Menopause is not the end of life. In fact, it’s a beginning of a new stage of life with freedoms and joys that previous generations of women didn’t have. We have more wisdom and life experience than ever, and we have an independence to pursue our dreams, which we had to delay during our 20s, 30s, and 40s.
Still, menopause does have symptoms, and some symptoms can be uncomfortable. The range can be mild to moderate or severe, and some women experience no symptoms at all. But one symptom can be very concerning: difficulty sleeping.
Sleep problems associated with menopause affect up to 50% of women. Some women can experience very debilitating insomnia, especially during the perimenopausal years. Even women who have slept well their entire lives may find their sleep disrupted around the mid-to-late-40s. This can be an early sign of perimenopause. The disruptions may happen spontaneously or as a result of night sweats or hot flashes.
Even though our hormones are changing, we still need restful sleep for our overall well-being. It is necessary for our moods and brain health. Insomnia exacerbates things like stress, memory loss, depression, and other physical symptoms that are common in menopause.
Let’s take a deeper look at what causes sleep disruptions during menopause and some natural strategies to help you get a good night’s sleep.
What causes sleep disruptions during menopause?
The hormonal changes during perimenopause are responsible for sleep disruptions. Both estrogen and progesterone play a role in restful sleep, so the declining levels that occur during menopause can result in insomnia and other disruptions. Lower estrogen levels are also associated with hot flashes and night sweats. Depression and anxiety can cause sleep disruptions as well like difficulty falling asleep and frequent night waking.
In addition, melatonin declines with age. It’s produced from serotonin, which is dependent on adequate estrogen levels. The lower estrogen levels can lower your melatonin levels. It can be further depleted in the setting of stress. So, you face several obstacles for restorative sleep.
How poor sleep affects you
Poor sleep can have a negative effect on your health including:
- Decreased sense of well-being and quality of life
- Increased risk of accidents, for example, car accidents are more common in people with impaired sleep
- Higher systolic blood pressure
- Increased anxiety and depression
- Headaches
- Weight gain
- Cognitive issues including forgetfulness, decreased focus, and memory
You should also take an inventory of certain issues in your life like stress, alcohol, recreational, OTC, and prescription medications can all cause sleep problems. Underlying medical issues including chronic pain, fibromyalgia, anxiety, depression, restless leg syndrome, reflux, thyroid problems, arthritis, sleep apnea, congestive heart failure, and more, can also cause or contribute to insomnia. Talk to your doctor if any of these persist or cause a significant disruption in your life.
A natural approach to better sleep in menopause
Changes to your hormones are a normal part of life and not something to fix with hormone replacement therapy (HRT). Still, dealing with erratic hormones can cause issues in your daily life. There are gentle approaches you can take to support your body and symptoms in this transition with herbs, supplements, and lifestyle approaches. Sleep is one of those areas that you can improve if you pay attention and support your environment.
Lifestyle support for better sleep in menopause
Changes to your lifestyle represent the best approach for restful sleep. Make sleep a priority and follow the following key steps:
Integrate an evening wind-down
Good sleep starts in the hours before bed. You need to make it a priority and a daily lifestyle ritual. Simple things like turning the lights down low, making time for self-care like a soothing bath, keeping a sleep journal to write your worries away, and staying off devices at least one hour before bed can help with better sleep.
No alcohol
Alcohol disrupts your sleep. Even a modest amount up to an hour before bedtime can reduce melatonin production by nearly 20% and trigger hot flashes. Alcohol can make you feel depressed and is a breast cancer risk factor.
Red wine is the worst culprit. If you do have a drink, have vodka. It’s cleaner and while it still causes many women some symptoms, it’s better tolerated than other alcohol. Keep it to one drink and no simple or added sugar.
Strategize ahead if you have night sweats
Keep your bedroom temperature no higher than 67 degrees F at night – it’s the ideal sleeping temperature that encourages the best sleep for most of us. Also wear only light cotton sleepwear, and have blankets you can kick off or pull on easily as your temperature varies through the night from hot flash to night sweat.
Herbs and supplements for better sleep in menopause
Several herbs and supplements have been shown to be supportive of good sleep – without the risks of pharmaceuticals. In addition to those mentioned here for general sleep support, the following herbs and supplements have been specifically studied in menopause or for menopausal-specific application.
Melatonin
As mentioned above, your melatonin levels decline slightly as you get older – for some women, enough to interfere with sleep. Studies have shown that melatonin supplementation may postpone endocrine aging in women aged 40 to 60 in the menopausal transition causes hot flashes and night sweats.
5-HTP
Numerous studies have pointed to the beneficial 5-hydroxytryptophan (5-HTP) on sleep, A precursor to the neurotransmitter serotonin, important for sleep duration and quality, on sleep, 5-HTP has been shown to both decrease the time required to fall asleep as well as reduce the number of nighttime awakenings. Taking 5-HTP will raise serotonin levels, an important initiator of sleep.
Calcium and magnesium
A combination of calcium and magnesium, or magnesium alone can promote relaxation and sleep, improve sleep quality, and reduce anxiety. It can also help prevent bone loss associated with perimenopause. Magnesium may also help if restless leg syndrome or muscle cramps interfere with your sleep.
Hops
Hops decrease hot flashes and promote sleep. Hops contain a group of nonsteroidal phytoestrogens called prenylflavonoids. In one randomized, double-blind, placebo-controlled study, 67 menopausal women were given either a placebo or a 100 mcg or 250 mcg standardized hops extract for 12 weeks. At 6 weeks, the 100-mcg dose was significantly superior to placebo. There was a more rapid decrease in menopause symptoms scored for both doses of hop extract, especially the hot flash score.
Ashwagandha
Ashwagandha is an herb with roots in traditional Ayurvedic medicine, used to nurture and clear the mind, calm and strengthen the nerves, promote a sound and restful sleep. It’s also particularly helpful if you’re also experiencing stress and anxiety, including if you’re finding it difficult to cope with insomnia.
Valerian, lemon balm, and passionflower
Valerian has long been used by herbalists for sleep, and it helps with perimenopausal insomnia. Improvement may be immediate and more significant after 1 month of use. Its benefits may be even greater when used in combination with either lemon balm, another traditional herb for sleep as well as anxiety, or combined with passionflower and hops, also classic sleep herbs. A study of 100 women aged 50-60 years found statistically significant improvements in sleep quality when valerian was combined with lemon balm compared to a placebo group.
One study looked at the effects of passionflower when it was combined with hops and valerian and found it comparable to Ambien, without the risks or side effects. Passionflower promotes sleep and improves sleep quality, and helps you feel more rested when you wake; also useful for anxiety.
HRT for severe sleep problems
If herbs, supplements, and lifestyle changes don’t help restore your sleep rhythm, you may want to consider HRT. When sleep disruptions occur for too long, it will take a toll on your physical and emotional well-being. It may be helpful and act as a bridge to natural approaches. Start with the lowest dose possible and pay attention to when it can be eventually removed. Your doctor can help you with this. Look to underlying causes in addition to hormone imbalances, to make sure you’re covering all the bases for your total best health.