Sleep and the Menopause
Catherine Lawson
Insomnia is bad enough at any age but during the menopausal years lack of sleep compounds all the other symptoms which can come out of the woodwork at this time; anxiety, depression, fatigue, musculoskeletal pains, mood swings, brain fog and weight gain to name but a few. It’s not mother nature’s finest moment.
Several factors are at play when it comes to poor sleep during menopause, the first being the reduction in the hormones which play a key role in the quality and duration of our sleep: estrogen, testosterone and progesterone. When hormone levels start to drop, one of the consequences is disruption to our circadian rhythms. Getting to sleep is one thing, staying asleep is quite another. In addition, there are physical symptoms which make it difficult to get to sleep and stay asleep, most notably night sweats; the drop in hormone levels also plays havoc with the body’s internal temperature regulation system resulting in waves of insufferable heat. It’s not easy to sleep through that kind of physical discomfort.
Stress is another pervasive issue during menopause resulting in negative thoughts, roller-coaster emotions and the associated feelings of anxiety which can keep us wide awake. With problems feeling ten times worse through the night when our minds are running free, it’s easy to get into that vicious cycle of stress keeping us awake and the worry of being awake keeping us stressed.
And then there’s the subject that no-one really wants to talk about; the increased need to urinate. When you’re up and down several times a night it’s hard to get a clear run at a good quality sleep and it’s often the very thing which, once we’ve been up, leaves us reaching for a book at 3am and wondering if we should go one more time before trying to nod off again.
With so many factors to consider it stands to reason that there won’t be one quick fix. In addition to the lifestyle choices which would be recommended for anyone struggling to sleep at any age (clean diet with minimal sugar, reduction in caffeine and alcohol, regular exercise, no technology at bedtime, uncluttered environment and relaxation techniques such as meditation and mindfulness) here are some menopause related strategies:
- HRT can help deal with the reduction in hormone levels which leads to poor sleep and can also help lessen other symptoms such as night sweats, stress and the frequent need to urinate
- Magnesium has been shown to significantly improve menopause related insomnia. It can help keep our circadian rhythms right, reduce levels of cortisol (stress hormone) and increase levels of melatonin (sleep hormone) all of which help us get a better night’s sleep (please note – medical advice from a doctor should be sought before making any decisions re: HRT or alternative supplements)
- Invest in a free-standing fan and keep it on through the night to mitigate the discomfort of night sweats. As a rule, keep the bedroom on the cool side
- Develop a sleep routine to try and train your body back into a rhythm; aim to head to bed at the same time each night and follow a routine which mentally prepares you for sleep (shower, put the side light on, get a book out, etc.)
- Limit your liquid intake for a couple of hours before bedtime to try and reduce visits to the loo through the night.
Finding the right balance of strategies and interventions can feel relentless, particularly when you’re tired, but it’s well worth the effort. When you finally break the cycle of insomnia and get that good night’s sleep, the impact on every aspect of your wellbeing can be profound.
