Insomnia during menopause – helpful tips to beat them
Author: Joyce Walsleben
Insomnia during menopause are one of the most common symptoms which can impact most on a woman’s daily life. In this article Dr. Joyce Walsleben provides some helpful tips.
Doctor, I swear, I was a great sleeper then suddenly, bang, I keep waking up at night and can’t get back to sleep! Help!
Well, if that describes you, and you are 35 or older, still menstruating and otherwise healthy, you should be considering peri-menopause as an issue. Unfortunately, sleep difficulty seems to be one of the first symptoms of peri-menopause, a time that could actually last up to 10 years. It’s a time when your estrogen and progesterone, major reproductive hormones, begin to get out of synch and fluctuate because of waning ovarian secretion.
Turns out our brains also use estrogen and progesterone, sometimes in a chain reaction to produce other important hormones which may modulate mood and sleep factors. We women are nothing if not complicated. It’s almost as though we go backwards to puberty at this time.
But there is always hope on the horizon. These early years give you time to prepare better habits which will help you avoid other symptoms as time marches on.
So, the first thing to realise and relax about is that you are NOT going crazy. Rather you are probably beginning a normal progression to another interesting stage which is guaranteed to end …sometime. In the meantime, you need to tighten up your schedules and clean up some habits. I know, it’s a pain but the rewards are great.
Tips to beat insomnia during menopause
Choose a fairly standard wake up time
By fairly standard, I mean close to the same time EVERY day. Then let your bedtime be dictated by how much sleep you think you need. Do NOT go to bed so early to catch sleep that you wind up with sleep onset insomnia. Just find a 7-8 hour window based on your wake time. If that seems like too much sleep time for your schedule, tighten it up a bit in the beginning by going to bed later. Lingering in bed trying to snatch pieces of sleep is counterproductive. But, as you begin to sleep better you will see that you are more productive in the day, thereby giving you more time to sleep at night.
Make sure your bedroom is comfortable
If your mattress is older than 8-10 years, consider getting a new one. They only last so long. Check out noisemakers and get rid of those you can (not the kids though). Your sleep area should be DARK (consider an eye mask), quiet, comfortable and SAFE. If you awaken, DO NOT LOOK AT THE CLOCK! In fact hide all the electronics and their light. You can set an alarm and if you wake before it, roll over, get comfortable and drift back to sleep. It’s none of your business what time it is if the alarm hasn’t rung. You will only anger yourself and become more alert.
Do not get up if you wake up in the night
I am probably the only one who will tell you NOT to get up and do something else when you wake in the night. We are always more interested in doing something else, but everything we do seems to allow light into our system and the light reduces our melatonin and makes it even harder to fall back to sleep. Just know that waking in the night is normal! We all do it briefly every 90 minutes or so. It’s just when your hormones are messing around with the sleep factors in your brain, you are more alerted to the otherwise normal arousals and you wake further. Getting upset about it only worsens the issue. If however, you are having a panic attack, you may get up and stay in the dark. If I can’t go back to sleep, I tell myself the kitchen or bathroom needs scrubbing and that is an instant sleepmaker.
Try to get as much daylight as you can during the day
If you work outside the home, go outside for lunch. The exercise and light will work wonders. Exercise does reduce the stress. If you have energy and time, exercise in the evening, but not any closer to bedtime than three hours.
Food, especially protein, also matters
You don’t want a heavy spicy dinner to digest all night. But, you do want some protein and a little carb within an hour of sleep.. maybe some cheese and cracker, or yogurt. This is true especially if you are weight conscious and dieting. Your brain needs these nutrients to produce the chemicals for sleep.
If we want to talk medications, sometimes a low dose birth control pill during this time works wonders by giving the fluctuating hormones a base level to which you can regulate. If things are really bad, there are also antidepressant type drugs available that can be taken in low doses, just to give those brain chemicals some added stability. You do not want to use the sedation side effect of an antihistamine. They dry you up (an issue which may also arise) and last too long in your system. Check out any over the counter drugs for the ingredients, and always remember to consult with your doctor when in doubt.
I wish you a happy peri-menopause, and lots of good support at home.
About the Author
Dr. Joyce Walsleben is a retired associate professor in the School of Medicine at NYU Langone medical center in New York, US. She is a nurse and psychologist boarded in Sleep Medicine and served as Director of the NYU Sleep Disorder Center doing clinical and research work for almost 20 years and Sleep Medicine Associates of NYC since its founding. She is also the co-author of the book “A Woman’s Guide to Sleep: Guaranteed solutions for a good night’s sleep” published in 2001. She is also the author of numerous papers and chapters on sleep disorders. She currently lives in Vermont and can be reached at firstname.lastname@example.org