As menopause can be a time of major hormonal change for women, it’s natural to expect some disruption to your normal sleep routine. Declining levels of oestrogen and progesterone can have a drastic impact on your sleep. Oestrogen is important for managing the level of magnesium in the body. This is a chemical which allows your muscles to relax, so low levels make it more difficult to fall asleep.
Falling levels of oestrogen are also the primary factor in causing night sweats, which can disrupt the sleep cycle. Progesterone helps you fall asleep and stay asleep; lowered levels make it more difficult to slip into deep sleep. Even if you do not wake during the night, your sleep isn’t as restful as it should be.
There are a range of sleep disruptions that may affect you, including hot flushes, mood disorders, insomnia and sleep-disordered breathing. Sleep problems can be very disruptive, may lead to daytime drowsiness, and are often accompanied by anxiety or depression. They may also cause you to have trouble concentrating during the day.
Both insomnia (sleeplessness) or disturbed sleep (leading to tiredness and fatigue) can be largely due to night sweats, discussed in our Hot Flushes page. Prior to a hot flush, your body temperature may rise, leading to an awakening. As hot flushes last for approximately three minutes, your quality of sleep can be affected by them.
“Estimates are that between 40 and 60 per cent of women will be affected by insomnia, or another sleep disruption,” says Dr Heather Currie, founder of Menopause Matters and an associate specialist gynaecologist and obstetrician at Dumfries and Galloway Royal Infirmary.
This symptom of the menopause can be the most disturbing/disruptive. “It’s still uncertain exactly what is the cause of much sleep disruption suffered in the menopause,” states Dr Currie. “We know oestrogen deficiency is partly responsible, and some sleep disturbance is caused by hot flushes and sweats. It’s also believed that the reduced production of melatonin may be responsible, and other conditions such as depressive disorder, sleep related breathing or movement disorders may also be involved,” she says.
“If you feel your sleep problems are related to flushes and sweats then treatment of those can help,” says Dr Currie. “This includes simple steps such as keeping your room well ventilated (try leaving a window or door open at night) or using a fan in your bedroom,” she says. “For some, cognitive behavior therapy (CBT) may be helpful. A lot is still not understood about these issues, and more research is needed regarding the role of melatonin in sleep disturbance during the menopause,” she adds.
Some simple steps may help you minimise sleep disruption. Make sure you have a regular bedtime schedule, which should include going to bed at the same time every night. Avoid taking phones, or other technology into the bedroom, and avoid caffeine after mid-afternoon.
“If your menopause symptoms continually keep you up at night, make an appointment to see your GP to discuss possible treatment options,” advises Dr Currie.
For more information on how to manage your symptoms visit Menopause Matters.