Menopause & Sleep: When You Need More Zzzzzs.

This: You yawn. Ready for sleep, you close your eyes.

Only nothing happens.

Or this: You fall asleep. But you wake throughout the night, finding it impossible to rack up anything close to forty winks.

Sound familiar? Menopause and sleep make mighty incompatible bedfellows.

You’ve heard of women and insomnia. But women, insomnia and menopause? Well, that’s a whole ’nother story. You might know some of the major sleep issues, like:

·  Difficulty falling asleep or staying asleep

·  Waking too early

·  Waking up during the night

·  Next-day tiredness, irritability, depression or anxiety; difficulty concentrating, decreased work performance and mood

It’s nothing new, although it may be new to you if you’ve recently reached menopausal status. Research finds that sleep issues affect up to 47 percent of perimenopausal women and up to 60 percent of postmenopausal women.

Need a Nap?

When it comes to menopause and sleep, the land of nod can be a foreign territory.

As you travel through the menopausal transition — beginning with perimenopause — your ovaries begin to run out of gas as they move towards the end of the line on producing the hormones estrogen and progesterone. (Once you’ve been without a menstrual cycle for 12 consecutive months, which usually happens in your early 50s, you’re officially post-menopause.)

Somewhere along the way, as your ovaries begin to slow their production of hormones, the many changes of menopause symptoms surface. Mainly sleep problems, but others too; like dry skin, hair, eyes and mouth; weaker bones; weight gain; vaginal dryness and mood swings.

What’s behind this phenomenon — and more importantly, why is it so hard to fall, and stay asleep?

There’s likely no one answer. Indeed, your sleep difficulty is crawling with culprits.

·  Night Sweats A close cousin to hot flashes, these are heat surges that hit during the night. They can drench your clothes and sheets and rouse you from a deep sleep, obviously making it very difficult to stay asleep and/or get back to sleep. (Some women even have to get up to change their sheets, which can make it all the harder.) And when these night sweats are accompanied by heart palpitations (which they commonly are for some)? Sleep can be even more elusive.

·  Hormonal changes Did you know that progesterone has sedative effects? And that melatonin (a hormone your brain produces that fosters sleep) production wanes as you get older? Decreasing amounts of progesterone and melatonin can add up to sleep problems. Research clearly recognizes the struggle, with one study stating that “women are continuously under the influence of hormonal changes from menarche to menopause… placing women at an increased risk of sleep disturbance.” Thank you, Dr. Obvious.

·  Restless Legs Syndrome (RLS) This neurological disorder causes an uncontrollable desire to move your legs, typically in the evening or when you’re lying down. Research finds that menopausal status  can increase both the frequency and severity of RLS symptoms.

·  Obstructive Sleep Apnea (OSA) This breathing disorder, when breathing stops and starts during sleep, occurs when throat muscles relax. When it happens, your brain senses breathing problems and wakes you up so your airways can reopen and you can breathe again. Usually, these awakenings are so brief that you might not even notice them, but still, you are waking up, and this cycle can lead to next-day fatigue and irritability. Research states that because women’s anatomy also changes with menopause — namely, our upper airway — breathing can become more compromised during sleep. Not unexpectedly, that same research finds that OSA rises significantly after menopause, affecting up to 67 percent of post-menopausal women.

·  Depression and Anxiety Most of us know that menopause can be a turbulent time, both psychologically and hormonally, making bouts of depression and anxiety likely at times. And what follows is sleep disturbance — because, well, think about it: can you really rest easy when you have so much on your mind? Neither can we.

·  Aging In general, the older you get, the more sleep difficulty  (even if you never passed through menopause — just ask many men). That’s due to a whole host of other issues, including but not limited to a change in our circadian rhythm and conditions that rise with age like arthritis, heart disease, diabetes (high or low blood sugar can contribute to insomnia), nighttime urination and use of certain medications.

Like Eating, Drinking and Breathing, Sleep is a Basic Need.

