To compare the disparities in the modified Kupperman’s score（KMI）and peripheral blood micro indicators between non-interaction between heart and kidney syndrome and liver depression and Qi stagnation syndrome of perimenopausal women experiencing sleep difficulties.

Eighty patients with perimenopausal sleep disorders were selected as research participants using the Pittsburgh Sleep Quality Index（PSQI）. Among them，40 patients had non-interaction between heart and kidney syndrome and 40 patients had liver depression and Qi stagnation syndrome. The data，including traditional Chinese medicine syndrome collection forms and KMI scales was gathered. Enzyme-linked immunosorbent assay（ELISA）was used to quantify serum inflammatory markers［interleukin-1β（IL-1β），tumor necrosis factor-α（TNF-α）］and neurotransmitter levels［gamma aminobutyric acid（GABA），glutamic acid（Glu）］in two groups.

The study findings revealed that noninteraction between heart and kidney syndrome had higher values for time to fall asleep，sleep time，sleep efficiency，sleep disorder score and total PSQI score compared to the liver depression and Qi stagnation syndrome group（P<0.05）. Additionally，the liver depression and Qi stagnation syndrome group had a higher daytime dysfunction score than the non-interaction between heart and kidney syndrome group（P<0.05）. Furthermore，the non-interaction between heart and kidney syndrome group exhibited higher values for hot flashes，sweating，muscle and joint pain，palpitations，urinary system symptoms and total KMI score compared to the liver depression and Qi stagnation syndrome group（P<0.05）. Conversely，the liver depression and Qi stagnation syndrome group had higher scores for emotional excitement，depression，suspicion，dizziness，headache and skin ant sensation compared to the non-interaction between heart and kidney syndrome group（P<0.05）. Serum levels of IL-1βand TNF-αwere also higher in the liver depression and Qi stagnation syndrome group. The levels in the non-interaction between heart and kidney syndrome group were significantly higher than those in the other group（P<0.05）. In contrast，the serum GABA level in the non-interaction between heart and kidney syndrome group was lower than that in the liver depression and Qi stagnation syndrome group，while the Glu level was higher（P<0.05）.

In women experiencing sleep difficulties during the perimenopausal period，the non-interaction between heart and kidney syndrome is associated with worse overall sleep quality compared to the liver depression and Qi stagnation syndrome. Additionally，the non-interaction between heart and kidney syndrome is also linked to more severe perimenopausal symptoms. The sleep disturbances and perimenopausal symptoms have distinct classifications. There are significant differences in the expressions of IL-1β，TNF-α，GABA and Glu between the two syndromes，which may contribute to the objectivity and precision of traditional Chinese medicine syndrome differentiation for sleep disorders in perimenopausal women.