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MENOPAUSE: WHAT'S HAPPENING
Is Menopause Disrupting Your Sleep?
Jan. 26, 2022
Three things can hit you hard at night, sending you into that exhausted-but-wide-awake purgatory. If you’re tired of the routine, and just plain really tired, read on for expert help on menopause and sleep.
For many women in midlife, chronic insomnia, or waking up in the wee hours, feels like a doomed destiny. You can blame biology.
Perimenopause, that stretch of time that typically begins in your early- to mid-40s, marking the transition between your reproductive years and menopause, often goes hand-in-hand with sleep disturbances.
In fact, according to the Journal of Menopausal Medicine, sleep disorders affect about 39 to 47 percent of perimenopausal women. The culprit: changes in your hormones, most specifically estrogen and progesterone.
“As women reach menopause they experience more sleep fragmentation from the depletion of the female hormones,” explains Abhinav Singh, MD, MPH, FAASM, a sleep physician and internist, medical director of the Indiana Sleep Center and a medical review expert at the Sleep Foundation. Add to that, “overall reduction of melatonin secreted with age also reduces sleep drive.” It’s a one-two gut punch to what used to be your most luxurious, pleasurable, restorative escape.
The effects of which not only make you exhausted, but put a serious squeeze on all the other things you’re juggling in life.
According to the Journal Sleep Medicine and Disorders, sleep issues from menopause can greatly impact everything from a woman’s social life to physical and psychological health to workplace productivity.
Why does menopause affect sleep?
There are three big drivers behind this nightmare situation. But there are also fixes. We get into both.
1. You’re battling menopausal hot flashes
These sudden episodes of increased body temperature are the most common sign of perimenopause, affecting 60 to 70 percent of women, and seem to be directly tied to a decrease in estrogen levels.
“They can happen when you sleep, called night sweats, and about 70 percent of the time they cause waking,” says Kristi Tough DeSapri, MD, assistant professor of OB/GYN and internal medicine at Northwestern Medicine Center for Sexual Medicine and Menopause.
Dr. DeSapri notes that menopausal hot flashes aren’t always perceived, which is why it may not be an obvious source of your sleeplessness. Another reason, research has found that there are changes in the brain that occur right before a hot flash that can trigger awakening, regardless of whether you feel the heat.
2. You’ve started snoring
As women enter perimenopause, “they experience a decrease in progesterone,” Dr. DeSapri explains. “That can cause relaxation of the larynx and of some of those muscles connected to the respiratory system, which can lead to an increase chance of obstructive sleep apnea.” Obstructive sleep apnea (OSA), is a common sleep-related breathing disorder that causes you to stop and start breathing while you snooze.
At the same time, women typically gain about two to five pounds during perimenopause, which increases the likelihood of OSA by creating fat deposits in the neck (pharyngeal fat) that can block the upper airway during sleep.
3. You’re anxious
Research confirms that feeling anxious is common during this transitional period. “Stress and anxiety impact sleep by driving up cortisol levels, reducing the ability to relax and to reach consolidated healthy sleep cycles,” says Dr. Singh. “If your stress levels are high, sleep is more fragmented and non-restorative.” (Curious about mental health during menopause? Read this.)
How to get better sleep during menopause
Good sleep during menopause means adopting a new routine, according to Dr. DeSapri.
Handling hot flashes
If you know, or suspect, you’re having hot flashes, try these tried-and-true strategies:
Keep your room cool at night (66-68 degrees, or colder).
Consider getting a fan specifically designed to go under your sheets. Yes, really!
Before bed, steer clear of common triggers, like spicy foods, saunas, and alcohol (a glass or two might seem to help you drift off, but will bring the fire a few hours later).
Keep a cooling rescue product nearby. This portable skin-soothing atomizer delivers powerful relief in one quick spritz by stimulating nerve ending receptors to provide an immediate cooling effect.
Dealing with stress
Address your stress with meditation or mindfulness practices (there are many great apps for that, like Calm or Headspace). Consider Cognitive Behavioral Therapy (CBT) to help with practical strategies for managing stress (read deeper on how to manage perimenopause stress here).
You may also find CBD beneficial. This ingredient interacts with the body's endocannabinoid system to promote a sense of calmness and well-being. Consider CBD in supplement form—this one packs a host of other good-for-menopause ingredients—or in topical form, like this Daily Glow Facial Cream which does double duty as an incredible moisturizer and blocks cortisol from causing stress-induced collagen loss.
Get moving & evaluate your food intake
Exercise is key—whatever you love to do to get your heart pumping for 30 minutes a day will not only mitigate anxiety, exercise has been shown to help prevent sleep apnea. On that note, a nasal decongestant and breathing strips can open airways, in addition to sleeping on your side, rather than on your back.
If you’re carrying some extra weight, consider talking to a nutritionist who can provide a healthy eating plan to lose some pounds. You can chat one-on-one with a Registered Dietitian trained in menopause-related topics by downloading the Phenology app. This gives you the chance to ask an empathetic professional about how your nutrition, wellness, hydration and lifestyle can affect your symptoms, and get real answers via text-based chat.
Look to naturally powerful supplements for support
“There are also some supplements we recommend to patients for overall sleep quality,” says Dr. DeSapri.
On sleepless nights affected by menopause, magnesium and melatonin can be very helpful in easing the body to wind down. For example, Elevated Evening gummies pair melatonin with saffron, clinically shown to reduce stress and anxiety and support a positive mood and restful sleep. Combined with genistein, which reduces the frequency and duration of hot flashes, these gummies pack a powerful—and restful—punch.
“And if nothing is working, speak with your doctor sooner rather than later,” advises Dr. Singh. “It may prevent temporary sleep issues from becoming chronic insomnia.”
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