Ah - is there anything better than waking after a night of deep, restful sleep? You start the day with a clear head, feeling energized and ready to take on the world. Yes, I promise it is possible. However, if you are anything like most women struggling with the joys of perimenopause, that restful type of sleep seems like a thing you can only dream of (no pun intended).
In this article, we will discuss the reasons why our sleep is disrupted, the importance of quality sleep for women in midlife and some tips to bring you closer to feeling refreshed after a night’s slumber.
Related: How To Thrive (Not Just Survive) In Midlife: Part 2 -- Stop the Stress
Why Can’t I Sleep?
The standard advice is to aim for 7-8 hours of sleep per night. But 1 in 3 women in perimenopause reported they get less than seven hours and 1 in 2 say they don’t feel rested when they wake in the morning.1 Women are under a lot of stress at home and at work. Add to that the hormonal changes that take place as we enter perimenopause and menopause and it is easy to see that many things can contribute to our collective lack of sleep.
Some of the most common reasons why women in periomenopause have trouble sleeping are:
Teenagers
They also cause gray hair. Just kidding…kind of. Women start to experience disrupted sleep the minute they become moms. Between nighttime feedings, the endless trips to make sure the baby is breathing, and the early morning cries for more food, becoming a mom forever changes your sleep. Women tend to become lighter sleepers as a result - ready to jump whenever necessary. As children grow, the reasons for lack of sleep change slightly - the early morning practices, last-minute school projects, and then waiting up until midnight to make sure they get home safely. Raising children is such a blessing — but your sleep pays the price.
Related: Stress & Sleep
Hormonal Changes
The decreasing estrogen and progesterone in your system can cause sleep disruption and insomnia. Progesterone is our anti-anxiety, pro-relaxation hormone, so the decline of this hormone can contribute to overall stress and anxiety. Estrogen, in turn, plays a role in our circadian rhythm signaling which may cause our body to feel like we aren’t ready for bed at such a reasonable hour (and so, we proceed to stay up binging Netflix way beyond our normal bedtime). Estrogen also contributes to our bodies’ melatonin production. This chemical is necessary for inducing sleep. Less estrogen equals less melatonin and conversely more cortisol, the stress hormone.2
Perimenopausal Symptoms
Waking up drenched in sweat from the night sweats that accompany midlife changes is incredibly disruptive to a good night’s sleep. Again, declining estrogen levels are to blame as it helps to control the body’s ability to regulate temperature. As it declines, we can become more sensitive to even slight changes in temperature and in the body’s attempt to cool down, we experience a hot flash. Night sweats are just hot flashes that occur at night. Obesity and smoking can increase the risk of severe hot flashes.
Other Causes
As we progress through to full menopause and further hormonal decline, frequent nighttime urination, restless leg syndrome and sleep apnea can also become a barrier to restful sleep.
Why Is Sleep So Important?
It Protects The Brain
This is a time when your brain compresses all of the information it took in for the day. An ongoing lack of sleep has been associated with cognitive decline as we age.3
It Positively Affects Mental Health
Fluctuating hormones and life’s stressors can affect our mental health. This is exacerbated when sleep is lacking. Many studies have looked at the bi-directional effect lack of sleep and depression/anxiety have on one another and have reinforced the importance of quality sleep.4
It May Help Regulate Blood Sugar & Metabolism
Sleep deprivation and continued nighttime awakenings lead to greater fluctuations in blood glucose. The result can be a tendency towards insulin resistance and the potential for developing Type 2 diabetes.5
It may help with weight loss.
Weight gain is a major concern for many midlife women. A lack of sleep is thought to disrupt our appetite control hormones, ghrelin, and leptin, which can affect our hunger cues throughout the day.6
It is cardioprotective
Heart disease is the leading cause of death in women in the U.S.7 Poor sleep or a general lack of sleep is associated with increased systemic inflammation, high blood pressure, elevated cholesterol, and the development of atherosclerosis.8
Tips to Reclaim a Restful Night’s Slumber
Creating good sleep hygiene can be key to getting a restful night’s sleep. Sleep hygiene is simply the healthy habits you can add to your routine that set you up to get the best night’s sleep possible. For example, establishing a consistent sleep schedule, turning off electronics before bed, and exercising regularly all play a role in promoting better sleep.
Read More: Tips For Better Sleep
What If I Still Can’t Sleep?
If getting a consistent night’s sleep continues to be a challenge after implementing some good sleep hygiene habits, consult your healthcare provider to explore lifestyle factors and other options for supporting improved sleep. There are many “sleep” supplements on the market. . Some people turn to melatonin for help in falling asleep because it is readily available and “safe.” For temporary needs, it may be a good choice. A word of caution, however: melatonin has a negative feedback loop. This means by giving your system a melatonin supplement, the pineal gland then believes there is enough melatonin in the body and reduces production. After a while, we can become dependent on it because the body isn’t making enough melatonin, disrupting our sleep in the long run.9 And while it may help you fall asleep, the data is limited as to whether it has any effect on the sleep disturbances faced by menopausal women.10 Consider instead a cup of decaffeinated herbal tea along with a relaxing bath, or simply a magnesium supplement. Magnesium has many benefits and numerous studies have shown its association with significant improvements in sleep quality.11
Sleep is critically important to overall health and well being especially as we transition into menopause. With all of the challenges women face during midlife, preserving sleep quality has to be at the top of the list of priorities. As with most things, consistency is the key to results. So, try to incorporate a few of these tips into your routine and enjoy a good night’s sleep.
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References
1 Strickland, A. Women in midlife aren’t sleeping enough, study finds. CNN Health. 2017. https://www.cnn.com/2017/09/07/health/women-sleep-menopause/index.html
2 Gersh, F. Menopause: 50 Things You Need to Know - What to Expect During the Three Stages of Menopause. California: Rockridge Press. 2021.
3 https://www.brainandlife.org/articles/could-getting-more-high-quality-sleep-protect-the-brain/
4 https://pubmed.ncbi.nlm.nih.gov/16259539/
5 https://www.primary-care-diabetes.com/article/S1751-9918(21)00047-4/fulltext
6 Beccuti, G; Pannain, S. Sleep and obesity, Current Opinion in Clinical Nutrition and Metabolic Care: July 2011.14:4. 402-412. doi: 10.1097/MCO.0b013e3283479109. https://journals.lww.com/co-clinicalnutrition/Abstract/2011/07000/Sleep_and_obesity.16.aspx
7 https://www.cdc.gov/heartdisease/women.htm
8 Grandner, Michael A et al. “Sleep: important considerations for the prevention of cardiovascular disease.” Current opinion in cardiology vol. 31,5 (2016): 551-65. doi:10.1097/HCO.0000000000000324. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056590/
9 https://www.countingsheep.net/Melatonin-risks/#How_Melatonin_Affects_other_Hormones
10 https://www.menopause.org/for-women/sexual-health-menopause-online/causes-of-sexual-problems/sleep-problems
11 Schwalfenberg, Gerry K, and Stephen J Genuis. “The Importance of Magnesium in Clinical Healthcare.” Scientifica vol. 2017 (2017): 4179326. doi:10.1155/2017/4179326. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637834/
