head trial. The meta-analysis examined patient-reported sleep outcomes; it does not establish that either drug should be chosen over another treatment for an individual patient.
Sleep Outcomes Beyond Hot Flashes
Hot flashes and night sweats can disrupt sleep, and poor sleep is a major concern for some people seeking care for menopause symptoms. The findings give clinicians and patients more trial-based information about sleep disturbance when considering non-hormonal treatment options for vasomotor symptoms.
Lemos told MedPage Today that the results may matter for women who cannot or do not want to use hormone therapy, particularly if sleep is a leading complaint. JoAnn E. Manson of Harvard Medical School, who was not involved in the research, said the analysis addressed a gap in information about whether vasomotor-symptom treatments reduce sleep disturbance. The results are evidence of an association in clinical trial data, not a guarantee of benefit for every patient.
menopause cooling pillow for night sweats
As an affiliate, we earn on qualifying purchases.
As an affiliate, we earn on qualifying purchases.
How the Drugs Target Symptoms
Menopausal hormone therapy is a preferred treatment for vasomotor symptoms, but it is not suitable for everyone, and some women may prefer a non-hormonal approach. Fezolinetant and elinzanetant are non-hormonal options recommended for vasomotor symptoms. Fezolinetant blocks the NK3 receptor; elinzanetant acts on both NK1 and NK3 receptors.
These medicines act on the brain’s thermoregulation system, which is involved in hot flashes. The review was prompted in part by the fact that large trials of these drugs had measured sleep as a secondary outcome, while a meta-analysis focused on sleep had not been conducted, Lemos said. The current work combined results from existing trials rather than testing a new treatment in a new group of participants.
“They may help women sleep better, not just have fewer hot flashes.”
— Maria Julia Lemos, MD, study presenter, speaking to MedPage Today
cooling mattress pad for hot flashes and night sweats
As an affiliate, we earn on qualifying purchases.
As an affiliate, we earn on qualifying purchases.
Limits of the Sleep Evidence
The analysis included only seven trials, and the studies differed in participants, treatment regimens and follow-up periods. Sleep outcomes were patient-reported, and only five trials used the same questionnaire for pooled analysis. Lemos also noted that the researchers could not separate sleep improvement caused by easing hot flashes from any effect on sleep apart from broader symptom relief.
The larger effect reported for elinzanetant in subgroup analyses does not show that it is superior to fezolinetant in direct clinical comparison. No head-to-head trials were included, and the reported estimates should not be read as predictions for an individual patient. The supplied report does not provide evidence about longer-term sleep effects beyond the 24-week analysis or establish which patients are most likely to benefit.
breathable moisture-wicking pajamas for menopause night sweats
As an affiliate, we earn on qualifying purchases.
As an affiliate, we earn on qualifying purchases.
Direct Comparisons Still Needed
The next evidence needed, according to Lemos, is head-to-head research comparing fezolinetant with elinzanetant. Such trials could clarify how the medicines compare directly, including their effects on sleep and vasomotor symptoms. Until then, the meta-analysis adds information from placebo-controlled studies but does not settle which option is more effective.
For now, the findings support further attention to sleep outcomes in research on menopause treatments. Decisions about therapy remain individual; patients should discuss available options, risks and suitability with a qualified health professional.
sleep mask for light blocking and better sleep
As an affiliate, we earn on qualifying purchases.
As an affiliate, we earn on qualifying purchases.
Key Questions
What did the meta-analysis find?
Across placebo-controlled trial data, neurokinin-receptor antagonists were associated with reduced sleep disturbance in menopausal women with moderate-to-severe vasomotor symptoms. Improvements were reported at four, 12 and 24 weeks in the pooled analysis.
Which medicines were included?
The trial data included fezolinetant and elinzanetant, both non-hormonal treatments for vasomotor symptoms. The review did not directly compare the drugs in a head-to-head trial.
Does the analysis show that elinzanetant works better?
Subgroup analyses reported a larger sleep effect for elinzanetant than for fezolinetant at four and 12 weeks. Because the comparison was not from a head-to-head trial, it does not establish that one medicine is superior.
Can the sleep benefit be separated from hot-flash relief?
No. The researchers said the analysis could not determine how much of the sleep improvement resulted from reduced hot flashes and other vasomotor symptoms, rather than a separate effect on sleep.
When did the reported improvement appear?
The pooled analysis found a treatment-associated improvement by four weeks, with results also favoring treatment at 12 and 24 weeks. These findings describe the study data and do not guarantee an individual response.
Source: rss
Cold & flu season Picks
humidifiers
As an affiliate, we earn on qualifying purchases.
