Treatment Of Menopausal Insomnia Using Melatonin
In humans, the circadian rhythm of melatonin release from the pineal gland is highly synchronized with the habitual hours of sleep . The daily onset of melatonin secretion is well correlated with the onset of the steepest increase in nocturnal sleepiness . Endogenous secretion of melatonin decreases with aging across genders , and, among women, menopause is associated with a significant reduction of melatonin levels . Exogenous melatonin reportedly induces drowsiness and sleep, and may ameliorate sleep disturbances, including the nocturnal awakenings associated with old age .
How To Get Better Sleep During Menopause
Many women experience sleep disturbances during and after menopause, as well as in the preceding years . We ask the experts about how to treat these issues to improve sleep and boost health and well-being.
Reviewed byDr Sarah Jarvis MBE
21-Jun-21·8 mins read
In 2016, research conducted on behalf of the British Menopause Society revealed that 42% of women surveyed had unexpected menopausal symptoms that were worse or much worse than expected. One of these was sleep disturbance. More than 70% experienced night sweats that disrupted their sleep. Other studies suggest that up to 63% of women will experience insomnia or other sleep problems at menopause. A multi-ethnic study in the USA found that difficulty staying asleep was the most prevalent problem, with sleep maintenance and early morning wakening worsening significantly through late perimenopause.
Investing In Cool And Comfortable Bedding
Certain mattress types like latex mattresses, innerspring and hybrid beds featuring layers of gel-infused foams are better at regulating heat than those mattresses made entirely of memory foam known for retaining body heat. Women in menopause should consider getting one such bed with special cooling features which will help them stay cool and sleep well throughout the whole night.
Besides mattresses, there are cooling pillows as well and special sheets made of breathable linen or cotton that can help women in menopause deal easier with hot flashes and sweating that follows them.;
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Preexisting Mental Health Issues
Women who are diagnosed with clinical depression, heightened anxiety , or other mental health issues can have an even higher rate of insomnia as they go through menopause. Again, since the chemicals in the brain responsible for these emotions are imbalanced, they disrupt the production and regulation of progesterone and disrupt sleep patterns.;
A large number of women find that insomnia is especially prevalent if they have been diagnosed with anxiety-based mental health issues. Coupled with menopause, this condition can become worse and increase the number of symptoms of insomnia that may not have been present prior to menopause.;
What Menopausal Women Eat Could Have An Impact On Their Risk Of Developing Insomnia
Researchers recently looked at detailed dietary data from over 50,000 postmenopausal women enrolled in the Womens Health Initiative study between 1994 and 2001. Carbohydrate intake was measured in several ways: glycemic index and glycemic load , measures of added sugars, starch, total carbohydrate, and dietary fiber, and specific carbohydrate-containing foods such as whole grains, processed or refined grains, whole fruits, vegetables, and dairy products. They then looked at each participants risk of developing insomnia after three years of follow-up.
They found that the risk of developing insomnia was greater in women with a higher-GI diet, as well as in women who included more added sugars in their diet. Added sugars included white and brown sugar, syrups, honey, and molasses. The risk of developing insomnia was lower in women who ate more whole fruits and vegetables.
The researchers accounted for and adjusted for many potentially confounding factors, including demographic , behavioral , psychosocial , and medical factors .
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What Is Menopause And What Are Its Symptoms
Menopause comes with ages and women officially reach it once 12 months have passed since their last menstrual period. But, before menopause occurs, women go through a period known as perimenopause which can last anywhere from 3 to 10 years. Perimenopausal symptoms usually start in the mid 40s and can continue through the early 50s.
During perimenopause, ovaries produce lower amounts of key hormones than they used to produce before, including estrogen and progesterone, and as the levels of these hormones fall, symptoms of menopause worsen. Women experience a wide range of symptoms and one of the most common symptoms is insomnia.
Other symptoms include:
- Reduced sex drive
Create A Room Thats Suited For Sleep
Oftentimes, the room youre trying to get some shut-eye in is interfering with your ability to do just that. Three main components of a bedroom can affect your sleep.
This includes temperature, light, and noise. You can address this by:
- Keeping your bedroom temp as cool as you can handle. A solid recommendation is around 65°F . Cooler rooms make you more likely to hibernate well.
- Shutting off any lights. This includes alarm clocks and cell phones. The buzzing and blinking lights of a cell phone can alert your brain even when youre asleep, and youll be waking up at odd hours without any clear explanation.
- Stopping any unnecessary sounds. Turning off the radio, removing ticking clocks, and shutting down appliances before you tuck in can help lull you into a good nights sleep.
- Consider trying products designed for better sleep. These products can support you in getting adequate quality sleep.
