menopause and sleep

Sleep is very touchy. Even the slightest things can scare it away and make it elude you for long nights. For instance, if you’re sick, you may be unable to sleep for many nights. If you’re too stressed, sleep can evade you. If you’re too excited about something, it can make sleep go away. When you regularly experience stress, hyper arousal, or medical conditions, it can wreak havoc on your sleep quality and quantity.

Modern women are often under greater stress than men. Today’s women aren’t staying at home and cooking and cleaning anymore. They are going to work, managing demanding careers, raising children, caring for aged parents, and also doing their bit for the community. Women are capable of single-handedly managing both home and work and taking care of every little detail. But as a result, they also suffer from greater stress.

Around the age of 35 through 40, women begin to experience perimenopause symptoms. This is when women approach the end of their reproductive phase. Various symptoms mark the onset of menopause, from weight gain to mood swings to hot flushes. But a common complaint is insomnia or poor sleep quality. Several women approaching midlife complain of sleep difficulties. More often than not, the cause is perimenopause or menopause.

Symptoms of Menopause

Menopause doesn’t happen in a day. It begins from the time a woman crosses 35 and continues until the age of 45 or more. This transition phase is called perimenopause. Some women reach menopause too early while others can keep having children till 45. It all depends on the genetic makeup of the person.

Both perimenopause and menopause have similar symptoms. Not all women experience all of them, though. Some of the most common signs of perimenopause and menopause are:

Irregular Periods: As a woman crosses 35, irregular periods is the biggest sign of perimenopause. With time, periods become severely irregular and scanty, before stopping altogether. However, irregular periods can also be a sign of some other medical condition that only a doctor can diagnose.

Heavy or Scanty Periods: As the fertile phase of a woman comes to an end, periods are not only irregular but also heavier or scantier than usual. However, these may also be an indicator of some other underlying medical condition, especially if you haven’t yet reached the age of perimenopause.

PMS-Like Symptoms: Premenstrual syndrome usually gets worse in the years approaching menopause. Mood swings, breast tenderness, weight gain, bloating, and abdominal cramps are some of the symptoms that are common during perimenopause.

Hair and Skin Changes: Because menopause is all about hormones, these changes can affect your hair and skin. You may notice graying of hair or severe hair fall.

Night Sweats and Hot Flushes: Bodies of women approaching menopause get hot very easily. When others in a room are feeling cold, they might feel hot. This more commonly happens at night, making sleep difficult. Night sweats and hot flushes are tell-tale signs of menopause, especially when they happen at night. Feeling stuffy and uncomfortable can make it hard to sleep. All these factors contribute to insomnia and poor sleep quality.

Some other symptoms of perimenopause are:

  • Heart palpitations
  • Headaches
  • Loss of libido
  • Forgetfulness and concentration problems
  • Muscle cramps
  • Urinary tract infections

Insomnia during perimenopause or menopause isn’t because of one factor. Several factors combine to make sleep difficult for menopausal women.

What Happens During Menopause?

The transition from perimenopause to menopause is marked by the decline in production of certain hormones. These are estrogen, progesterone, and testosterone. These three hormones not only regulate the reproductive and menstrual cycle but also have a significant impact on energy, mood, libido, cognitive and emotional functioning, and sleep. When these hormones start to decline, there is bound to be some problem to the normal functioning of the body.

Both estrogen and progesterone are responsible for promoting sleep and relaxation and keeping away anxiety and depression. Progesterone is not only the one behind each monthly cycle, labor, and breastfeeding but also regulates mood and keeps the sleep-wake cycle normal. Loss of progesterone also contributes to osteoporosis.

As the hormones fluctuate and decline all through the perimenopausal and menopausal stages, sleep often tends to be increasingly disrupted. When women cross perimenopause and enter menopause, it is not unusual for women to routinely experience insomnia and have a hard time falling and staying asleep.

Treating Insomnia During Menopause

It must be noted that as long as a woman continues to have irregular or scanty periods, she is experiencing perimenopause or menopause. The end of this stage is post-menopause when periods have been absent for 12 months or more. This means that the hormone rebalancing is now complete, and the body is not producing estrogen, progesterone, or testosterone anymore.

Not all women experience severe insomnia during perimenopause or menopause. But if sleep difficulties are keeping you up night after night, it’s time to take the necessary steps to stop or prevent them.

Instead of treating insomnia, healthcare practitioners are generally suggesting treating the root cause. Are hot flushes keeping you up? Are you experiencing rapid heartbeats or hyperarousal? Are you always too hot to be comfortable?

These are some common complaints during menopause, but there are steps to get relief.

The first things to control are your sleep habits. As your body changes, your sleep habits must also change along with it. Certain things to follow to ensure proper sleep hygiene are:

Sticking to Specific Sleep and Wake Times: When your sleep and wake times keep changing every day, the body is confused. Instead, stick to a particular bedtime and the same wake-up time every single day, even on weekends. This habituates the body to a rhythm. For instance, if you go to bed at 10 every night and wake up at 6 every morning, the body will automatically feel sleepy when it approaches 10 o’clock, and also be able to wake up without an alarm clock in the morning. Routine bedtime and wake-up time is the first step in healthy sleep hygiene.

Preparing Your Body for Sleep: As part of healthy sleep hygiene, you need to prepare yourself for sleep, so that the brain and the body know it’s time to shut down for the day. When you keep working till late or continue to use electronic devices, the body doesn’t get the indication that it’s time for bed. Instead, you should unplug, turn out the lights, take a relaxing bath, and do some light reading to induce sleep.

Avoid Alcohol and Tobacco: Certain things can interfere with your sleep hygiene, alcohol and tobacco being two of them. If you are in the habit of smoking or drinking before bed, it’s time to kick the habits when you reach perimenopause. Both alcohol and tobacco interfere with melatonin production and delay the onset of sleep. Alcohol also hinders REM sleep, the most restorative stage of sleep linked to cognitive functioning and memory formation.

Evaluate Your Bedroom: Often, we don’t have the right conditions for falling asleep. The room is too cold or too hot, the bed is uncomfortable, and ambient noise keeps making its way in. When you’re experiencing menopause-related insomnia, you need to take a good look at your bedroom and change what’s needed. If the room is too hot, you will only feel more uncomfortable. Keep your room as cool as possible to keep the hot flushes and night sweats away. If the room is too cold, turn up the thermostat to bring it to a comfortable temperature or use blankets. Also, change the mattress if it’s sagged and doesn’t provide the best support. You can also keep a bucket of ice beside your bed to cool off if you get hot during the night.

Don’t Stress Over Sleep: Stressing oversleep is one of the worst things to increase your insomnia. If you wake up in the middle of the night unable to fall back asleep, don’t stay in bed tossing and turning and worrying about not being able to sleep. Instead, get out of bed, have a nice, soothing drink, turn on a reading light and read a relaxing book. However, make sure to stay away from electronic devices and bright lights, because they can make it even harder to go back to sleep.

Remedies for Menopause-Related Insomnia

Because menopause is purely hormonal, the oft-suggested medical remedy is hormone replacement therapy. But not only is it expensive but can also have various side effects. Instead, there are natural remedies you may try for beating insomnia and having a better sleep.

Some of the non-drug ways to treat insomnia are:

  • Melatonin supplements
  • Acupuncture and acupressure
  • Relaxation techniques like meditation and deep breathing

In many cases, a mild dose of birth control pills may also be prescribed to balance the hormones and control symptoms of menopause.

If menopause has been giving you sleepless nights, do not hesitate to consult your general physician or gynecologist to work towards the best remedy.

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