Updated at: 12-03-2022 - By: Jane Brody

Hot flashes and mood swings were referred to be the “change of life” by our mothers and grandmothers, and it was also the unofficial beginning of middle age. The unpleasant side effects of menopause might be expected by many women. However, in addition to increased perspiration and weight gain, many women do not expect to experience sleep disturbances.

Grace Pien, M.D., M.S.C.E., an assistant professor of medicine at the Johns Hopkins Sleep Disorders Center, notes that sleep quality and sleep disruption are less well-known alterations throughout this time of life, although they are very prevalent.

In later life, a restful night’s sleep may seem like an unattainable fantasy. During perimenopause, the time before menopause when hormone levels and menstrual cycles become erratic, many women find it difficult to sleep. Even after menopause, many women continue to suffer from bad sleep. As Pien points out, aid is on the way.

When it comes to sleeping, what constitutes “a good night’s rest?” According to Pien, women should aim for seven to eight hours of undisturbed excellent sleep per night. Some people require less sleep than others; this is not a hard and fast rule. You may not be receiving enough restful sleep, she explains, if you find yourself waking up frequently during the night and unable to get back to sleep.

What Sleep Issues Are Associated With Menopause

As a woman progresses from perimenopause through menopause, her menopausal symptoms can change. Some 39 to 47 percent of premenopausal women and 35 to 60 percent of postmenopausal women suffer from sleep problems.

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For many menopausal women, the most common sleep issues include hot flashes, sleeplessness, sleep apnea, and other mood and sleep issues.

Hot Flashes

Hot flashes are brief, intense bursts of intense heat and perspiration throughout the body. Face-to-chest and body-wide hot flashes are the first signs of menopause. As few as 30 seconds or as many as five minutes are possible. Around menopause, 75% to 85% of women experience hot flashes. Hot flashes normally last seven to ten years but can last much longer.

A common term for night sweats is a hot flash at night. When a woman experiences a hot flash, she experiences an increase in her core body temperature and increased blood flow to her face. As a result of the heightened levels of heat and adrenaline that accompany hot flashes, it might be difficult to drift off to sleep again. Sleep deprivation and daytime exhaustion result even if a woman is able to rapidly return to sleep after being awakened several times. Nearly 44 percent of women who suffer from severe hot flashes are clinically diagnosed with chronic insomnia.

Insomnia

When you have trouble getting asleep or staying asleep for more than three nights in a row, you have insomnia. Restless sleep, a lack of total sleep, waking up early, and a feeling of exhaustion are all symptoms of insomnia. Feelings of anxiety and irritation can be exacerbated by sleep deprivation from insomnia, which can also impair concentration and memory and lead to headaches and inflammation.

Chronic insomnia affects one out of every seven adults. Insomnia affects one in every four women, roughly twice as many as it does males. Insomnia is more common in postmenopausal women than in premenopausal ones, with up to 61% of these women reporting symptoms.

Sleep-Disordered Breathing

Postmenopausal women are more likely than premenopausal women to experience snoring and sleep apnea. As a result of OSA, snoring, gasping, and choking noises can be heard, as well as an overall decrease in quality of sleep for the sufferer.

OSA affects 2% of females. Every year that passes after the onset of perimenopause increases a woman’s risk by 4%. A lack of progesterone in postmenopausal women has been linked to the development of sleep apnea, according to new studies. Pregnant women may benefit from taking progesterone to avoid the pauses in breathing linked with OSA, according to a new study. OSA is less common in postmenopausal women who are on hormone replacement therapy.

Other Mood and Sleep Disorders

Restless legs syndrome and periodic limb movement disorder are two more sleep disorders that can arise during menopause. Uncomfortable sensations and interrupted sleep are common symptoms of many illnesses.

Depression and anxiety are common companions to menopausal sleep problems, and these mood disorders can exacerbate the problem. Anxiety and despair may be exacerbated by a lack of sleep.

How Does Menopause Affect Sleep?

There are two reasons for this: estrogen and progesterone are no longer being produced by the female reproductive system. Mood, hunger, sleep, and sex drive are all influenced by these two hormones. Progesterone, for example, has been linked to sleep apnea and other sleep disorders, thus reduced levels may be a contributing factor.

It is thought that estrogen is involved in the metabolism of serotonin as well as other neurotransmitters that influence our sleep-wake cycle. Estrogen also lowers our body temperature at night, making it more favorable to a good night’s sleep. Estrogen also has a calming impact on the mind and body. When estrogen levels drop, it’s possible that women will feel hotter, sleep worse, and have a worse mood.

