Sleep & Menopause

 

As we move through perimenopause our ability to sleep can deteriorate. Our busy modern lives can be a big reason, as can declining levels of our sex hormones, oestrogen and progesterone.

Oestrogen influences the levels of serotonin and other brain chemicals that affect our sleep-wake cycle and help keep our body cool at night. Progesterone stimulates certain brain receptors that calm the brain and relax the muscles. The lower levels of progesterone common in perimenopause mean many women feel more anxious, with a whirring mind that doesn’t want to turn off at the end of the day.

A good night’s sleep is a key driver of health and our overall sense of wellbeing. Disrupted sleep not only impacts energy levels but can compound other common menopausal symptoms such as mood, mental sharpness and weight gain.

For some, HRT and its replenishment of oestrogen and progesterone can help address sleep problems. However, for those not taking HRT or for those who find it doesn’t resolve the problem, there are lots of other approaches that help.

Understanding your circadian rhythm, your internal 24-hour body clock, is key to getting better sleep. In the morning, your body releases cortisol which helps you wake up and feel energetic. Towards the end of the day, your cortisol levels should decline while, the sleep hormone, melatonin increases.

To promote sleep, we have a list of tips that ensure you are ready to sleep deeply at bedtime and wake feeling refreshed.

Prepare for bed from when you wake up

Keep to a regular sleep schedule. Get up the same time every day, no matter how poorly you have slept and keep to a regular bedtime.

Throw your curtains open when you wake and, if you can, take a walk outside. This will promote your cortisol production and support your body clock.

Some people love a nap (it can boost brain function, alertness and mood) but, to ensure it doesn’t impact your sleep at night, remember – not for too long and not too late. Naps should be no longer than 20-30 minutes and before mid-afternoon.

Being active, whether that’s exercise or other movement, has been shown to improve sleep. Try to schedule in a 20–30 minute walk every day.

Create the right sleep environment

Bedrooms should be uncluttered and calm.

A drop in your core body temperature helps promote sleep. Make sure your bedroom is relatively cool (about 18 degrees). Some people like to have a hot shower or bath before bed. It sounds converse but warming yourself up encourages your body to reduce its core temperature. Having a hot water bottle by your feet does the same trick.

Only sleep in your bed. One common issue with sleep can be nodding off on the sofa which means we fall asleep too early.

Make smart choices in the evening

Avoid stimulants. Caffeine can be helpful to boost energy levels, but it lingers in your system for longer than you expect. Keep caffeinated drinks to the mornings if you’re struggling to fall asleep. Nicotine can also stimulate you and is more likely to wake you up than help you drop nod off.

Steer clear of food and drinks with high sugar content as they often disrupt blood sugar levels and impact your quality of sleep. Waking up in the early hours can be a sign of this. Choose foods high in tryptophan which helps make melatonin – turkey, chicken, fish, eggs, beans and pulses are good sources.

It’s best to eat your evening meal at least two hours before bedtime. Late meals mean the digestive process can increase your body temperature and blood sugar levels which disturb sleep. Equally, aim to have your last drink two hours before bed to help prevent unnecessary trips to the loo in the night.

Alcohol has a sedative effect on the brain and can help people feel relaxed. However, research indicates that even one glass of wine can significantly impact sleep quality.

Be careful with using screens. If you are struggling to sleep well, stop watching TV or looking at your phone or computer at least an hour before bed.  What you’re watching can affect your sleep – if it’s something that energises rather than calms your mind (a horror movie or the evening news), it’s best avoided.

About an hour before bed, dim the lights to cue to your body that it’s night-time and to encourage melatonin production.

Avoid vigorous exercise in the evening as while it might make you feel physically tired, it is likely to increase cortisol making it harder to fall asleep.

There are several supplements that research shows can help with sleep. Taken at bed-time, magnesium and CBD oil are generally considered to be beneficial. For those of you who need some extra support, take 3-5g of the amino acid glycine in a herbal tea. It helps produce calming brain chemicals.

Waking in the middle of the night

We talk to a lot of women who fall asleep OK at bedtime but wake in the night and really struggle to fall back asleep.

There are 2 parts to this. The first is why we wake up, the second is what we can do to fall back asleep.

Beyond needing to go to the loo and night sweats, another important reason some women wake up is low blood sugar. The body’s natural response is to maintain blood sugar levels, so it releases adrenaline and cortisol to boost blood sugar when it dips down. Unfortunately, this wakes us up. If you find that having a snack helps you fall back to sleep, then balancing your blood sugar during the day by cutting back on foods that contain sugar and flour is a great place to start.

Once we’re awake, anxiety can rob us of the ability to drop back off. Over-thinking and worrying kicks in and further wakes us up.

Breathing techniques can help here as they calm the nervous system. Try ‘box breathing’ where you breathe in for a 4 count, hold for a 4 count, breathe out for 4 count and hold for 4 count, repeat for few minutes. You can also try visualisation exercises. Imagine you are somewhere relaxing and really dig into the detail, it helps distract your mind and move you to a sleepy state.

This sounds obvious but don’t clock-watch if you wake up. This increases stress and worry preventing you getting back to sleep. In fact, sleep experts advise not having your phone in the bedroom and turning your alarm clock to face the wall.

What about snoring?

Whether it’s you that snores or your partner, it can seriously disrupt sleep. If you snore, or think you might, it’s worth looking for solutions. Snoring can mean you get less oxygen to the brain which increases brain fog. It is also linked to difficulty managing blood sugar which can cause weight gain and fatigue.

Sleeping on your side instead of your back can help keep the airway open. A simple (though admittedly not very glamorous) option is to tape your mouth shut with a little surgical tape. This stops mouth breathing and limits snoring. At-home devices such as the iQoro (which strengthens the muscles in your soft palette to minimise snoring) may help www.iQoro.com.

Please note, if you find yourself repeatedly waking throughout the night, making gasping or choking noises during sleep, snoring loudly and/or your breathing seems to stop and start then it is important to ask your GP for an assessment for sleep apnoea.

Supporting your sleep is one of the most important things you can do to support your midlife health. If you believe you are experiencing insomnia, then you should speak to your GP. Insomnia is when you struggle to fall asleep or stay asleep for 3 nights a week for a period of 3 months or more. Your doctor will be able to discuss accessing insomnia treatment such as Cognitive Behavioural Therapy for Insomnia (CBT-I).

For more details about Ludo Partner WomenWise and how we can create a personalised perimenopause plan for you by understanding your biology and lifestyle, check out

 

www.womenwise.health

insta: womenwise_health

 

or email us on help@womenwise.health

 

Got a question? We’d love to talk to you.

You can book a complimentary 15-minute online consultation by clicking on the calendly link in our Instagram bio or on our website.