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Sleep and The Menopause

Sleep and The Menopause
18 October 2022 Samantha Anderson

TEMPUR® sleep specialist examines how the menopause affects sleep and provides tips to address sleep issues this World Menopause Awareness Day.

Women’s health issues often take a back seat when it comes to cultural conversations around wellbeing. As part of World Menopause Awareness Day (18 October), TEMPUR® sleep specialist & sleep counsellor, Thomas Høegh Reisenhus, shares his knowledge of how menopause impacts women’s sleep later in life, and the steps they can take to minimise menopause-induced sleep issues.

“From hot flashes and mood swings to potential weight gain, the side effects of the menopause are fairly well known. However, another fundamental area of a woman’s day-to-day that is affected by the menopause is sleep, which can create further ripple effects that will impact overall health and wellbeing,” says Thomas.

“The impact of menopause on sleep shouldn’t be overlooked, and neither should the importance of a good night’s sleep. Women who are unable to obtain around eight hours of quality uninterrupted sleep a night are at risk of chronic fatigue and enhanced menopausal symptoms such as lethargy.

“Women’s hormonal health is an area that deserves more research and recognition, however, for those who are approaching the menopause or suffering its symptoms, the best place to start is to be informed. There are a number of small lifestyle changes that can help to make quality sleep more achievable during this time of life.”

Read on for Thomas’ guide to menopause and sleep…

Sleep and age

The menopause is a stage of female hormonal health that occurs around middle-age as periods stop occurring. However, ageing in general comes with symptoms that also affect sleep quality. A common misconception is that the older you get, the less sleep you need, when in fact, our bodies still require eight hours of sleep, it’s just that this becomes harder to achieve.

The changes in sleeping patterns that come with age are due to an aging suprachiasmatic nucleus (SCN). The SCN controls our circadian rhythm – our 24-hour sleep-wake cycle – so deterioration of this directly impacts the quality and duration of sleep we enjoy as we age.

Changes in the production of the sleep-inducing hormone melatonin may also contribute to disruptions to our sleep cycle as we get older.

As such, women entering the menopause are already having to deal with the physiological changes that come with age and now have further hormone imbalances to contend with, affecting body temperature, breathing and mood patterns.

Hormonal disruption

The hormones that regulate the female reproductive system and balance many other aspects of the body are those most affected during the menopause.

The ovaries stop producing progesterone and oestrogen and this has a knock-on effect on many functions in the body, such as temperature regulation and even breathing. These hormonal changes then have an effect on sleep.

Lower progesterone levels have been linked to sleep apnea as progesterone is believed to prevent the relaxation of the upper airways, which causes breathing to momentarily stop. Obstructive sleep apnea symptoms include heavy snoring and gasping, which can cause frequent waking, leading to poor quality sleep.

Hormonal changes at the time of the menopause can also affect blood sugar levels. Both progesterone and oestrogen affect the insulin sensitivity of cells, and as these levels change during menopause this can lead to fluctuating blood sugar levels. This can then trigger energy spikes, tiredness, low mood, and cravings for caffeine or carb-heavy, high-sugar foods – all of which can negatively impact sleep.

Night sweats

A well-known symptom of the menopause is hot flashes. This happens when a sudden body temperature increase causes a sensation of overheating and perspiration.

Hot flashes at night invariably lead to night sweats, which are uncomfortable and disruptive to sleep for several reasons. Generally speaking, our core body temperature whilst sleeping is very slightly lower – approximately 1 degree lower – than in the daytime. Therefore, a sudden rise in body temperature will cause us to wake, leading to inconsistent sleep patterns and an inability to achieve the optimum cycle of continuous REM (rapid eye movement) and non-REM sleep.

Ensuring your bedroom is slightly cooler than the rest of your home – around 18°C – is important come bedtime and can help with night sweats. Likewise, lightweight cotton bedding and pyjamas that allow your skin to breathe whilst also wicking away moisture will help to keep you comfortable during the night. Make sure your duvet is not too high a tog if you are suffering from night sweats. It might be worth replacing it with a temperature-regulating duvet or using blankets that you can layer up and remove if you get hot in the night. It’s also advisable to open windows in the evening to allow cool air to circulate.

