16 Ways to Beat Insomnia during Menopause

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:

1. 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.
2. 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. 
3. 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.
4. 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.
5. 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.
6. 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.
7. 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).
8. Take a hot foot bath, it draws the blood away from the head, making sleep easier.
9. 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.
10. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.

Sources and Additional Information:

http://www.netplaces.com/menopause/managing-cognitive-and-neurological-changes/insomnia-and-its-role-in-menopause.htm

http://menopause.about.com/od/copingwithmenopause/a/Insomnia_meno.htm

http://my.clevelandclinic.org/disorders/menopause/hic_menopause_and_insomnia.aspx

http://www.sleepfoundation.org/article/ask-the-expert/menopause-and-insomnia

http://www.power-surge.com/educate/insomnia.htm

Burning Mouth Syndrome as Symptom of Menopause

Most people can relate to the uncomfortable feeling that occurs after scalding their mouth on hot soup or coffee. It's a relief when that burnt feeling subsides after several days. But imagine experiencing that burning sensation all day, every day. The condition is called burning mouth syndrome (BMS), and damage to the nervous system during menopause may be to blame, according to an article published in the May/June 2011 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry (AGD).

Although BMS can affect both sexes, the study confirms by a 7:1 ratio that women in their menopausal and post-menopausal years are more likely to be affected by BMS.

What is Burning Mouse Syndrome?

Burning mouth syndrome causes chronic burning pain in your mouth. The pain from burning mouth syndrome may affect your tongue, gums, lips, inside of your cheeks, roof of your mouth, or widespread areas of your whole mouth. The pain can be severe, as if you scalded your mouth. Other names for burning mouth syndrome include scalded mouth syndrome, burning tongue syndrome, burning lips syndrome, glossodynia and stomatodynia.

Symptoms

Unfortunately, the cause of burning mouth syndrome often can't be determined, since it is characterized by a burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory findings. Affected patients often present with multiple oral complaints, including burning, dryness and taste alterations. Burning mouth complaints are reported more often in women, especially after menopause.

In many patients with the syndrome, pain is absent during the night but occurs at a mild to moderate level by middle to late morning. The burning may progressively increase throughout the day, reaching its greatest intensity by late afternoon and into early evening. Patients often report that the pain interferes with their ability to fall asleep. Perhaps because of sleep disturbances, constant pain, or both, patients with oral burning pain often have mood changes, including irritability, anxiety and depression. Earlier studies frequently minimized the pain of burning mouth syndrome, but more recent studies have reported that the pain ranges from moderate to severe and is similar in intensity to toothache pain.

Typically, patients awaken without pain but note increasing symptoms through the day and into the evening. Conditions that have been reported in association with burning mouth syndrome include chronic anxiety or depression, various nutritional deficiencies, type 2 diabetes (formerly known as non–insulin-dependent diabetes) and changes in salivary function. However, these conditions have not been consistently linked with the syndrome, and their treatment has had little impact on burning mouth symptoms.

Symptoms of burning mouth syndrome include:

• A burning sensation that may affect your tongue, lips, gums, palate, throat or whole mouth
• A tingling or numb sensation in your mouth or on the tip of your tongue
• Mouth pain that worsens as the day progresses
• A sensation of dry mouth
• Increased thirst
• Sore mouth
• Loss of taste
• Taste changes, such as a bitter or metallic taste

Little information is available on the natural course of burning mouth syndrome. Spontaneous partial recovery within six to seven years after onset has been reported in up to two thirds of patients, with recovery often preceded by a change from constant to episodic burning. No clinical factors predicting recovery have been noted.

Causes

"The cause of BMS is currently unknown, but our findings support the theory that this is a neuropathic condition," says lead study author Gary D. Klasser, DMD. "For reasons unknown, it seems that the BMS patient's nerves are not sending and/or processing information correctly—there's a short circuit in the nervous system and the brain can't turn off the pain receptors."

Other recent studies have pointed to dysfunction of several cranial nerves associated with taste sensation as a possible cause of burning mouth syndrome.

