Insomnia and Sleep Problems

As a woman nears menopause, her ovaries stop producing the hormones estrogen and progesterone. The decrease in these hormones may bring an onset of new symptoms, including hot flashes (a sudden feeling of warmth that spreads over the body) and night sweats. As your body’s temperature begins to rise during sleep, you wake up. By the time the hot flash has passed, you’ve been up for several uncomfortable and sweaty minutes. Many women find returning to sleep afterwards to be difficult.

The National Sleep Foundation suggests that more than half of menopausal women will have sleep problems as a result of hot flashes and sweating. Lack of sleep at night can potentially lead to other problems, including daytime drowsiness, fatigue, and mood swings.

Causes of Sleep Problems

In addition to hot flashes and sweating, women in perimenopause and menopause may also experience sleep problems as a result of depression, anxiety, or mood disorders. If you’re facing extra emotional stress, the mental toll may be preventing you from sleeping. Any sleep you do get may be restless, as your mind hasn’t been able to free itself from the worries and anxieties you face during the day. In addition, physical conditions such as sleep apnea, restless leg syndrome, and insomnia can contribute to sleep problems during menopause.

Treatment Options

Your doctor may recommend a few lifestyle changes that can reduce the frequency of hot flashes or make sleeping through them possible.

Eat well and get plenty of exercise.

It’s imperative that you eat regular, balanced meals and exercise daily to help prevent hot flashes. Eating or exercising too close to bedtime can interrupt your body’s natural clock and may inhibit sleeping.

Wear loose-fitting clothing to bed.

Sleep in clothes made from natural fibers, such as cotton, which allow the body to breathe more easily. The fabric will wick moisture off your skin.

Use cotton sheets.

The fabric stays cooler against your skin, and it keeps heat from building up around you, which may cause sweating.

Keep your bedroom cool.

A cool room is more conducive to sleep than a warm one. Keep ceiling fans or standing fans running to circulate air.

Avoid spicy foods.

Any foods, spicy or not, that cause you to sweat may cause sleep disturbances if you eat them in the hours leading up to bedtime.

Avoid nicotine, caffeine, and alcohol.

If you drink soda or coffee or smoke too close to bedtime, your body won’t be able to shut down the natural boost of energy that nicotine and caffeine give it. A glass of wine before bed may help you to fall asleep, but it interferes with your natural sleep cycle. While you may go to sleep more easily after drinking some wine, you’re more likely to wake up earlier than normal and feel less rested.

Relax whenever possible.

Emotional stress can heighten sensitivity to temperature changes, which may bring on hot flashes and sweating. Try relaxation techniques such as yoga, exercise, and massage to help your body naturally cope with stress or anxiety that you may be facing.

If these lifestyle treatments bring you no relief, your doctor may suggest hormone replacement therapy (HRT). Estrogen replacement is most commonly administered through a pill, a patch, or a vaginal cream. In some cases, the estrogen is combined with progesterone, but studies have pointed to potential increased rates of breast cancer, heart disease, blood clots, and stroke in people who took combined estrogen-progesterone HRT over an extended period of time. (Estrogen alone did not show this increase in breast cancer or heart disease, but it did show an increase in blood clots and stroke.) Therefore, most doctors begin HRT with the lowest possible dose, and they try to keep patients on HRT for as short a time as possible.