Poor sleep is a common issue as women go through menopause, thanks to hormonal changes and symptoms such as night sweats. And yet sleep is absolutely essential to our physical and mental health.
Sleep disturbance affects up to 42% of women before menopause, climbing to 47% in peri-menopause and 60% post-menopause. Ugh!
Peri-menopause is the transitional phase when periods become irregular, until menstruation stops with the menopause. Erratic hormonal levels in peri-menopause and reduced levels following menopause can trigger physical and emotional symptoms. These changes can cause difficulty to fall asleep, while night sweats can wake you up during the night.
What causes these sleep problems?
Sex hormones play an important role in regulating natural sleep patterns. Oestrogen helps the body to use serotonin, and progesterone increases production of GABA. Serotonin and GABA are both neurotransmitters that help us to sleep. From peri-menopause, our sex hormone levels fluctuate significantly. This affects the body’s temperature regulation and can stimulate adrenaline, both of which can impair sleep. After menopause, progesterone production stops, and we lose its sleep-protective benefits; oestrogen levels fall sharply, and we lose much of its protection.
Melatonin is the hormone which tells the body when it is time for sleep. Melatonin levels should increase after dusk, peak in the middle of the night, be low by dawn and negligible by mid-morning, in harmony with sunlight and darkness. A decrease in sex hormones causes the body to secrete less melatonin. Compounding the problem is that melatonin levels tend to decrease with age.
Hot flushes and night sweats occur as a result of impaired body regulation of temperature induced by changing hormone levels. They provoke a sensation of heat and can be accompanied with anxiety and palpitations from a surge of adrenaline.
The decline of sex hormones can trigger mood issues: anxiety, which makes it difficult to fall asleep - or back asleep after night sweats; and depression, which can lead to non-restorative sleep and waking early in the morning. Conversely, insomnia can be a cause of anxiety and depression, in a vicious cycle.
What to do?
There ARE plenty of things you can do. Menopause doesn’t need to be a death sentence for sleep. It’s important to make sleep a priority, particularly during and after menopause, through adapting lifestyle and dietary behaviours.
In the day: Get early morning sunlight, exercise and phytoestrogens. Avoid caffeine after lunch, and go easy on spicy food.
In the evening: Eat early and take care of your blood sugar. Eat foods rich in tryptophan and magnesium. Leave out the nightcap. Dim the lights and make your bedroom a sleep haven.
At bedtime: Aim for a consistent time to bed and wake each day. Balance your blood sugar. Practice mindfulness. Have a bath. Have an orgasm!
Supplements: There are a number of options which may help to support sleep. But this is the internet, and I don't know you or your specific needs. And all supplements aren't for everyone. We can have a chat and explore your options and check safety.
These are just some general ideas. For a strategy that's tailored to your unique issues and needs, get in touch!
Good sleep doesn't need to end with menopause. On the contrary: menopause is really the moment to prioritise good sleep.
Scotti McLaren Nutrition nutrition@scottimclaren.com
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