Insomnia as Menopause Symptom
There are multiple menopause symptoms – we counted more than 30, but if going in details the list would be much longer. Some of the symptoms are unpleasant, but manageable, others might become the sources of the major sources of the body malfunctioning. Insomnia is considered one of the most tiresome and debilitating menopause symptoms.
While insomnia is a typical symptom of menopause, it also plays an active cause-and-effect role in other menopausal conditions. Night sweats and panic attacks, for example, can contribute to insomnia. Long-term insomnia can contribute to heightened anxiety and feelings of fatigue, moodiness, and irritability. When women don't get enough rest, they can have difficulty with concentration, focus, and memory, and their overall physical and mental health can suffer.
Insomnia — a condition characterized by an inadequate amount or poor quality of sleep occurring three or more nights a week — isn't a concern just of menopausal women. As a nation, the United States appears to have entered a time of greater sleeplessness than ever before. The National Sleep Foundation (NSF) (an independent, nonprofit organization) released the results of its own national sleep survey in 2003, revealing that 71 percent of American adults between the ages of 55 and 74 report some sort of sleep problem, and most say they were able to get more sleep in the past (as little as five years earlier) than at the time of the survey.
Menopausal women are at particular risk for insomnia. In a 2006 Harris poll, women suffering from insomnia reported that this was the symptom of menopause that bothered them the most, with 72 percent of participants experiencing it frequently (at least once per week), and 59 percent losing on average three or more hours of sleep each night. The vast majority of these women, 88 percent, said they have more fatigue during the day, 62 percent said they are more irritable, and 44 percent said they cannot do their job as well.
What are the Causes of Menopausal Insomnia?
There are multiple factors of your health conditions during menopause which might cause your sleep disruption. Hormone levels, health issues, lifestyle, and situational stressors all play a role in whether you get to sleep and stay asleep. After the age of 40 (and sometimes before) you may have trouble getting or staying asleep because of:
- Declining hormone levels and minerals deficiency (like calcium and magnesium), which impact your sleep/wake cycle.
- Hot flashes and night sweats that wake you up and may require you to stay awake to recover or change bedding.
- Health issues that wake you including thyroid problems, pain, breathing difficulties or other reasons for waking or discomfort.
- Sleep apnea, which is related to both changing levels of estrogen and to weight gain – both common in menopause.
- Life stressors -- everything from ailing parents to surly teenagers, divorce, job worries, money problems, and family issues can keep you awake once you are roused in the night.
- Depression and/or anxiety that may or may not be related to any of the above.
- Diet and use of substances such as caffeine, nicotine, alcohol or supplements.
- Medications, both prescription and over the counter, with side effects that keep you awake.
- Poor “sleep hygiene” that sets you up to be awake when you want to be asleep.
What Can You Do About Insomnia?
What to do about sleepless nights depends on what is causing them. Here are some practical recommendations on increasing your chances of having a good night sleep:
- Cut out the stimulants. Stop, or greatly reduce your intake of caffeine; quit smoking (there are so many good reasons for quitting); don’t drink alcohol; cut back on chocolate; and check any supplements or diet medications to see if they have a side effect of sleep disturbance. In relation to alcohol, it may help you relax and fall asleep, but it should not be used as a sleep aid because it has a rebound effect. It can disturb your sleep later and can cause you to awaken in the middle of the night. If you cannot live without coffee, try at least not to consume it after noon. Remember that caffeine in coffee, tea, soda and chocolate disturbs your sleep patterns by flushing the body of vitamin B - the nutrient responsible for calming you down and relieving stress.
- Treat your menopause symptoms. If anxiety or night sweats are waking you, treat your symptoms. Check with your medical provider and discuss what medications or supplements might be helpful for your symptoms. Whether you use black cohosh, flaxseed oil, antidepressants or a short course of hormone therapy, there are probably choices that will ease your symptoms enough to re-establish a good sleep pattern. Hormone replacement therapy (HRT) works by supplementing estrogen hormone that is no longer being made by your body in the same way as it was before perimenopause. Estrogen reduces hot flashes, vaginal symptoms, difficulty with urination, and other symptoms, including insomnia. However, it has its own drawbacks and side effects. HRT is recommended for shortest possible term in the lowest possible dose.
