Understanding the impact of menopause on sleep

It is World Sleep Day on 17th of March and we cannot stress enough on the importance of Sleep for a healthy life. In this feature Sharon James, UAE Menopause Coach tells us all about how sleep is impacted during the peri-menopause and menopause stages.

As we head towards peri-menopause and menopause, our sleep pattern is one of the many things that start to change. Women often wake at night due to hot sweats, needing the toilet, or simply finding it hard to switch off. Of course, disrupted sleep can happen at any point in our life due to things like stress, but we shouldn’t underestimate the impact of hormonal fluctuations.

According to the National Sleep Foundation, 61% of women report sleep problems in menopause, and difficulty sleeping tends to be among the earliest signs of peri-menopause. Why? Hormones play an important role in supporting the brain, ensuring we get good quality sleep. When our levels of estrogen and progesterone drop as we age, it causes a range of symptoms that interfere with night-time rest.

Estrogen, for example, helps us process serotonin, a building block of melatonin, which helps with our sleep/wake cycle. Progesterone (aka our calming hormone) increases the production of our brain chemical GABA, which calms down our brain and relaxes our body to get ready for sleep. Low GABA can be linked to insomnia. 

When we look at menopausal symptoms that cause sleep problems, hot flashes and night sweats tend to be top of the list, although other things that can interfere with it include joint pains and urinary problems. We also have the psychological affects like anxiety and low mood.

What effect does poor sleep have?

Sleep is central to our overall health and well-being. Apart from feeling fresh and energised in the mornings, it reduces inflammation, promotes growth and repair, and supports the immune system. Another important aspect is brain health. When we continuously have disturbed sleep, it can affect our short-term memory and reactions.

Sleep is also linked to weight management, which many women struggle with anyway during menopause. Good sleep helps us control our blood sugar levels. Plus, when we’re sleep deprived, we often have lower leptin levels (leptin indicates that we are full) and higher levels of ghrelin the hormone that stimulates hunger. If you’ve ever found yourself walking around the house with a bowl of ice cream at night, this is why! 

Implementing strategies and creating new habits

Thankfully, once we know why these things are happening, there is plenty you can do to make sure poor sleep doesn’t become a nightmare. And I would always advise establishing a good sleep routine in your 30s before hitting menopause to make life easier when you get there.

The American Sleep Foundation defines the following components of a good night’s sleep:

  1. The majority of time in bed should be spent sleeping at least 85% meaning, not watching TV.
  2. Falling asleep within 30 mins or less.
  3. Waking up no more than once a night
  4. Not waking up 20mins or less after you initially #fall asleep.

So how do we get there?

  1. Understand your circadian rhythm

Your circadian rhythm is your 24-hour body clock, split into day and night. When you reconnect with your natural patterns, it can alleviate many menopausal symptoms, and understanding how your body behaves at different times is the first step to retraining your habits.

  • Watch your evening food intake

If you eat your last meal around 6.30pm, this is the time your body temperature and blood pressure are naturally starting to rise. Heavy meals and too much protein mean our bodies have to generate even more heat to break down what you’ve eaten, making hot sweats worse. Stick to earlier evening meals and reduce protein. Sugar and starchy carbs disturb insulin production throwing your sleep hormones off balance, whereas banana and oatmeal contain amino acids to make us sleepy.

  • Stay cool

Keep the room temperature as cool as you can manage, wear light clothing and use light sheets you can remove easily. If you have a fan, place it close to your head to keep the pituitary gland cool and regulate your temperature. A cold shower before bed can also work wonders.

  • Minimise light

Ensure the bedroom is as dark as possible, and that includes any small sources of light from plug switches or electrical equipment. These can all hamper the production of melatonin. Melatonin production happens from 8pm and that’s when you want to start reducing bright light, as well as avoiding stimulating noises or sounds.

  • Breathe

Once you’re relaxed in bed, try deep breathing or meditation techniques before you sleep. They will calm the mind, lower the blood pressure, and support your body to get rid of stress. Stress in general causes high cortisol levels, which can also affect melatonin.

  • Start the day well

When you wake up, try to take a walk and get some natural light, as this exposure helps increase serotonin and set your body clock off on the right track again.

Menopause doesn’t have to mean surrendering to unwanted symptoms; many resources and treatments are available to help you navigate these natural changes. Studies have shown that HRT can improve sleep quality and decrease symptoms for some women. But lifestyle changes are still crucial to enhance your overall health and wellbeing.