In general, the cause of burning mouth syndrome can be classified as either primary or secondary. When the cause of burning mouth syndrome isn't known, the condition is called primary or idiopathic burning mouth syndrome. Some research suggests that primary burning mouth syndrome is related to problems with taste and sensory nerves of the peripheral or central nervous system, and most of the menopause related conditions fall in this category. However, in some cases the triggers for the burning mouse syndrome can be found in patients’ diet, lifestyle, or medications list, so that falls in the secondary burning mouse syndrome category.

Underlying problems that may be linked to secondary burning mouth syndrome include:

• Dry mouth (xerostomia), which can be caused by various medications or health problems.
• Other oral conditions, such as oral yeast infection (thrush), oral lichen planus or geographic tongue.
• Psychological factors, such as anxiety, depression or excessive health worries.
• Nutritional deficiencies, such as lack of iron, zinc, folate (vitamin B-9), thiamin (vitamin B-1), riboflavin (vitamin B-2), pyridoxine (vitamin B-6) and cobalamin (vitamin B-12).
• Dentures. Dentures can place stress on some of the muscles and tissues of your mouth, causing mouth pain. The materials used in dentures also can irritate the tissues in your mouth.
• Nerve damage to nerves that control taste and pain in the tongue.
• Allergies or reactions to foods, food flavorings, other food additives, fragrances, dyes or other substances.
• Reflux of stomach acid (gastroesophageal reflux disease) that enters your mouth from your upper gastrointestinal tract.
• Certain medications, particularly high blood pressure medications called angiotensin-converting enzyme (ACE) inhibitors.
• Oral habits, such as tongue thrusting and teeth grinding (bruxism).
• Endocrine disorders, such as diabetes and underactive thyroid (hypothyroidism).
• Hormonal imbalances, such as those associated with menopause.
• Excessive mouth irritation, which may result from overbrushing of your tongue, overuse of mouthwashes or having too many acidic drinks.

Treatments and drugs

There’s no one sure way to treat primary burning mouth syndrome, and solid research on the most effective methods is lacking. Treatment depends on your particular signs and symptoms, as well as any underlying conditions that may be causing your mouth pain. That’s why it is important to try to pinpoint the cause. Once any underlying causes are treated, your burning mouth syndrome symptoms should get better.

If a cause can’t be found, treatment can be challenging. There is no known cure for primary burning mouth syndrome. You may need to try several treatment methods before finding one or a combination that is helpful in reducing your mouth pain. Treatment options may include:

• A lozenge-type form of the anticonvulsant medication clonazepam (Klonopin)
• Alpha-lipoic acid, a strong antioxidant produced naturally by the body
• Oral thrush medications
• Certain antidepressants
• B vitamins
• Cognitive behavioral therapy
• Specific oral rinses or mouthwashes
• Saliva replacement products
• Capsaicin, a pain reliever that comes from chili peppers

Surgery is not recommended for burning mouth syndrome.

Lifestyle and home remedies

In addition to medical treatment and prescription medications, self-help measures may help improve your symptoms. You may find these self-help measures beneficial for reducing chronic mouth pain:

• Drink more fluids, to help ease the feeling of dry mouth.
• Don’t use tobacco products.
• Minimize alcohol intake to avoid the oral tissue irritation.
• Avoid products with cinnamon or mint.
• Avoid spicy-hot foods.
• Avoid acidic foods and liquids, such as tomatoes, orange juice, soft drinks and coffee.
• Chew sugarless gum to increase saliva flow.
• Try different brands of toothpaste.
• Take steps to reduce excessive stress.

"BMS is not a matter of life or death, but it is a matter of quality of life," says Dr. Antenucci. "Patients who believe they suffer from any of these symptoms should speak with their general dentist and seek out a health practitioner who has experience with this condition."

Sources and Additional Information:

http://www.knowyourteeth.com/print/printpreview.asp?content=article&abc=t&iid=293&aid=9413&chapt=-1

http://www.aafp.org/afp/2002/0215/p615.html

http://www.mayoclinic.com/health/burning-mouth-syndrome/DS00462

http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Common-Concerns/Dry-Mouth/article/Burning-mouth-syndrome.cvsp