We don’t really need to plead the case for sleep hygiene, but just in case you need more reasons than just to look and feel good the next day, there are these. A good night’s sleep helps…

·  Your brain. Its toxins and waste get “flushed out” in order to clear the way for new memories and information.

·  Your reflexes work better.

·  Enhance your mood, alertness, cognitive function, focus and energy.

·  Your immune system, breathing, blood pressure and cardiovascular health.

·  Your body release  important hormones that aid in repairing cells.

·  Deliver a greater protection from vaccines, according to recent research.

Simply put, getting enough quality sleep puts both your brain and body ahead of the game.

For those of you who make exercise a part of your life (and we hope that’s you!), here’s some encouraging news when it comes to exercise and sleep: a new study, published in the British Journal of Sports Medicine, finds that doing enough physical activity (like going to the gym or running) may counteract some of the adverse effects of sleep loss. Recommended amount is 75 minutes of vigorous activity or 150 minutes of moderate activity per week.

Yet another excuse to get moving — or at least to take some time for yourself. Here’s to some deep Zzzzzs tonight.

 Sources:

1. Danielle Pacheco. "Menopause and Sleep". Sleep Foundation. Updated Jan 22, 2021. https://www.sleepfoundation.org/women-sleep/menopause-and-sleep

2. "Sleep and Menopause", WebMD. Oct 13, 2021. https://www.webmd.com/menopause/sleep-disorders-sleep-menopause

3. "Sleep Deprivation and Deficiency". National Heart, Lung and Blood Institute. https://www.nhlbi.nih.gov/health-topics/sleep-deprivation-and-deficiency

4. Maria Cohut. "How waste gets 'washed out' of our brains during sleep". Medical News Today. Nov 2, 2019. https://www.medicalnewstoday.com/articles/326896#What-are-the-causal-links?

5. "The Benefits of Slumber". News in health. April 2013. https://newsinhealth.nih.gov/2013/04/benefits-slumber

6. Danielle Pacheco. "Menopause and Sleep". Sleep Foundation. Jan 22, 2021. https://www.sleepfoundation.org/women-sleep/menopause-and-sleep

7. "Postmenopause". Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/15224-menopause-perimenopause-and-postmenopause

8. "Insomnia". Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes/syc-20355167

9. Lee, Jinju et al. “Sleep Disorders and Menopause.” Journal of menopausal medicine vol. 25,2 (2019): 83-87. doi:10.6118/jmm.19192

10. Ian Franks. "What's to know about heart palpitations and menopause?". Medical News Today. May 30, 2017. https://www.medicalnewstoday.com/articles/317700#When-to-see-a-doctor

11. Jehan, Shazia et al. “Sleep, Melatonin, and the Menopausal Transition: What Are the Links?.” Sleep science (Sao Paulo, Brazil) vol. 10,1 (2017): 11-18. doi:10.5935/1984-0063.20170003

12. Wesstrom, J et al. “Restless legs syndrome among women: prevalence, co-morbidity and possible relationship to menopause.” Climacteric : the journal of the International Menopause Society vol. 11,5 (2008): 422-8. doi:10.1080/13697130802359683

13. "Sleep Apnea". Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631

14. Jehan, Shazia et al. “Obstructive Sleep Apnea: Women's Perspective.” Journal of sleep medicine and disorders vol. 3,6 (2016): 1064.

15. Rob Newsom. "Aging and Sleep". Sleep Foundation. Oct 23, 2020. https://www.sleepfoundation.org/aging-and-sleep

16. Danielle Pacheco. "Lack of Sleep and Diabetes". Sleep Foundation. Nov 20, 2020. https://www.sleepfoundation.org/physical-health/lack-of-sleep-and-diabetes

17. "What Counts as Physical Activity for Adults?". CDC. https://www.cdc.gov/physical-activity-basics/adding-adults/what-counts.html?CDC_AAref_Val=https://www.cdc.gov/physicalactivity/basics/adults/index.htm