While there are many well-known symptoms of menopause—hot flashes, hair growth, and weight gain—insomnia is one that isn’t always mentioned. But as it turns out, menopause-related insomnia is quite common. In fact, the chances of having insomnia go up as you enter menopause, with 61 percent of postmenopausal women experiencing symptoms, according to the National Sleep Foundation. If you’re struggling to get some shut-eye, here’s everything you need to know about the condition, plus doctor-approved tips that can help.
Symptoms of insomnia
Insomnia is generally characterized by trouble falling asleep or staying asleep, resulting in a lack of sleep that causes distress or difficulty with daily activities, says Dr. Rachel Marie E. Salas, MD and professor of neurology and nursing at Johns Hopkins. “If it happens at least three nights a week and lasts for at least one month, you may have what sleep experts call persistent insomnia disorder.” When symptoms are left untreated, it can become a negative ongoing cycle that leads to additional health problems. “Lack of sleep or poor-quality sleep can cause daytime impairments such as fatigue, malaise, difficulties with memory and concentration, mood disturbances, irritability, and difficulty coping with daily stressors,” Jennie Mastroianni, DNP, NCMP, a nurse practitioner at Tufts Medical Center, explains. “These symptoms can actually cause more stress and worsen insomnia.”
Is there a connection between menopause and insomnia?
Yes, according to experts. “Menopause can wreak havoc on women’s sleep. Sleep issues are common during and through perimenopause to post-menopause,” Dr. Salas explains. “The ovaries gradually decrease the production of the hormones estrogen and progesterone during perimenopause. These hormonal changes contribute to sleep issues that often continue into post-menopause.” If you are experiencing hot flashes and night sweats, it can cause sleep disturbances and sleep deprivation. “Women who are undergoing the menopausal transition may be more likely to report decreased sleep quality, particularly if they experience vasomotor symptoms (hot flashes, night sweats). Vasomotor symptoms associated with menopause can cause sleep disruption leading to daytime fatigue, irritability, difficulty concentrating, and overall reduced quality of life,” Dr. Mastroianni states.
How to promote better sleep
If you’re having trouble sleeping, whether hormone-related or not, here are some action steps you can take.
Proper sleep hygiene
In other words, adopt habits that increase your chances of a good night’s sleep. “Good sleep hygiene includes awakening the same time each morning, increasing daytime exposure to bright light, exercising regularly, and establishing a comfortable sleep environment,” says Mastroianni. “Avoidance of alcohol, stimulants (caffeine, nicotine), and daytime napping are also suggested. Cognitive behavior therapy (CBT) can also be effective in promoting better sleep.”
Create a sleep schedule and stick to it
According to Dr. Salas, it’s important to make sure your cycle of sleeping and wakefulness is consistent during the week and on the weekends. “While the majority of people require between seven and nine hours of sleep per night, it’s better to focus on the quality (consistent cycle), rather than quantity (amount), of sleep.”
Prepare your brain for sleep
As hard as we try, it’s impossible for most of us to fall asleep on command. That’s why it’s important to help your brain shift into sleep mode. Dr. Salas recommends adopting the following habits:
Create a pre-bedtime ritual. For instance, repeatedly showering and putting on pajamas can send your brain the message that it’s time to sleepSteer clear of foods, beverages and activities that are over-stimulating. These include caffeinated drinks (as mentioned above) exercising and eating a hearty meal too close to bedtimeSet aside time to calm your mind. In other words, don’t pick a fight with your partner right before you go to sleep. Avoid doing anything that will stress you out.Disconnect from your devices. Turn off your electronics at least a half-hour before bed. The blue light from your phone is scientifically proven to keep you awake.
Is insomnia treated differently when it’s connected to menopause?
Insomnia related to menopausal-associated vasomotor symptoms can be treated with hormonal and non-hormonal prescription therapies. “Hormone therapy is the most effective treatment for vasomotor symptoms and can be offered to women who have no medical contraindications to estrogen or progesterone,” Dr. Salas explains. “Treatment should be individualized using the best clinical evidence to maximize benefits and minimize potential risks.” Non-hormonal therapies can be used off-label to treat women who are not candidates for hormone therapy. “These therapies include certain antidepressant medications such as paroxetine, venlafaxine, and escitalopram,” Dr. Salas states. “Gabapentin, a medication used to treat epilepsy, migraines, and nerve pain, is also effective in treating vasomotor symptoms. Since gabapentin can cause drowsiness, it is administered at bedtime and can be a good therapeutic option for women with bothersome night sweats.” Next, read 50 quotes about menopause that will resonate with every woman.
Sources
National Sleep Foundation: “How Can Menopause Affect Sleep?”Rachel Marie E. Salas, MD, professor of neurology and nursing at Johns Hopkins MedicineJennie Mastroianni, DNP, NCMP, nurse practitioner at Tufts Medical CenterHarvard Health: “Blue Light Has a Dark Side”
