Is sleeping soundly in perimenopause and menopause an impossible dream?

A quality night’s sleep is critical to leading a long and healthy life. However, for women going through any stage of menopause, sleep can be elusive.  Worse, if you worry about not being able to get a good sleep, you are creating a vicious cycle: sleep poorly – wake up exhausted – dwell on not sleeping well – go to bed worrying about whether you are going to sleep well – Have another terrible sleep – wake up exhausted…


To add insult to injury, our society puts a certain amount of pressure on everyone to “tough it out” or “be all that you can be” and “do more with less.” All of these sayings prompt men and women alike to sacrifice sleep in the name of producing more.

For women, it seems to be doubly true – where many feel like they must be perfect at work and perfect at home. We stay up until midnight (or later) to bake a child’s birthday cake for school the next day or tweak a presentation for work that was probably good enough or clean the bathroom because we didn’t have time during the day…

The thing is, research is now showing that the best thing you can do for your own mental and physical well-being is sleep better and longer. Five to six hours per night is not only bad for your current health, it’s bad for your long-term physical and cognitive health.

As it is, women are twice as likely to suffer from Alzheimer’s or other forms of dementia than men, and the number is not insignificant at 1 in 5, or 20% of the female population and research is linking a lack of sleep to dementia. 


Why our sleep quality starts declining

You may have noticed that at some point in your 40s or early 50s you could no longer fall asleep at the drop of a hat. Or you could fall asleep, but you wake up in the middle of the night for a few hours, or you wake up at 5:30am when you really want to wake up at 7:30am.

In addition to external responsibilities keeping your mind and heart racing, the decline in estrogen and progesterone are contributing to your sleep difficulties.

Estrogen contributes to your sleep in a variety of ways:

Estrogen signals to your hypothalamus that it’s time to lower your core body temperature in preparation for sleep. However, as your estrogen levels deplete, so does one of the sleep signals, meaning your core temperature may be higher than it used to be (for instance, maybe you have become a hot sleeper needing far fewer blankets/covers than in the past).

In addition, the decline in estrogen and progesterone doesn’t always occur in equal amounts. It is the gap between the two hormones that is one cause of your hot flashes and night sweats. Night sweats not only make your sleep uncomfortable, they can also lead to insomnia.

Researchers are uncovering more information about the power of sleep all the time. Dr. Matthew Walker has recently changed his belief about sleep from it being one of the 3 pillars of a healthy life (along with diet and exercise), to the foundation for diet and exercise. Without a good night’s sleep, it will be difficult to succeed in the other two.


Make sleep a priority

I know it’s easier said than done but start evaluating what you can let go of at the end of the day in order to give yourself the best sleep possible. Aim for 7 to 9 hours per night of sleep. Do the important things and let the rest go. Seriously, let it go, delegate, leave things undone. Whatever it takes, you are now focusing on getting a good night’s sleep. If you don't think you can do it on your own, search out a menopause sleep specialist near you.


Consistency is key

Maintain the same bedtime hours through weekdays and weekends to help your circadian rhythm. You may have to retrain yourself to sleep better again. If you find it difficult to fall asleep at night, make sure you get up at the same time every morning, regardless of the time you fall asleep. If you do this on a consistent basis, your body will eventually adjust to the new wake-up and bedtimes.


Actively lower your core body temperature

Estrogen plays a role in lowering our core body temperature which is one of our sleep signals. Menopause causes a decrease in estrogen so your core body temperature may not lower as much as it used to. Take a bath or warm shower about an hour before bedtime. The hot water opens your pores and blood vessels at your body’s surface and helps your core heat escape which lowers your core body temperature preparing you for sleep.


Eliminate electronics and screens from your room

TVs, computers, tablets, phones, any other flashing lights (like the modem, for instance). These devices prevent your body from triggering sleep mechanisms such as your natural melatonin and keep you awake longer.


Read a book, but maybe not an exciting book

The key here is to get your mind and heart to calm down. While you probably don’t want to read about a plunging stock market or work-related documents, you also might want to stay away from the latest thriller or mystery. If it triggers your heart to start racing, you will have trouble falling asleep.


Empty your mind

As you turn your light out, if you find that you have racing thoughts, keep a pen and paper on your night table to write down anything you need to remember in the morning. Practice meditation, deep breathing, or other techniques to fall asleep.


Sleep in a cold room

Experts recommend a room temperature of 65F/18C as ideal for comfortable sleeping. For me, I will break out into night sweats with a room temperature over 60F/15C. I believe this has to do with my core body temperature not being as low as it used to be. Pay attention to your room temperature as it will definitely affect your ability to sleep through the night.


Sleep in a dark space

In addition to a cold room, you need a dark and quiet room. If you live in the middle of the city, that can be a challenge to achieve. The easiest and more affordable option may be to invest in a good quality sleep mask. If you don’t like the feeling of a mask, there are blackout blinds and curtains available in many shapes and sizes.


A quiet space

A quiet room may be more challenging than a dark room for some. Do you sleep with a snorer? Is there a lot of traffic or other urban noises outside your space? Is your household on a different schedule than you? Look for a simple white noise machine to help block out sounds. Other possibilities are noise-cancelling headphones, earplugs or a white noise app on your phone.


Avoid certain activities

Setting yourself up for sleep success means that in addition to doing all of the above, you need to avoid certain things: Avoid vigorous exercise and alcohol within three hours of going to bed. Avoid caffeine after noon. Avoid spicy foods or a heavy meal within three hours of bed. Avoid difficult conversations or arguments in the evening. Anything that will stimulate your nervous system into fight or flight mode will prevent you from sleeping well.

As we enter menopause, it becomes harder to achieve a good quality sleep. Contrary to previously thought, a good night’s sleep is just as important as when we were younger.

I hope these tips will help improve your sleep quality and quantity. It may take your body some time to adjust, so be patient. Consistency is key, so keep at it and eventually, your body will realize you’re serious about getting a good sleep again. Remember that sleep is the foundation for a long, healthy, and productive life, so making it a priority should be your first priority.

Psst! If you suffer from night sweats, don’t forget to grab a copy of our Night Sweats Journal so you can start sleeping better soon!

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