Sleepless in menopause: The quest for rest

“It seems I have mostly evaded menopause symptoms, but my sleep! Oh my sleep has gone to hell!”

This sentiment, uttered by my 53 year old menopausal client captures the essence of a struggle many women face during menopause and perimenopause(the time period up to 10 years before menopause).

Good quality sleep is crucial because it allows the brain to process information, repair itself, and consolidate memories, while also supporting overall physical health, mood regulation, and cognitive function.

A lack of sleep worsens all health symptoms, lowers immunity, leads to poor mood and contributes to brain fog.

Poor sleep has many facets, and today I will explore some reasons why sleep becomes elusive in menopause/perimenopause and what can be done to reclaim restful nights.

Dr Lisa Mosconi (Neuroscientist, Researcher, Author) points out the following statistics:

Over 40 per cent of menopausal/perimenopausal women regularly get less than 7 hours of sleep. Almost 30 per cent find it hard to drift off to sleep. 36 per cent routinely wake up throughout the night.

The Culprits Behind Menopausal Sleeplessness

Current research shows that the decline in estrogen and progesterone during menopause/perimenopause plays a significant role in sleep disturbances. Estrogen is crucial for regulating the body’s use of serotonin, a neurotransmitter that affects mood and sleep, while progesterone has a sleep-inducing effect and helps relax muscles.

Night sweats and hot flashes can be culprits causing women to wake up multiple times during the night. Hormonal fluctuations can also lead to mood changes, increased anxiety, and depression, all of which contribute to poor sleep quality.

As a stress and anxiety specialist, I see firsthand the critical interplay between unresolved stress, trauma, and poor sleep. The surge of stress hormones keep you awake and vigilant so you can find solutions to the real/perceived “threat”.

Chronic/ongoing stress disrupts the balance of neurotransmitters that regulate sleep, making it difficult to achieve restful sleep and intensifying the cycle of anxiety and insomnia.

The Scientific Impact

Dr Mosconi explains that neurological changes in menopause/perimenopause can significantly impact sleep, and lower estrogen levels impact deep sleep. Chronic sleep deprivation feeds into the cycle, leading to increased inflammation, cognitive decline, and in the long term, heightened symptoms.

The Stress Impact

In times of high stress, the brain's primordial survival mechanisms can hijack your ability to sleep. The amygdala, responsible for the fight-or-flight survival response, becomes hyperactive, flooding the body with stress hormones like cortisol and adrenaline, increasing alertness and vigilance, making it difficult to wind down.

Furthermore, the pre-frontal cortex, which regulates reasoning and decision-making, becomes less effective, amplifying feelings of anxiety and restlessness. According to neuroscientists, this evolutionary adaptation, designed to keep us alert in dangerous situations, can backfire in modern life, leading to chronic sleep disruptions during stressful periods.

Effective Interventions

Stress Reduction: While menopause can be overwhelming, stress and anxiety can certainly be managed! Meditation, deep breathing exercises, and yoga can help manage stress and anxiety, promoting better sleep. Reach out for help if self interventions are not working for you.

Menopause Education: Knowing what to expect and understanding options during menopause/perimenopause is certainly empowering so that you are not blindsided by symptoms, and not rushing around anxiously seeking a diagnosis.

Meal Timings: Eat at least four hours before bedtime to prevent blood sugar spikes and digestion issues that can disrupt sleep, thus ensuring more restful and restorative slumber.

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