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How does Menopause affect Sleep?

How does Menopause affect Sleep?

When we asked women what health goals were most important to them, many said improving sleep came #1. So we wanted to share some information on sleep during menopause and tips for improving it.

There are many types of sleep disturbances, including difficulty getting to sleep, difficulty staying asleep, early morning waking, poor quality of sleep, fewer hours sleeping, and daytime sleepiness. In fact, surveys suggest sleep related symptoms affect over 6 in 10 women, with around a quarter saying that a lack of sleep affects their daytime activities. Poor and insufficient sleep has health impacts beyond menopause, too. Insufficient sleep is associated with detrimental effects on our mental, heart, and cognitive health.

Why does menopause affect sleep?

The changes in hormones during menopause can affect your sleep. They do this by directly affecting your sleep cycles, and indirectly by causing symptoms like night sweats, anxiety, or low moods. Needing to pee more frequently during the night, or joint aches and pains can also affect the quality and quantity of sleep you get.

Lower levels of oestrogen are responsible for many of the indirect symptoms listed above, and oestrogen replacement can be very effective at reducing these symptoms. However, it is menopausal progesterone decline that can directly affect sleep. Let us explain.

Progesterone helps to promote a sense of calm and relaxation by acting on brain pathways that increase a substance called GABA. Do you remember the last time you had a glass of wine, and that comforting, relaxing feeling after 10 minutes? That was the alcohol acting on your brain to increase GABA activity. During menopause, lower levels of progesterone can mean less GABA, and increased anxiety or restlessness when trying to sleep.

Besides GABA, melatonin is another important hormone that reduces with age, and its release is stimulated by oestrogen and progesterone. Melatonin coordinates our circadian rhythms, giving us the sleepy sensation at night time. 

What can I do to help with sleep?

If your lack of sleep is affecting your daytime activities and mood, you can consider treatments such as hormone replacement therapy (HRT) or cognitive behavioural therapy (CBT). Research shows both are effective, though you may have to try them in order to determine what works best for you. Another alternative to help with sleep during menopause is taking over the counter melatonin, which has also been shown to be beneficial.

Developing healthy waking and sleeping habits can help too. There's even a term for it, "sleep hygiene". Tips for practising good sleep hygiene include:

  1. daily exercise (try a 30-min walk),
  2. avoiding screens before bed,
  3. eating a healthy balanced diet without too much food before bed,
  4. avoid drinking caffeine, even one cup of coffee in the morning can affect your night's sleep,
  5. reducing alcohol,
  6. practices for reducing stress, such as acupuncture or hypnotherapy.

If you are up in the middle of the night and can’t fall back asleep, we recommend reading a book by a low light. For more reading on sleep, we like Matthew Walker's book Why We Sleep, which is all about the science of sleep. And the author himself says in it that he'll take it as a compliment if you fall asleep reading it!

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