- Keep your bedroom cool. You have a very sensitive hot flash threshold during menopause, so you want to keep your body as cool as you can without being uncomfortable. Anything that raises your body temperature can trip the switch, so keep your bedroom temperature a few degrees lower at night.
- Keep your bedroom dark. You want to send your brain the message that nighttime is for sleep, and light cues you to wake up and stay up.
- Moderate your body temperature to minimize night sweats. Wear light pajamas, and keep a cool rag or cold pack in a zip plastic bag next to the bed. Put the cool pack on your face and chest as soon as you notice a hot flash coming on, and do deep breathing until the flash passes. Try to stay relaxed while you do this. However, wear light socks to bed to help control core body temperature.
- Practice slow, deep breathing during the day so that when you wake with anxiety or a hot flash, you can use it immediately to calm and relax yourself.
- Practice good sleep hygiene: Go to bed at a regular time, use your bed only for sleep and sex, relax before bed, don't have a television in the bedroom, and don't eat for at least two hours before bed. Avoid napping during the daytime. Wake up and rise from the bed at the same time (even on weekends).
- Take a hot foot bath, it draws the blood away from the head, making sleep easier.
- Learn some relaxation techniques to “talk yourself down” during the night. Progressive relaxation, cognitive behavioral therapy, biofeedback or self hypnosis are all techniques that will serve you during periods of insomnia, and also at other distressing moments in your life.
- Take medications as prescribed. When you are experiencing insomnia, talk to your medical provider about the medications you are already taking. Side effects can keep you awake.
- Exercise outside during the day. The combination of natural light, vitamin D and exercise is a recipe for better sleep. Be sure to do it early in the day, both for the daylight and so that it doesn’t rev you up before bedtime. In particular, be sure to avoid vigorous exercise at least 3 hours before bedtime.
- Eat healthy. Eat healthy snacks that won’t hinder you falling asleep in the evening. Turkey, tuna, bananas, grapefruit, yogurt, milk, figs, dates and whole grain crackers with peanut butter are all high in tryptophan, an essential amino acid that promotes sleep. Try to avoid foods like cheese, bacon, sausage, tomatoes, spinach and wine close to bedtime, as these foods contain tyramine, an amino acid which raises the release of the brain stimulant norepinephrine and promotes alertness. Get adequate calcium and magnesium from leafy green vegetables, broccoli, tomatoes, citrus fruits, nuts, yogurt, whole grains and soy products to keep your muscles relaxed and functioning properly.
- Consider natural supplements and teas. Health food stores sell a number of different herbal teas that help some women fall asleep more easily. One can also try sleeping potions such as Calms Forte, Snoozers, Easy Sleep, Valerian Root, a natural sedative, all of which are sold at health food stores. Let's never forget the power of certain herbal teas, especially Chamomille and Peppermint. Contains no caffeine, is pleasant to the taste and produces relaxing effects. Melatonin is a substance that helps many older people get a better night's sleep. As we mature, our bodies do not produce as much Melatonin as they once did. The usual dose is 3 mg.
- Drink milk. Milk contains a substance called tryptophan. The body uses tryptophan to make serotonin, a chemical in the brain. Serotonin helps control sleep patterns, appetite, pain, and other functions. Milk does not contain enough tryptophan to change sleep patterns, but drinking a glass of milk before bed may help you relax.
- Consider sleep medications for brief periods. When you are experiencing insomnia, talk to your medical provider about the medications that might be prescribed for sleep. There are several types of prescriptions that help, including antidepressants, anti-anxiety medications, and sedative/hypnotic drugs. A short course might get you back into a natural sleep pattern.
- Get help if you need it. A doctor, counselor, personal trainer, acupuncturist, massage therapist, or naturopath – either alone or in combination – may have words of wisdom and help for your body that will restore your sleep cycle.
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