HIRREM Hot Flashes Study

Inclusion Criteria: * Women, age 40 and above * Intact uterus and ovaries * Have at least 5 hot flashes per day (with at least one being categorized as moderate to severe, in a stable pattern for one month). Exclusion Criteria: * Less than 5 hot flashes per day * Does not experience at least 1 moderate to severe hot flash per day * Unable, unwilling, or incompetent to provide informed consent * Physically unable to come to the study visits, or to sit comfortably in a chair for up to two hours * Known seizure disorder * Known or potential pregnancy (females with last menstrual period less than one year from enrollment will be tested for pregnancy prior to randomization) * Severe hearing impairment (because the subject will be using headphones during the interventions) * Ongoing need for treatment with opiate, benzodiazepine, or anti-psychotic medications, anti-depressant medications such as SSRI, SNRI, or tricyclic, and sleep medications such as zolpidem or eszopiclone * Use of pharmaceuticals for treatment of vasomotor symptoms or any type of hormone replacement therapy * Use of supplements for improvement of vasomotor symptoms including but not limited to black cohosh, soy isoflavone extract, and red clover leaf extract * Menopausal symptoms resulting from, or associated with surgery, chemotherapy, radiation, or use of other chemicals or medications * Anticipated and ongoing use of recreational drugs, alcohol, or energy drinks * Ongoing need for treatment with thyroid med…