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Improve Sleep Hygiene During The Menopause
Good sleep hygiene is crucial for encouraging restful sleep. Before trying anything else, menopausal women should follow these steps:
- Establish a bedtime routine This may involve taking a bath, doing stretches, reading a book or journaling
- Try not to nap during the day
- Try to establish a regular sleeping pattern but do not fight sleep
- Sip water throughout the day to prevent dehydration and nocturia
- Reserve the bedroom for sleeping only watch TV, read and work in a separate room
- Make sure the bedroom is dark enough consider blackout curtains
- Ensure adequate exposure to natural light during the daytime
- Try not to use electronic devices after 8 pm. If this is not possible, install a blue-light filter on all electronics and activate it at least 3 hours before bedtime
- Eat light, healthy meals throughout the day and try not to snack before bedtime
- Wear loose-fitting night clothes and choose comfortable bedding
Whats the Evidence?
Numerous studies have shown that self-help management for insomnia is highly effective when done consistently. Although menopausal women may not receive immediate relief by implementing these tips, a consistent approach is likely to reap many health-related benefits.
The Skinny On Life During Menopause Besides Insomnia
As you probably already know, menopause occurs when our body decides to cease the baby-making process. It typically happens between 40 and 60 years old. Youve officially hit menopause when youve had 12 consecutive months without a period. Its a roller coaster, and admittedly, not the most fun one youll ride in your life. There are many symptoms that come along with menopause, including hot flashes, vaginal dryness, and irregular periods. Youre probably irritable, ready to bite the head off of your closest friend or family member. Plus sessions in the sack can be a little painful, uncomfortable, and lackluster. And on top of it all, you cant even sleep it off. You may find yourself awake half the night and struggling to sleep for the rest of it.
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Why Does Menopause Cause Sleep Problems
The menopause brings with it many unwelcomed physical and psychological changes. One of the most common complaints is sleep problems, with 60 per cent of menopausal women experiencing insomnia and fragmented rest at this time . A host of different factors are known to trigger sleep disruptions from night sweats to increased anxiety but usually, hormonal changes are at the root cause.
Can Menopause Cause Insomnia Know The Connection Between These Two Conditions
A lot of women face insomnia during menopause, know the cause and relation between these two conditions.
There are certain stages when our body starts reacting differently because of changes going on in the body. Most of them are hormonal changes that affect the conditions and functioning of different organs. Women face similar issue once when their menstruation period starts and once when it ends. Then stage when menstruation period ends is called menopause. This is the time when women no longer produces eggs in the ovaries and hormones affect the body in such a way that is can also cause insomnia. Today let us understand the relation of menopause and insomnia and how does it affect your body with the help of a gynaecologist.;
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Treatment Of Menopausal Insomnia Using Hypnotics
One four week study has shown improvement in sleep quality, sleep duration and greater reduction in insomnia specific daytime symptoms with the use of zolpidem 10mg/night as compared to placeo in perimenopausal and post-menopausal women . Similar results have been found with the eszopiclone 3mg/night in another study .
Creating A Soothing Bedtime Routine
A warm bath right before bedtime or drinking a cup of hot tea or a glass of milk can stimulate falling sleep faster. In addition, meditation or deep breathing exercises can also help eliminate stressful or worrisome thoughts that keep them up at night and help them fall asleep easier and stay asleep.
What Treatments Are Available
As is the case with most menopausal issues, many treatments involve Hormone Replacement Therapy . In cases where hormone treatments are not ideal in a particular case, there are non-hormonal medications, and alternative ways to potentially treat menopause-related sleep problems.
- ;Hormone Replacement Therapy: There are several types of hormone therapies available to women. They include bioidentical hormones, synthetic hormones and combinations of the aforementioned. Bioidentical hormones are biologically identical to the hormones women produce in their ovaries: estrogen, progesterone, and testosterone. Hormone replacement therapy can alleviate symptoms by providing the body with adequate hormones for the body to function well.
- Nonhormonal Medication: A doctor may also recommend non-hormonal medications to treat symptoms in lieu of hormone replacement therapy.
- Antidepressants can not only treat depression and mental health issues caused by menopause, but also vasomotor symptoms like hot flashes.
- Brisdelle is medication containing a very low dose of paroxetine, which is branded as Paxil, and is approved only for the treatment of night sweats and hot flashes. The dose is too low to effectively treat depression.
- Gabapentin can decrease the frequency and intensity of hot flashes and night sweats.
- Clonidine is a hypertension medication that may help with vasomotor symptoms but usually not as effectively as the medications mentioned above.
Tips For Improving Sleep Long Term
- Go to bed and get up at a regular time. Routine is very important for establishing a good sleep pattern. Establishing and sticking to set times may take a few weeks so bear that in mind
- Ideally avoid having a nap in the day. If you do, make it no more than 30-40 minutes in the early afternoon
- Exercise regularly but dont overdo it within two hours of going to bed
- Get to know what sleep you need. The average is 6-8 hours but this does vary for individuals and reduces as you age
- Other factors can of course interfere with sleep including physical symptoms, other than those associated with the menopause. If you are taking medication for other reasons ensure you take them at the time of day they are prescribed for.
