Does menopause cause sleep disorders?
Positive Pause article about menopause and sleep disorders as featured in the Sunday Times.
Q: During and after menopause, the number of women who report sleep problems increases sharply. Why is this?
A: Hormonal changes during perimenopause (the phase leading up to your last period), impacts women’s ability to sleep, and is one of the first indicators that women are entering their peri-menopausal years. This is when women’s ovaries decrease the production of oestrogen and progesterone, a ‘feel-good sleep-promoting hormone.
Falling oestrogen levels also affect the body’s ability to produce and use serotonin and melatonin, neurochemicals that help assist and regulate women’s sleep/wake cycle.
Low oestrogen levels through menopause and beyond contribute to sleepless nights and insomnia. Menopause is individual to every woman, for some women once they have gone through menopause and their hormonal fluctuations balance out, their ability to sleep may begin to improve. For others, sleep disorders may arise such as sleep apnoea. Women’s hormones have a lot to answer for when it comes to sleep!
Q: Based on your work, what are the most common way in which menopause impacts sleep?
A: As women’s hormones begin to duck and dive, a variety of menopause symptoms may impact on sleep. As the ovaries stop producing eggs, the hypothalamus, the section in the brain that acts as the body’s thermostat, goes into overdrive, producing hormones to encourage ovulation resulting in heat surges, hot flushes and night sweats
Hormonal surges cause blood vessels to dilate, increasing blood flow to the skin - making women hot! At night this disrupts sleep and comfort. Pyjamas and sheets become soggy and damp before chilling as they cool down, making it difficult to get comfortable again and drift back to sleep.
Life stresses impact sleep through menopause.
61% of women suffer anxiety during perimenopause. Hormonal anxiety and depression are one of the most underestimated symptoms of menopause. Whether brought on by worry about kids leaving home, going through exams, or having their own hormonal challenges. The sandwich generation is dealing with elderly parents, insecurities at work or relationship issues, all may impact the quality of sleep.
Other menopause symptoms induced by hormonal fluctuations may cause discomforts, such as joint pains, restless leg syndrome, headaches, heavy or irregular periods and digestive disorders.
Relationship problems centred around bedtime activities may impact getting to sleep. When all a woman essentially wants to do is sleep, loss of libido creeps into bed. They may worry about upsetting partners, as sex is at the bottom of the to-do list, or they’re embarrassed to talk about more intimate menopause symptoms such as vaginal dryness. This can cause sex to be painful - love literally hurts!
Q: Are there any remedies, treatments or strategies that can be employed to tackle the effects on sleep?
A: Yoga breathing exercises, mindfulness, meditation, and CBT are helpful therapies and strategies proven to help calm, relax and focus your thoughts when you’re either suffering from menopause anxiety, or night sweats and can help you get to fall asleep, or get back to sleep. Cut out caffeine, in cold and hot drinks, including your average builder’s tea, and substitute with decaffeinated coffee and herbal teas. If you stick with caffeine, avoid drinking caffeine (including fizzy drinks) after 4 pm, as caffeine lingers in the system.
Our Positive Pause mantra says menopause is a time to pause and reassess your health and lifestyle. This means looking at your diet, and cutting out refined carbs and sugars, as they are silent, sleeping enemies. If hot flushes are causing problems, then alcohol might help you fall asleep, but it raises your temperature and the high sugar content will wake you later - so cut back, or cut it out.
Regular aerobic exercise, especially outside in the fresh air, where the sunlight helps produce sleep-inducing melatonin is also beneficial, although better earlier than later in the day.
Avoid taking technology into your bedroom as the blue light is not conducive for sleep. Make your bedroom a sleep haven, block out the light, but ensure you open a window. Having a cooler room encourages your body to rest and sleep and is helpful if suffering night sweats.
Relaxation before bedtime is a must; try a bath with a few handfuls of magnesium or Epsom salts. Magnesium is great for regulating your body clock. If there is ever a time to pamper yourself it’s through menopause. Aromatherapy may help, treat yourself with essential oils in your bath, or a diffuser with lavender, Valerian or Clary sage, we’re also partial to a sleep-inducing pillow spray.
If all the above lifestyle changes (which are not difficult or costly), have not helped, and sleep is still elusive, then it might be time for a trip to your GP to talk about HRT. The benefits for most women outweigh the risks. It’s proven to help with hot flushes and night sweats, so if that’s what’s causing your sleepless nights then it could be the solution to regulate those fluctuating hormones that are robbing you of your precious slumber.
June 2019
