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Menopausal Insomnia

Podcast Episode 18 transcript.

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Today, I’m talking about menopause and sleep.


Long-term disturbed sleep is a major symptom of menopause that often goes unrecognised and has long-term effects that include diabetes, obesity, dementia, cardiovascular disease and can also lower immunity.


The Sleep Foundation found that 12% of all women experience sleep disturbances, but for women in their 40s and 50s, this increases to 40%, and for those going through menopause, this increases to 50%.


There are many possible causes of sleep disorders in menopausal women, including night sweats, restless legs syndrome, and sleep apnea.


Some women struggle to fall asleep, others struggle to stay asleep and wake up many times during the night, and others find they wake up early in the morning and can’t go back to sleep no matter what they try.


Both progesterone and oestrogen have been found to affect sleep. As their levels reduce very quickly, this confuses the body’s internal clock, known as the circadian rhythm.


Progesterone made in our body has both natural sedative and anti-anxiety properties. It also stimulates breathing, so lowered progesterone levels, together with weight gain that can happen during menopause, can lead to sleep apnea. This is not only snoring and sometimes waking up gasping. Sleep apnea can also give people headaches, insomnia, depression or anxiety and daytime fatigue.


Oestrogen is associated with producing various chemicals, like serotonin, that affect sleep patterns. The body’s oestrogen production has been evidenced to increase sleep quality and total sleep time by keeping the central body temperature low and affecting serotonin response and uptake in the brain. Serotonin has an antidepressant effect.


Anxiety can make it difficult to sleep. On the other hand, menopausal sleep disturbance can lead to anxiety and depression. So, women find themselves in a bit of a catch-22 situation.


Knowing how much hormones affect sleep, it makes sense that Hormone replacement therapy helps menopausal insomnia. Studies have shown that estrogen replacement therapy improves sleep quality, enables falling asleep, decreases nighttime wakefulness, and reduces vasomotor symptoms.


Here are some tips to improve sleep, especially if you are struggling. I admit I’m guilty of not following some of these tips, and I tend to find that tiredness accumulates over several days.


  1. Try to follow a regular sleep schedule - which means going to sleep and waking up at the same time each day, even on weekends.

  2. Keep to a routine—allow time for winding down, reading a book, taking a bath, or listening to a relaxing podcast.

  3. Avoid screen time on a TV, mobile device, iPad, or laptop. Blue light blocks a hormone called melatonin that makes you sleepy. As a result, you will find yourself less drowsy than usual at night, and it will take you longer to fall asleep.

  4. Keep your bedroom cool.

  5. Avoid napping during the day.

  6. Avoid eating too close to bedtime.

  7. Exercise is good, but not too close to bedtime.

  8. Avoid caffeine, which is found in coffee and tea, later in the day. It can linger in the body for up to 12 hours, interrupting sleep.

  9. Although some people use Alcohol and cannabis to relax, they have been found to disturb sleep.

  10. Lastly, practice relaxation techniques as part of the daily routine


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