04 Mar Sleepless In Menopause: Try These Tips for Insomnia
Next to hot flashes and night sweats, insomnia is one of the most well-known symptoms of menopause. The link between menopause and sleep disorders is well-established. An estimated 40-60% of women suffer from sleep problems during menopause. 26% report having such severe symptoms that it affects their daytime functioning. Menopause is believed to disrupt normal sleep function through two main mechanisms: (1) Hormones: changing levels of estrogen and follicle-stimulating hormone (FSH) have been associated with problems falling and staying asleep. (2) Vasomotor symptoms (VMS): hot flashes and night sweats.
Lack of sleep is possibly the most detrimental of all menopause symptoms because it affects our body’s ability to function properly. Without sleep, nothing else works. Several studies show that even a short period of sleep deprivation affects our cognition, memory, reaction time, and ability to handle stress. One 10-year study of 70,026 women showed that those that slept less than 5 hours per night had a higher risk of being diagnosed with diabetes. A meta-analysis of 30 studies concluded that children sleeping 10 hrs or less and adults sleeping 5 hours or less per night are at an increased risk for obesity. Sleep has a key role in supporting an array of the body’s hormones and metabolism. Chronic sleep deprivation is often a factor in obesity. People that sleep less tend to eat more because they have more time to eat and tired individuals tend to eat more to combat exhaustion. Further research indicates that sleep affects two important hormones related to appetite: ghrelin and leptin. Ghrelin, which increases appetite, is higher with lack of sleep. Leptin, which decreases hunger is lower with lack of sleep. Sleep loss also increases the levels of circulating endocannabinoids, which are chemicals responsible for the “munchies” with marijuana use. In essence, not getting enough sleep leads to losing hunger control.
In his book “Why We Sleep” Dr. Matthew Walker writes that “sleep is the single most effective thing we can do to reset our brain and body health each day.” During menopause, our hormones can make it harder to attain this brain and body reset. It’s worth trying well known basic sleep tips, but if your insomnia is more severe, here are some scientifically proven options:
Cognitive-Behavioral Therapy (CBT): CBT-I is a well-researched form of treatment for insomnia. It focuses on helping you identify and replace thoughts, attitudes, feelings, and behaviors that cause or worsen sleep problems with thoughts and habits that promote sound sleep. The goal of CBT-I is to improve your ability to respond to challenging and stressful situations.
Physical Activity: Women who exercise are less likely to be depressed, more likely to sleep better, and overall report more positive effects on menopause symptoms. Regular exercise has also been linked to improved sleep. For exercise to help improve sleep, try to avoid exercising close to bedtime. Morning workouts will be more beneficial. Moderate intensity workouts and walking have been shown to offer the best results for better sleep and less anxiety. Other helpful practices include mindfulness exercises such as Hatha yoga and Tai Chi.
Hormone Replacement Therapy (HRT): This is a polarizing topic, but from a research perspective, hormone replacement remains the most effective option. There is an abundance of research indicating the benefit of HRT on menopause symptoms, especially hot flashes and insomnia. If you want to learn a bit more about the pros and cons of HRT, check out my post on this topic.
Learning about sleep has been an interest of mine for years due to my life long sleep challenges. If you’re interested in finding out more about sleep, I recommend reading Dr. Walker’s book. I found it fascinating and helpful.
Stay curious, unafraid, and armed with knowledge!
– Dr. Maria Luque