Jamie Sculley, ND
How Menopause Affects Your Sleep
Updated: Sep 24, 2020
Why do some women experience insomnia during menopause?
A woman begins a hormonal shift in her 40's called perimenopause where her ovaries stop releasing eggs and this causes a decrease in circulating estrogen and progesterone. This change occurs about 5-7 years before menopause and it can involve symptoms like hot flashes, irregular periods, fatigue, weight gain, vaginal dryness, mood changes and insomnia. A woman is in menopause when she hasn't had a period for at least one year and after this time she is considered post-menopausal.
Insomnia can be one of the symptoms of perimenopause and menopause because estrogen and progesterone both play a role in sleep. Progesterone is a calming, sleep inducing hormone and estrogen is involved in being able to fall asleep quickly and get deep restful sleep. Decreased levels of both hormones in menopause can make falling asleep difficult or cause you to wake up frequently at night.
Hormones aren't the only things that are changing in a woman's life before and after menopause. This can be a time of great change in other areas like work, family and personal life.
Family and work life may be changing such as children moving out of the house, which can cause anxiety or depression for some women. Sleep loss may make these mood changes worse.
New health issues may arise as a woman ages or new medications may affect sleep quality.
Hot flashes, caused by a surge of adrenaline, wake many women up from sleep. It can be difficult to relax and fall back asleep or she may even have to get out of bed because of sweating through pajamas or sheets.
Changes in the bladder due to menopause may cause frequent urination and the need to get up multiple times per night.
Menopause can affect metabolism and weight gain, which can result in the development of sleep apnea. Snoring is a common sign of sleep apnea because the airways become blocked during sleep as your tongue and throat relax. It's an important condition to get checked out if you think you might have it.
What you can do about insomnia in menopause
Chronic insomnia may lead to other health issues such as obesity, cardiovascular disease, high blood pressure, diabetes, depression and anxiety so it's an important issue to discuss with your doctor.
Mindfulness relaxation techniques - This can include meditation, affirmations, journaling, yoga, hypnosis, and deep breathing exercises. These techniques work well especially if insomnia is caused by mood changes because it can calm the mind and body.
Hormone replacement or supportive therapy - Hormones and menopausal symptoms can be supported either through natural medicine or hormone replacement. Relieving symptoms like hot flashes may help to reduce night time awakenings. Hormone replacement therapy has some risks depending on your age and health history so it's important to talk with your doctor to determine if the benefits outweigh the risks.
Good sleep hygiene - Having a night time routine helps your body wind down and get ready for sleep. Sleep hygiene can include creating a cool, dark sleep environment, using a fan or air conditioner, wearing lighter clothing to bed, and avoiding blue light and electronics before bed. If you'd like to know more read my past blog here.
Use sleep promoting botanicals - Herbs are a great way to calm the mind and body and promote restful sleep. You can try herbs like valerian, chamomile, kava, lemonbalm, and passionflower. I always recommend checking with your doctor for interactions if you're taking other medications. Although it's not an herb, melatonin is another natural sleep aid that can help you fall asleep more easily.
Avoid alcohol and caffeine - Alcohol may make you feel sleepy but it prevents your body from going into REM sleep so overall sleep quality suffers. If you drink caffeinated beverages limit them to the morning only.
Limit fluids - If you find you're getting up to urinate more than once per night try not drinking liquids a couple hours before bed.
Perimenopause begins when a woman is in her 40's and usually lasts about 5-7 years until she is in menopause. Menopause is when a woman hasn't had a period for at least one year, after this time she is post-menopausal. Insomnia can be one of the symptoms of perimenopause and menopause because estrogen and progesterone both play a role in sleep. Changes in a woman's life such as work, family, and personal life as well as her physical and mental health may contribute to insomnia. Insomnia can lead to other health conditions so it's important to talk to your doctor about it. Treatments for insomnia include mindfulness relaxation, hormone replacement, natural hormone support, good sleep hygiene, sleep aids like botanicals and melatonin, limiting caffeine and alcohol use and limiting fluids before bed.
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“Estrogen Treatment Restores Normal Sleep Patterns in Menopausal Women.” WebMD, WebMD, 17 Mar. 2000, www.webmd.com/menopause/news/20000317/estrogen-treatment-restores-normal-sleep-patterns-in-menopausal-women#1.
“Sleep Problems and Menopause: What Can I Do?” National Institute on Aging, U.S. Department of Health and Human Services, 2017, www.nia.nih.gov/health/sleep-problems-and-menopause-what-can-i-do.
Walsleben, Joyce. “Menopause & Insomnia: Causes & Solutions.” National Sleep Foundation, www.sleepfoundation.org/articles/menopause-and-insomnia.