Before going to bed:
- Get yourself into a routine, perhaps have a warm bath or do some light reading
- Avoid going to bed when youre too hungry or too full. A light snack is OK
- Have your last caffeine drink in the late afternoon/evening, including any fizzy drinksor chocolate
- Alcohol does not help you to sleep so best avoided if you can.
- Ensure your bedroom has a restful feel. Ideally the room should be cool but not coldand screen out as much noise and light as is practical for you
- Get comfy! Good bedding and a good mattress are essentials
- Use your bedroom just for sleep and sex!
- Avoid watching TV in bed or using your laptop and/or phone.
If you wake up in the night:
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How Many Stages Does The Menopause Have
It has 3 stages
Hot Flashes And Night Sweats
Hot flashes are a characteristic symptom of menopause. Its the sudden rush of heat taking over your body, leading to flushing of the skin and excessive sweating. Hot flashes can occur at any time of the day, and there isnt an exact reason for what causes this sudden symptom. Still, research suggests hot flashes are related to the changes in hormone levels, which may cause the body to become more sensitive to slight changes in temperature.
Night sweats occur when your temperature dramatically increases while youre sleeping, causing flushing and excessive sweating. This can be enough to jolt you awake. Because of the rush of heat, you may feel anxious or more alert, making it difficult for you to fall back asleep.
Insomnia During Menopause: Whyyyyy
With everything youve got going on, it can already be hard to sleep during midlife. But it gets even harder when menopause joins the party. More than half of all women going through menopause have trouble falling and staying asleep. Outside of lifes everyday challenges, there are many changes happening in your body that may be responsible for keeping you awake. Lets take a deeper look at the reasons you may be up all night.
Can The Menopause Cause Snoring
During this time, you may also develop a sleep disorder, like obstructive sleep apnoea, which can further disrupt your sleep . Its not uncommon to gain weight after menopause, often resulting in larger neck circumference. Due to these changes to the upper airway, your breathing patterns may change while you sleep, and this can lead to snoring.The apnoea in sleep apnoea refers to a breathing pause that lasts around ten seconds . This pause alerts the brain and rouses you from sleep, causing decreased overall sleep quality.
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Theres Hope For Sleepless Nights
Well, thats a long list of insomnia-causing ailments. But its important information all of us savvy women entering menopause. Luckily for those of us dealing with menopause-induced insomnia, there are some things that can help. For starters, practice good sleep hygiene by keeping the room dark and cool and staying off your phone at least an hour before bed. Write down all the things that have been bothering you before you go to sleep to help mitigate any anxiety. Cooling, moisture-wicking blankets and sheets wouldnt hurt either, and can help you stay cool and dry when you get night sweats. Dont rely on sleeping medication to help you through the night, you dont want to get addicted to a temporary solution. If things are really piling up, it may be time to see a doctor.
Yes, its true, the menopausal transition is a difficult time, but it doesnt have to slow you down or keep you from the things you love. The hot flashes and sleepless nights are temporary while your body adjusts. Youll be much more comfortable, and rested, on the other side.
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Genitourinary Syndromes Of Menopause
A 2015 study revealed that 45%-63% of menopausal women experienced bladder and vaginal symptoms including nocturia , soreness and irritation, and dyspareunia . The decline in oestrogen leads to atrophic changes of the delicate tissues in the bladder and vagina, which can cause sleep disturbance.
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Does Sleep Return To Normal After Menopause
In the postmenopause stage , your ovaries no longer produce the sleep-enhancing hormone, progesterone, but continue to produce oestrogen albeit at low levels.With the calming of hormonal irregularity, most sleep problems and insomnia eventually improve. However, postmenopause is different for every woman, and for some, insomnia may continue for a while .Since quality rest is vital to maintaining your overall health, sleep problems can be hugely debilitating. A lack of sleep can make you feel anxious, depressed and irritable, affect your productivity, lead to forgetfulness, and deplete your energy levels.If you would like to find out more information on sleep health and how to improve it, we highly recommend visiting our sleep hub. You can also learn more about natural remedies for overcoming menopausal insomnia here.
Exercise Therapy For Menopausal Insomnia
Moderate exercise is the primary treatment for menopausal insomnia. Firstly, for women who live a sedentary lifestyle, moderate exercise will tire them out and create an additional need for sleep. Also, exercise can treat menopausal insomnia indirectly by helping to balance hormones.
It should be mentioned that intensive exercise is not recommended for menopausal women. Intensive exercise increases cortisol levels which can cause further damage to the delicate balance of hormones in the body. Active women are encouraged to exercise in the morning, as this will ensure their cortisol levels have returned to normal by bedtime.
Whats the Evidence?
Clinical research demonstrates that moderate exercise is useful for alleviating almost every symptom of menopause. According to the Journal for the North American Menopause Society, gentle exercise such as Yoga is excellent for reducing sleep disturbances in menopausal women. Moreover, yoga is a manageable exercise therapy that most women can practice daily. As such, yoga is likely to provide menopausal women with a long-term solution.
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