When perimenopause arrives with its roller-coaster ride of hormonal ups and downs, the entire orchestra gets out of sync, says Dr. Yan-Go, and disrupted sleep is frequently the result.

The most common causes of sleep disorder are chronic fatigue syndrome, post-traumatic stress disorder, menopause, stress, anxiety, postpartum depression, and congestive heart failure.

Since the symptoms of perimenopausal depressive disorder not only involve with biological factors, but also social factors, therefore, it is a typical social-psychological-medical pattern.