For sudden night time hot flashes, keep an icepack in the freezer. This can be placed under the sheets or behind your neck to give an instant cooling effect that will help to lower your body temperature and assist you in falling back to sleep.

Tossing and turning

As the Menopause disrupts the ability to fall asleep, tossing and turning can become a common part of the nightly routine. When this happens, simply get up and move to another room for a short while. Your bedroom should be a space dedicated to sleep and calm.

Try a soothing activity that promotes relaxation and calm – perhaps one that you enjoy as part of your evening wind down routine. Reading, journaling, guided meditation, a gentle yin yoga practise are all great options to calm the mind and body if you’re struggling to doze off. Once you start to feel sleepy, you can return to your bed.

The key thing is not to allow yourself to fret about the fact you can’t sleep as doing so will only cause further frustration and anxiety and further hinder your ability to drift off. If you still can’t sleep, don’t feel the need to fight it, simply shut your eyes and reassure yourself that you are still enjoying some much-needed rest.

Start the day right

How we start our day not only impacts our ability to get the most out of it, but also the quality and quantity of sleep we enjoy come night-time, and this is true at all stages of life.

First thing’s first; a consistent wake time is just as important as a consistent bedtime – and ideally this shouldn’t change at the weekend. A consistent sleep schedule and solid morning routine can help improve productivity by helping you better prioritise your time and anticipate what lies ahead, allowing you to feel better equipped to cope with the demands of the day. A routine will also make it easier to adopt healthy habits long-term.

Enjoy a mood-boosting activity first thing – checking your phone and getting sucked into social media isn’t the most positive way to start your day. Some light stretching, meditation, a morning walk, a mindful shower, or even just a quiet cup of tea before you crack on with your to-do list are all great ways to ease yourself into the dawn of a new day.

A healthy breakfast is also a key part of any morning routine; a cup of coffee to go simply won’t cut it if you want to enjoy sustained energy throughout the day. Aim to enjoy a healthy mix of whole grains, lean protein, healthy fats, and slow-release carbohydrates. Energy and mood-boosting options include wholegrain toast with poached eggs and avocado, Greek yoghurt with mixed berries and seeds, or a bowl of porridge topped with sliced banana and nut butter.

Food for thought

There are various dietary changes that can help with menopause and with sleep more generally. Soy-based foods, such as tofu, miso soup or edamame beans, contain phytoestrogens known as isoflavones, which mimic oestrogen and have been known to ease menopausal symptoms such as hot flashes or night sweats.

Other simple adjustments to your diet can really help improve the quality and quantity of sleep overall. Foods and drinks that contain high levels of specific antioxidants and nutrients such as magnesium and melatonin are known to enhance sleep.

Magnesium’s sleep-promoting qualities are related to its ability to reduce levels of the stress hormone cortisol, which can interrupt sleep. You can increase your magnesium intake by consuming more bananas, legumes like beans, lentils and pulses, and whole grains such as wholemeal bread and brown rice.

The ‘sleep hormone’, melatonin, helps to regulate your internal clock and signals your body to prepare for sleep, so consuming melatonin-rich foods – nuts and seeds (almonds, walnuts, peanuts, flax seed, sunflower seeds), grains (rice, barley or rolled oats), and various fruits and vegetables (asparagus, cucumber, broccoli, cherries, tomatoes and corn) – before bed can help promote a good night’s rest.

Lean proteins such as turkey and chicken are rich in the amino acid tryptophan, which the brain converts into serotonin, relaxing the body before sleep, whilst fatty fish such as salmon, mackerel and trout have exceptional amounts of Vitamin D and healthy omega-3 fatty acids to help regulate serotonin levels in preparation for sleep.

Calcium is another important nutrient for sleep as it helps the brain use tryptophan to manufacture melatonin. As well as cow’s milk, spinach, kale and cabbage are good sources of calcium.

Quality sleep should be achievable for everyone as the foundation of good health and by following some simple steps, those suffering from menopausal symptoms can ensure a good night’s rest. If sleep issues persist, however, it is important to speak with a GP to explore whether there may be other causes and get the necessary treatment.


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