How to Sleep Through Menopause

By Staness Jonekos

Co-author of The Menopause Makeover

We have all had sleepless nights, but for millions of post-menopausal women it happens 61 percent of the time, affecting their quality of life and their relationships. I, too, suffered from insomnia, thanks to irritating night sweats provoked by fluctuating hormones. Being sleepless through menopause made me irritable and fatigued daily. I had difficulty concentrating and it created tension with my husband because I was cranky and impatient.

There are two types of insomnia. According to the National Institutes of Health, primary insomnia is its own disorder. A number of life changes can trigger primary insomnia, including long-lasting stress and emotional upset. Primary insomnia generally occurs for periods of at least one month.

Secondary insomnia is a symptom or side effect of some other problem, and is the most common type. Most menopause-related sleeplessness is secondary insomnia.

What causes secondary insomnia?

• Certain medical conditions: sleep apnea, arthritis, chronic pain, headaches, asthma, overactive thyroid, hot flashes, heartburn, sleep disorders (restless leg syndrome, sleep-related breathing problems)
• Medicines: asthma medicines, allergy and cold medicines, beta blockers
• Substances: caffeine, stimulants, tobacco, alcohol

Being a busy woman, daily exhaustion is normal. Throw in menopausal aging and it was no surprise that I was staring at the ceiling nightly trying to fall and stay asleep.

Karen Giblin, Founder of Red Hot Mamas North America, recently conducted a sleep survey with Sunovion Pharmaceuticals Inc.

Giblin says, “Of the 900 sleep survey participates who suffer from insomnia, 79 percent of menopausal women have trouble staying asleep, and 63 percent struggle just trying to fall to sleep.”

I was not alone! Most of us blame night sweats for insomnia, but I was surprised to find out that many menopausal insomniacs don’t suffer from night sweats at all. So what’s keeping us up at night?

Empty nest syndrome, caring for aging parents, relationship changes, career adjustments and mid-life stress, bundled together with hormones in flux is a recipe for sleepless nights. Progesterone is our sleep-promoting hormone, so a decrease in this hormone contributes to a night of tossing and turning. Declining estrogen can make you more susceptible to stress, fueling this sleepless potion.

I suffered from several of the sleep depriving offenders. It took just one severe night sweat to start the cycle of thrashing around, changing my PJs and laying in bed awake, waiting for a repeat performance.

Insomnia during menopause clearly can affect the quality of your life. Women suffering from insomnia live with daily fatigue and irritability, and that can contribute to intimacy issues with her partner.

Giblin says, “62 percent of women ages 40 to 65 said they have not talked to their healthcare provider about insomnia.”

I was one of them, because I never considered insomnia an actual symptom worth discussing with my clinician.

A former menopausal insomniac herself, Giblin continues, “Sleeplessness during menopause can compromise your health, both physically and mentally. People who get too little sleep develop poor health and higher percentages of chronic diseases.”

Indeed, insomnia can increase your risk for high blood pressure, heart disease, diabetes and problems with your immune system. Getting proper sleep is important to your health!

Let’s not forget the recent studies last year that found a lack of sleep contributes to weight gain. When you are sleep-deprived, your metabolism does not function properly. Sleep is also necessary for the nervous system to function properly.

Sleeping tips during menopause

• Create a sleep schedule, and follow it each night
• Do not go to bed until you are tired
• Avoid caffeine, nicotine and alcohol right before bed
• Enjoy decaf tea
• Do not watch the news right before going to bed
• Do not watch TV in bed
• Take a soothing bath or shower before bedtime
• Your bedroom should be a sleeping sanctuary and a place for lovemaking
• Avoid daytime naps
• Clear your mind before you get under the covers
• Make sure your room is dark
• Keep your bedroom cool to prevent night sweats, keep a fan nearby
• Wear cotton pajamas, and have an extra pair handy
• Exercise daily. Vigorous exercise should be done during the morning or afternoon.
• Yoga may help promote good sleep
• Try aromatherapy for relaxation
• Own a comfortable bed
• Wear socks to bed to help control core body temperature

We are all different and require different amounts of sleep to feel rested during the day. The North American Menopause Society (NAMS) says, “Most adults require 6 to 9 hours of sleep each night.” I was lucky to get 3 hours of uninterrupted sleep a night – what’s a menopausal gal to do?

Talk to your healthcare provider about insomnia

• Keep a sleep diary
• Track a typical night
• Document what keeps you up at night.
• How long did it take for you to fall asleep?
• How long did you sleep in total?
• How did you feel the next day?
• Talk to your partner and see if he/she has noticed any differences in your sleeping habits.
• Discuss any lifestyle changes you’ve made to improve your sleep.
• Ask if menopause is affecting your sleep
• Are there any current medications that could be contributing to your insomnia
• What lifestyle changes do you need to make to get better sleep
• Are you experiencing more stress?
• Discuss a strategy to manage your insomnia

When lifestyle changes fail NAMS recommends consulting a clinician to rule out sleep disorders or breathing problems.

Dr. Wendy Klein, co-author of The Menopause Makeover, says, “It is best to tailor therapy for menopausal insomnia to the needs of the individual woman. Generally, combining medical and non-medical therapies is better than either one alone.”

Supplements such as botanical valerian have been found to improve sleep after two weeks of use. Talk to your doctor about the risks and benefits before taking over-the-counter products to treat insomnia. If depression is contributing to your sleep problems, your healthcare provider may prescribe an antidepressant or other prescription medications.

For some women, prescription sleep medications can help bring relief. The National Institutes of Health states: some medications are meant for short-term use, while others are meant for longer use. Side effects can occur, so talk to your healthcare provider about the risks and benefits of using medicines to treat insomnia.

Getting a good night’s rest during menopause benefits your health, both physically and emotionally, and can contribute to a smoother transition.

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