As we grow older, our sleep-wake pattern likewise changes and becomes less predictable. Early fatigue and a more early rise in the morning lead to less overall sleep. Menopausal women may also be more susceptible to sleeplessness because of this.
Menopause-related mood swings can be caused by a variety of factors, including changes in one’s life circumstances that coincide with menopause. Caregiving for elderly parents and anxiety about their own aging can all add to the burdens that women already bear.

Menopause and other age-related problems may cause women to begin taking drugs, which can have a negative impact on their sleep. A lack of sleep can be exacerbated by age-related symptoms such as joint discomfort, muscle aches, and bladder issues.

Can Treating Menopause Improve Sleep?

Two typical therapies for menopause are Estrogen Replacement Therapy (ERT) and Hormone Replacement Therapy (HRT), both of which enhance estrogen and progesterone. Menopausal symptoms such as hot flashes, sleeplessness, and mood swings can be effectively treated with any of these two approaches.

Some women, particularly those with a history of blood clots, strokes, heart attacks, or certain forms of cancer, may experience major side effects with HRT. Therefore, doctors are advised to give HRT at the lowest effective dose and only for a limited period of time. It’s critical to discuss the dangers and advantages of HRT with your doctor, as there are a variety of options for treating the symptoms of menopause.

Menopausal symptoms, such as hot flashes, can be alleviated with SSRIs and antidepressants, such as fluoxetine, paroxetine, and venlafaxine. Hot flashes may be reduced and sleep quality improved by some medications.

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Phytoestrogen is found in soy products such as tofu, soybeans, and soy milk. Some study suggests that a soy-rich diet may help reduce hot flashes and enhance sleep by mimicking the effects of estrogen in plants. Ginseng, black cohosh, and red clover extract are all over-the-counter supplements that include phytoestrogens, which are similar to those found in soy. It’s impossible to tell for sure whether natural supplements can relieve menopausal symptoms or have any side effects because they aren’t closely monitored by the FDA. You should always discuss any potential treatment options with your physician.

This natural sleep hormone can be used as an over-the-counter prescription as well. In postmenopausal women, low dosages of melatonin enhanced mood and sleep onset. Age-related declines in melatonin levels are common, as are those in estrogen and progesterone.

Menopause-related sleeplessness can be alleviated with cognitive-behavioral therapy (CBT). Your therapist will help identify the thoughts and behaviors that are negatively affecting your sleep, then teach you how to substitute them with healthier ones that will help you get a good night’s sleep instead.

Tips for Sleeping Better With Menopause

Consult your doctor if you’re having trouble sleeping because of menopause. They are familiar with your medical history and can make suitable treatment recommendations, such as drugs and dietary adjustments, to help you sleep better. The following sleep advice may also be helpful.

  • Maintain a healthy weight and a healthy diet.” After menopause, women’s bodies tend to gain weight, which may contribute to OSA symptoms. Hot flashes can be triggered by spicy or acidic foods eaten right before bedtime.
  • Tobacco, caffeine, and alcohol should be avoided in the late afternoon and early evening to avoid disrupting sleep cycles. These chemicals have the potential to cause sleep disturbances and reduce the quality of your rest.
  • Avoid waking up in the middle of the night or early in the morning by using the restroom before you go to bed. Try to refrain from consuming any drinks for at least an hour before going to sleep.
  • Reduce your level of tension as much as you can. Anxiety and tension can keep you awake at night, making it difficult to get to sleep in the first place. Stress reduction can be achieved by the regular practice of massage, exercise, and yoga. Consult a mental health expert if you’re experiencing depression or anxiety.
  • Develop a nighttime ritual that soothes your nerves and reduces your stress levels. Relax in the tub while listening to music or reading a book. Meditation or deep breathing are good ways to unwind.
  • Plan ahead of time how you’re going to get back to sleep in case you wake up throughout the night sweating. Don’t watch television or do anything else that will keep you awake, including reading.
  • Keep a change of clothes or a glass of iced water on your nightstand.
  • To keep cool at night, either wear thin pajamas or go to bed barefoot. Another approach is to wear moisture-wicking exercise clothing. Natural fibers, like cotton, can be swapped out for cooler bedding.
  • Make sure your bedroom is kept at a cool, comfortable temperature.
  • Reduce the temperature in your bedroom to about 65 degrees Fahrenheit. To further cool the air and improve circulation, turn on the air conditioner or install a fan next to your bed at night.
  • Consistently observe a regular sleep routine, including the time you go to bed and when you wake up. In order to get enough rest at night, you should avoid taking naps throughout the day, especially if they last more than 20 minutes.

Several women encounter sleep problems after menopause, but there are many ways to alleviate them. If you’re still having trouble sleeping, talk to a CBT-trained therapist who has worked with women going through menopause before.

