Studies show that a lack of sleep can lead to decreased function in the daytime, with lack of concentration, irritability, and a weaker immune system common symptoms. For women going through menopause, this can have devastating effects, as quality sleep can be a rarity.
Fortunately, sleep disorders can be managed and treated.
Sleep and menopause
Menopause is a time of major hormonal, physical and psychological change for women and while symptoms can vary, most women experience some level of sleep disturbance. During the perimenopause or menopause phase, a woman’s ovaries gradually decrease the production of oestrogen and progesterone and this change in hormone levels can significantly disturb her sleep.
For some, this means tossing and turning due to hot flushes and night sweats, but for others it can mean insomnia.
What is insomnia?
Insomnia is a disorder that prevents you from getting adequate sleep. It’s not as clear-cut as having difficulty falling asleep or staying asleep. Many insomnia sufferers may:
- Take 30 minutes or longer to fall asleep
- Get fewer than six hours of sleep on three or more nights of the week
- Wake too early
- Not feel rested or refreshed following sleep
- Continually worry about sleep
- Feel sleepy and tired throughout the day
- Suffer frequent memory lapses
Over time insomnia can take a toll on health and wellbeing, with many insomnia sufferers experiencing:
- Weight gain
- Trouble focusing or paying attention
- Memory loss
- Increased risk of accident or error
- Frequent headaches
- Gastrointestinal issues
Approximately 61% of women who are menopausal experience frequent bouts of insomnia.
Why does insomnia occur?
There are a number of reasons why insomnia occurs so frequently during menopause and there’s no one answer. Menopause-induced insomnia can be caused by:
1. Hormonal changes
Progesterone is a sleep-producing hormone and as menopause slows the production of progesterone, you may find it harder to fall asleep and stay asleep. Other hormone changes that affect sleep quality include oestrogen, prolactin, cortisol and melatonin.
2. Hot flushes
Due to the rapid decrease of hormones, your body can experience surges of adrenaline. This is the same chemical responsible for your reaction to stress or a fight-or-flight scenario and your body can have a hard time handling it. This can make falling asleep challenging and can also cause you to wake hot, sweaty or suffering palpitations.
If you’ve recently started taking medication or supplements, these can interfere with sleep just as natural chemicals and hormonal changes can. Sleep disturbance is a side effect of many medications and over-the-counter supplements, so you may need to weigh up the pros and cons.
As most women hit menopause around the age of 50, there are a number of lifestyle factors that could be causing added stress. Work, family and personal relationships take their toll on more than just your mental health, they affect your sleep too.
5. Poor diet
Eating too late in the evening can affect your digestion and make sleep difficult. You should also avoid drinking stimulants such as coffee, tea and alcohol too close to bed.
If you feel you are struggling to get a good night’s rest, talk to your doctor. You’ll be asked about your sleeping habits, so if you can, keep a sleep diary in the week leading up to your appointment. Make notes of the times you sleep and how you feel each day.
Your doctor may choose to check for any underlying conditions that could be causing your insomnia, which may mean a blood test. Self-reported questionnaires may provide more information regarding perceived sleep quality. Tests available during a specialist sleep consultation include:
- Overnight polysomnography (PSG) to detect breathing disorders, narcolepsy, movement and circadian rhythm disorders
- Wrist actigraphy to assess sleep patterns and awakenings
- Continuous EEG recording to assess the various sleep stages
- Respiratory monitoring and leg EMG to assess periodic leg movement
- Multiple sleep latency tests (MSLT) to assess the time it takes to fall asleep
Following thorough investigation and evaluation, there are a number of ways in which insomnia can be managed. Strategies may include medications and lifestyle and behavioural modification. Lifestyle modifications may include:
- Regular schedules
- Regular exercise
- Elimination of caffeine and alcohol
- Controlled temperatures
- New, comfortable bedding
- Meditation and relaxation practices
- De-stress solutions (such as a warm bubble bath)
Hormone Replacement Therapy (HRT) can be used to manage hot flushes, which can show a marked improvement in sleep quality. Serotonin modulating antidepressants may also see an improvement. It is recommended that any medications used to manage menopausal symptoms be prescribed at the lowest effective dose and used for only brief periods – not long term.
Some believe that taking a supplement that combines magnesium and calcium will help aid sleep, as both are sleep boosters, and when taken together, can be even more effective. By taking magnesium, you also limit any potential heart problems that may arise from taking calcium alone.
Where to start
Insomnia has no one cure, so it’s important to treat it in a number of ways. Create a room that’s suited for sleep, eat earlier, practice relaxation techniques, ditch bad habits – whatever it takes to ensure you get a restful night’s sleep. Get control of your sleep and you stand a higher chance of deflecting other menopausal symptoms, while ensuring a solid base for your general health and wellbeing.