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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