Can Menopause Trigger Both Insomnia and Sleep Apnea? Understanding COMISA October 16, 2026 Can Menopause Trigger Both Insomnia and Sleep Apnea? Understanding COMISA Menopause can bring plenty of changes to sleep. Hot flushes, night sweats and hormonal shifts can make it harder to fall asleep, stay asleep or wake feeling refreshed. But for some women, there may be more than one sleep disorder behind those restless nights. Menopause is associated with an increased risk of both insomnia and obstructive sleep apnea (OSA).1 When insomnia and OSA occur together, it is known as COMISA, or comorbid insomnia and sleep apnea. Why can menopause affect sleep? During menopause, levels of hormones including oestrogen and progesterone decline.2 These hormonal changes can affect several processes involved in healthy sleep, including body temperature regulation and the sleep-wake cycle.2 Hot flushes and night sweats can also contribute to repeated awakenings. Other changes associated with menopause, such as more frequent urination, can make uninterrupted sleep even harder to achieve. As a result, insomnia symptoms are particularly common during this stage of life, with more than 60% of postmenopausal women reporting insomnia symptoms.3 Menopause and sleep apnea Menopause may also increase the risk of sleep apnea.1 Postmenopausal women are estimated to be two to three times more likely to have sleep apnea than premenopausal women.4 Declining oestrogen and progesterone levels may play a role, while changes in body fat distribution can also contribute to snoring and narrowing or closure of the airway during sleep.2 Importantly, sleep apnea can look different in women. While loud snoring and excessive daytime sleepiness are commonly associated with OSA, women may instead experience symptoms such as insomnia, fragmented sleep, fatigue, morning headaches and poor daytime functioning.1 This can make sleep apnea easier to overlook, particularly when symptoms are assumed to be simply part of menopause. When insomnia and sleep apnea overlap COMISA occurs when a person experiences both insomnia and OSA. Someone might struggle to fall asleep or stay asleep while also experiencing repeated breathing disturbances once they do drift off. This combination can have a significant impact on sleep quality, daytime energy and overall wellbeing. Research also suggests that COMISA is associated with poorer health outcomes than either condition alone.1 Because of this, identifying both conditions matters. Treating insomnia without recognising underlying sleep-disordered breathing may leave an important part of the problem unresolved. Don’t dismiss ongoing sleep problems Poor sleep may be common during menopause, but that does not mean you simply have to put up with it. If you regularly struggle to fall or stay asleep, wake frequently, experience morning headaches, snore, or feel persistently tired during the day, speak with your doctor or a sleep health professional. A proper assessment can help determine whether menopause-related changes, insomnia, sleep apnea or a combination of both may be affecting your sleep, and help you find the right treatment for a better night’s rest. How Sove CPAP Clinic Can Help If you are experiencing ongoing sleep problems during or after menopause, it can be difficult to know whether insomnia, obstructive sleep apnea or a combination of both is affecting your sleep. Because symptoms can overlap, identifying what is contributing to disrupted sleep is an important first step towards finding the right support. Founded in 2008, Sove CPAP Clinic is a leading provider of respiratory and sleep services in Australia, with over 100 clinics nationwide. Our team of sleep and respiratory clinicians and treatment consultants can help investigate sleep concerns such as frequent waking, difficulty sleeping, snoring and persistent daytime tiredness. We offer bulk-billed home sleep studies for eligible patients to investigate obstructive sleep apnea, as well as personalised, evidence-based care for other sleep problems. For people experiencing both conditions, recognising the possibility of COMISA can help ensure that both insomnia and sleep-disordered breathing are considered when determining an appropriate treatment approach. To speak with our team, book a sleep study or learn more about our sleep services, call 1300 76 29 39 or email info@thecpapclinic.com.au. When considering whether a sleep study is right for you, speak to your doctor. Medicare criteria and T&C’s apply. References 1. Clancy, Rosemary. “COMISA in Midlife Women: OSA & Insomnia | ResMed Sleep Institute.” Resmedsleepinstitute.Com, Resmed, 25 June 2026, https://www.resmedsleepinstitute.com/insights/comisa-insomnia-sleep-apnea-midlife-women. Accessed 9 Sept. 2026. 2) “Untangling the Mysteries of Sleep in Menopause.” Woolcock.Org.Au, 2023, https://www.woolcock.org.au/news/untangling-the-mysteries-of-sleep-in-menopause. Accessed 9 Sept. 2026. 3. Sleep Health Foundation. “Menopause and Sleep.” Sleephealthfoundation.Org.Au, Sleep Health Foundation, 12 June 2025, https://www.sleephealthfoundation.org.au/sleep-topics/menopause-and-sleep. Accessed 9 Sept. 2026. 4) “How Does Menopause Affect My Sleep?” Www.Hopkinsmedicine.Org, https://www.hopkinsmedicine.org/health/wellness-and-prevention/how-does-menopause-affect-my-sleep. Accessed 9 Sept. 2026.
