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Menopause

How to manage your sleep during menopause?

HOW COMMON IS INSOMNIA AMONG PERI- AND POST-MENOPAUSAL WOMEN?

Sleeping problems are quite common among peri- and post-menopausal women. Roughly 50% or more of women undergoing menopause struggle with lack of sleep1,2, indicating a higher prevalence rate compared with those in the pre-menopause stage2. Peri- and post-menopausal women also experience more frequent and more severe snoring2.

Menopause usually occurs in women between the ages of 45 and 559. During these years, these women also deal with various life challenges, such as career management, care for old parents, and children leaving home10. These challenges on their own are major sources of stress and anxiety, which may negatively impact sleep11. The situation is worsened when women also experience menopausal symptoms, such as hot flushes, joint pain, and night sweats8. All these factors tend to lead to anxiety and depression, which are commonly linked to menopause8 (link to articles 2 and 3 on the consequences of menopause). These challenges could also exacerbate sleeping problems8.

Not getting enough sleep negatively impacts your health. It may causethe following:3

  • Irritability
  • Depression
  • Fatigue
  • Forgetfulness
  • Falls and accidents

These symptoms should not be left untreated and must be immediately discussed with your doctor. Keep in mind that lack of sleep aggravates your negative mood, anxiety and even depression7, 8. You need to break through this vicious cycle and take control of your sleep. Fortunately, there are solutions to this problem. Your doctor can help you find the most suitable treatment plan for you.

How to deal with insomnia during menopause?

MEDICAL SOLUTIONS 

There are several solutions available at your disposal to help you sleep.

On the medical side, there are menopause hormone therapy (MHT) and sleeping pills.

  • Sleeping pills can help you quickly treat insomnia. However, these should not be used as a permanent solution to your sleeping problems4. Taking these pills every night over a prolonged period may harm your health and sleep even more. These may also have strong and long-lasting side effects, such as headaches and dizziness6.
    • Always consult a doctor before taking sleeping pills. Carefully read the potential side effects of the sleeping pill you plan to take as well.
  • MHT is aimed at treating estrogen deficiency symptoms during menopause(for more link to the article on MHT – article 5). This therapy can alleviate some of your symptoms13, particularly those that are directly linked to the decrease of estrogen secretion and that may disturb your sleep, such as hot flushes and night sweats8. However, it is necessary to consult with your doctor before you engage in MHT. Never start MHT on your own.

Low-dose birth control pills can be beneficial to stabilizing your hormone levels, which could ease insomnia. Low-dose antidepressants, which alter your brain chemicals, may also help with your sleeping issues. In both cases, it is vital to consult your doctor first and to never self-medicate.5

Aside from seeking medical treatment, lifestyle changes can also be extremely useful in coping with sleeping problems. Here are some adjustments you can make3:

  • Exercise helps your sleep12. Try not to exercise close to your sleeping hours because it could overexcite the body. 
  • A healthy diet, spacing your food consumption from your bedtime, and eliminating caffeine, theine, or other exciters would be helpful as well.
  • Establish a daily sleeping routine, in which you go to bed and wake up at the same time, including weekends.
  • Avoid napping in late afternoon to not disturb your night sleep.
  • Try not to stay in front of your screen before going to bed. Eliminate all unnecessary lights, including the screen light of your mobile phone, and noises. These substantially lower the quality of your sleep.
  • Check your bedroom temperature and make sure that it is neither too hot nor too cold. Generally, the ideal temperature is around 200C5. Try not to go to bed in thick clothes as well.
  • Practice relaxation techniques such as massages, light yoga, and stretching.

References

  1. The North-American Menopause society. Sleep problems https://www.menopause.org/for-women/sexual-health-menopause-online/causes-of-sexual-problems/sleep-problems Accessed 30.10.2020
  2. National Sleep Foundation. Menopause and Sleep. https://www.sleepfoundation.org/articles/menopause-and-sleep Accessed 30.10.2020
  3. National Institute on Aging, U.S. Department on Health and Human services. Sleep Problems and Menopause: What Can I Do? https://www.nia.nih.gov/health/sleep-problems-and-menopause-what-can-i-do Accessed 30.10.2020
  4. Harvard Health Center. Learn the risks of sleep aids. https://www.health.harvard.edu/sleep/learn-the-risks-of-sleep-aids Published July 2017, Accessed 30.10.2020
  5. Healthline. Can Menopause Cause Insomnia?, https://www.healthline.com/health/menopause/menopause-and-insomnia Published May 2016, Accessed 30.10.2020
  6. Addiction center. Signs of Sleeping Pill Abuse, https://www.addictioncenter.com/sleeping-pills/symptoms-signs/, Accessed 30.10.2020
  7. Harvard Medical School. Sleep and mood, http://healthysleep.med.harvard.edu/need-sleep/whats-in-it-for-you/mood, Accessed 30.10.2020
  8. Psychology today. 7 Surprising Connections Between Sleep and Menopause, Published July 2018, Accessed 30.10.2020
  9. NHS. Overview – Menopause, Accessed 30.10.2020
  10. Hunter M, Smith M in collaboration with the British Menopause Society. Cognitive behaviour therapy (CBT) for menopausal symptoms: Information for GPs and health professionals. Post Reprod Health. 2017;23(2):83–84.
  11. Sleep Foundation. Stress and Insomnia, https://www.sleepfoundation.org/insomnia/stress-and-insomnia, Accessed 30.10.2020
  12. Australasian Menopause Society. Lifestyle and behavioural modifications for menopausal symptoms, https://www.menopause.org.au/hp/information-sheets/1087-lifestyle-and-behavioural-modifications-for-menopausal-symptoms, Accessed 30.10.2020
  13. NHS. Hormone replacement therapy (HRT) – Overview. https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/#:~:text=The%20main%20benefit%20of%20HRT,mood%20swings Published 2020. Accessed October 23, 2020.