Hot Flashes and Sleep

Menopause-related insomnia is frequently accompanied by hot flashes. They can occur at any time of the day or night, and they are extremely unpleasant. Unexpected awakenings are sometimes accompanied by nighttime hot flushes.

Research demonstrates that many menopausal women really wake up immediately before a hot flash happens, despite the fact that it’s typical to feel that way.

According to her, “there are brain changes that lead to the hot flash itself, and those changes — not only the feeling of heat—may also be what causes the waking,” she explains. Sleep problems are increasingly common after menopause, even for women who don’t have hot flashes.

Other Menopausal Sleep Disruptors

The decrease of reproductive hormones, such as estrogen and progesterone, can cause sleep disturbances including apnea in women at this stage of life. Sleep disorders, such as daytime weariness, might go undetected because women commonly blame menopause for its symptoms and effects.

It’s two to three times more common in postmenopausal women than premenopausal women to suffer from sleep apnea, according to Pien. Prior to menopause, hormones appear to have a significant protective impact, but this effect diminishes with menopause.” In addition, the signs and symptoms of sleep apnea in women tend to be more modest. Consequently, they may be less inclined to get tested for sleep apnoea. Sleep apnea may also be overlooked by their doctors, resulting in further delays in diagnosis and treatment.”

Menopause-related sleep problems may be exacerbated by depressive and anxious symptoms.

Can Alternative Treatments Treat Hot Flashes and Help Me Sleep?

Soy products such as tofu and soybeans have been used as alternative treatments for hot flashes and to improve sleep quality. Phytoestrogen, a plant hormone found in soy products, works as a mild estrogen. Soy products haven’t been demonstrated to significantly reduce hot flashes in most studies.

The buttercup family perennial black cohosh has also been used to alleviate hot flashes and excessive sweating. Despite some promising results, research into the anti-menopausal effects of black cohosh has been problematic.

The FDA does not regulate or control dietary supplements like it does pharmaceuticals. Before taking any of these products, consult your doctor.

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Getting a good night’s sleep during the menopausal transition

The menopause transition and beyond is a great time to improve your sleep.

  • Maintain a regular sleeping pattern. Go to bed and rise at the same hour every day.
  • If at all possible, try to avoid taking a nap in the late afternoon or evening. It’s possible it’ll keep you up at night.
  • Be consistent with your bedtime routine.
  • Take a long, relaxing bath or relax with a good book.
  • Try not to watch television or use a computer or mobile device in your bed.
  • You may have trouble sleeping if the light from these gadgets bothers you.
  • Maintain a temperature that is neither too hot nor too chilly, and be as quiet as possible in your bedroom to avoid disrupting sleep.
  • Exercise at regular intervals throughout the day, but avoid doing so right before going to bed.
  • Large meals should be avoided close to bedtime.
  • Stay away from caffeine (found in many coffees, teas, and chocolate) after lunch and before going to sleep.
  • Don’t rely on booze to help you get to sleep.
  • Even a modest amount can make it difficult to fall and remain asleep..

Tips for improving sleep long term

General:

  • Keep a consistent bedtime and wake-up schedule. For a good night’s sleep, routine is essential. It may take a few weeks to establish and stick to a regular schedule, so keep that in mind.
  • Daytime naps should be avoided at all costs. If you do, stick to a 30- to 40-minute session in the morning.
  • Maintain a regular exercise routine, but avoid overdoing it within two hours of bedtime
    Find out how much sleep you require. The typical amount of sleep time is 6-8 hours, but this varies from person to person and decreases with age.
  • Physical symptoms other than those connected with menopause can also disrupt sleep, of course.
  • Make sure you take any additional medications you’re taking at the time of day that your doctor has recommended them for.

Before going to bed:

  • Get into a routine, such as taking a warm bath or reading a light book.
  • It’s best not to go to bed when you’re overly hungry or full. A small snack is fine.
  • Consume your final caffeinated beverage, whether it’s a soda or chocolate, in the late afternoon or evening.
  • You should avoid drinking alcohol if you can, as it will not help you get to sleep at all.

Your environment:

  • Maintain a peaceful atmosphere in your bedroom. Rooms that are chilly but not too cold, and that block out as much noise or light as possible, are ideal.
  • Make yourself at home! A nice mattress and good sheets are a must.
  • Sleep and sex are the only things you should be doing in your bedroom!
  • Avoid using your laptop or phone or watching TV in bed.

If you wake up in the night:

  • Get out of bed and go to another room if you can’t fall back asleep after 20 minutes.
  • When you’re tired, go back to bed and do something quiet.
  • Don’t keep an eye on the time or watch television while you’re working.
  • Even if it’s difficult, try your best not to think about your troubles or anxieties during this time of reflection.
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