A good night’s sleep can feel impossible on your menopause journey. Sleep disturbances are often a challenging problem for midlife women. Around 16 to 47 percent of women experience sleep disturbance during perimenopause (the transition to menopause), and 35 to 60 percent do after menopause.
Anyone must maintain a reliable, restful sleep schedule for energy levels, mood, and physical and mental health. However, during the menopausal transition, it can also support your bones, muscles, and heart, and help reduce the impact of symptoms like low mood, irritability, and brain fog on your daily life.
Why Do Women Have Sleep Issues During Menopause?
The cause can differ between individuals, and sometimes the cause may be hormonal changes related to menopause. For others, it could be midlife stresses such as anxiety over work, children, aging parents, or relationship issues. Hot flashes can also cause sleepless nights.
Fluctuating levels of estrogen and progesterone that occur during perimenopause and menopause can cause hot flashes in up to 80 percent of women. When these occur, they can cause night sweats, which can disrupt sleep. Some women even have to change their clothes or bed linens.
This causes an inability to obtain adequate deep sleep, and conditions such as loss of bladder control, joint pain, and depression, as well as alcohol and certain medications, can contribute to inadequate sleep. If you already have insomnia, the menopause transition can make it even worse. If menopause symptoms continually keep you up at night, make an appointment to see your doctor.
Consider Hormone Replacement Therapy (HRT)
Hormone replacement therapy (HRT) remains the most effective option for treating moderate to severe hot flashes and other menopause symptoms. While there has been some concern about the safety of HRT in the past, the benefits of hormone therapy use generally outweigh risks for otherwise healthy women with disruptive menopause symptoms who are under 60 years of age or within 10 years of the start of menopause.
But HRT may not be for everyone, and women who are at high risk for breast cancer or have a history of heart disease, stroke, and blood clots should talk to their doctor about whether HRT is right for them. Alternatives, such as low-dose antidepressants, can reduce the severity of hot flashes.
Move Your Body During the Day
People who have a regular exercise routine tend to be better sleepers, so if you’re not elevating your heart rate during the day, that may be another contributing factor to your difficulty sleeping. Exercise interventions, such as walking, yoga, and aerobic exercise, significantly reduced the severity of insomnia and alleviated sleep problems in menopausal women. The timing of your exercise is important; however, avoiding exercise within two to three hours of your bedtime, as it can also interfere with rest.
Sip Selectively
Caffeine, found in coffee, colas, tea, and chocolate, is a stimulant that can take as long as 10 hours to completely leave your system. Besides keeping you awake, caffeine may trigger hot flashes in some women by increasing their heart rate and causing blood vessels to expand. It’s best to avoid caffeine altogether if you are struggling with insomnia or night sweats that repeatedly wake you up.
But if you must have it, consume caffeine early in the day. Tea can be a soothing drink before bed, but it’s important to check which varieties contain caffeine. However, green tea is very good for your health, but it does have some natural caffeine in it. Skip the alcohol before bed, too. It’s another possible hot flash trigger.
Keep Cool
To ward off hot flashes and night sweats, keep your bedroom temperature comfortable and low. Loose-fitting sleepwear can also help to keep you cool, and taking a lukewarm shower before bedtime might help. Choose breathable cotton sleepwear, whether you prefer pajamas or a nightgown, and choose cotton sheets over synthetic materials.
Try Relaxation Techniques
If anxiety during menopause is keeping you awake at night, relaxation techniques such as meditation, yoga, or deep breathing can help you to de-stress. The good news is that there are so many apps available now that make practicing these techniques very accessible. If you wake up because of hot flashes (or for another reason), lying awake in bed isn’t likely to help you fall asleep again.
Give it about 20 minutes, then get out of bed and do something relaxing or move into another room, get a change of scenery, and read a book or do something quietly until you start feeling sleepy, then go back to bed.
Stick to a Schedule
You may be tempted to stay up late during the week and then catch up on rest over the weekend, but sticking to the same schedule every night is more conducive to getting quality sleep. That means going to bed and waking up at about the same time every day. It’s also helpful to develop sleep rituals, such as reading, meditating, or listening to soft music before bed.
See a Specialist
Chronic insomnia can contribute to heart disease, high blood pressure, and other lasting medical conditions. It also impacts job performance, your safety, and your overall quality of life. If you’ve been struggling with insomnia for three months or more, it’s probably time to talk to your doctor about it. Then, hopefully, you can get a referral for a qualified sleep medicine professional to figure out why that might be happening.
Sleep disturbances are a common part of the menopause transition due to hormonal changes, night sweats, and the stress of midlife. Establishing a consistent sleep schedule and regular daytime exercise can significantly improve sleep quality and help you relieve insomnia. Avoiding stimulants like caffeine and alcohol, especially later in the day, may help reduce hot flashes and night sweats, preventing disruptions to your sleep cycle.
If you’ve had chronic insomnia for three months or more, speak to a healthcare professional to discuss treatments such as hormone therapy or get a referral to a sleep specialist.
