Menopause is the time in a woman’s life when menstruation stops and she can no longer become pregnant. During this time, the ovaries stop making eggs and produce less of the hormones estrogen and progesterone. This natural event is usually experienced between the ages of 45 and 55. However, sometimes women begin to experience the symptoms of peri-menopause, or the transition into menopause, in their 30s.
One of the likely side effects of menopause is disturbed sleep or insomnia. Insomnia is the inability to fall asleep or stay asleep at night.
Experiencing chronic insomnia during menopause is common due to hormonal fluctuations that commonly occur. The lower levels of estrogen can make a woman more susceptible to stressors which cause sleep disturbances. The magnitude of the hormonal changes can wreak havoc on your emotional and physical state and cause disruptions in the sleep cycle. Insomnia symptoms can go from temporary to severe during the progression of menopause.
Some of the symptoms of insomnia include:
- Difficulty falling asleep or staying asleep
- Frequently waking up at night and trouble falling asleep again
- Waking up too early in the morning
- Restless sleep leading to excessive daytime fatigue
Sleep Disturbances and Hormone Changes
A woman experiences marked hormone alterations during the period of her life that includes peri-menopause, menopause and post-menopause. The ups and downs of progesterone and estrogen levels can throw off the entire body’s chemistry which affects daily life, including sleep. The drop in estrogen can make you more vulnerable to stress, and progesterone, which is known to promote sleep, also levels off.
Menopausal insomnia can worsen with any of the following symptoms:
- Irregular menstrual cycles which eventually stop.
- Hot flashes. Up to 85 percent of menopausal women experience this rush of adrenaline which increases body temperature and can wake you up.
- Night sweats caused by hot flashes.
- Mood swings, anxiety and irritability. About 1 in 5 women will experience depression during menopause.
- Loss of libido and vaginal dryness.
- Changes in diet or exercise.
Making the problem worse is the fact that the less sleep you get, the more pronounced the symptoms of menopause become, such as intense moodiness and fatigue.
Menopausal Insomnia Symptoms
During the menopausal transition, known as peri-menopause, a woman begins to have irregular periods. During this time, estrogen levels begin to decline and a woman begins to experience the symptoms of menopause. Symptoms such as hot flashes, night sweats or anxiety can disturb your sleep and you can experience temporary insomnia.
Once periods have stopped for 12 full months, you have reached menopause. Insomnia usually doesn’t end during post-menopause, however. Insomnia can be symptomatic of more serious sleep disorders, as well.
Statistics have shown that sleep disorders such as restless leg syndrome and sleep apnea are developed by post-menopausal women more frequently than in any other time of a woman’s life. Research has suggested that women going through menopause are eight times more likely to develop sleep apnea.
Aging is also a factor in post-menopausal insomnia, as the elderly account for a group with a high rate of insomnia. The elderly may be more prone to insomnia due to the medications they take, changes in social situations or increased anxiety or depression.
Treatment for Insomnia Caused by Menopause
Often, your doctor will treat the root problem causing the insomnia, which, in this case, is menopause. While you can control your sleep habits and practice better sleep hygiene, your hormones are out of your control without medication. One successful route to treating menopause-related insomnia is through hormone replacement therapy. This treatment can drastically reduce the symptoms of menopause and alleviate insomnia. By supplementing estrogen or progesterone that is no longer made by the ovaries at the same levels as before, symptoms such as hot flashes, vaginal dryness and urination difficulty are reduced. In most cases, this is a short-term regimen which is performed with the lowest possible dose, which may include taking birth control pills.
Not every woman is a candidate for hormone replacement therapy. Those who are not recommended to take supplemental estrogen or progesterone include women who have:
- Active or past breast cancer
- Active or recurrent endometrial cancer
- History of stroke
- Active or recurrent blood clots
- Liver disease
- Known or suspected pregnancy
- Abnormal vaginal bleeding
There are also some side effects of hormone replacement therapy, such as monthly bleeding, irregular spotting and breast tenderness. Less common side effects include blood clots, fluid retention, headaches, dizziness, or skin discoloration and irritation.
Be aware that hormone replacement therapy does come with some risks, such as a higher incidence of endometrial cancer, blood clots, stroke, breast cancer and heart disease. Talk to your doctor if you have questions or concerns about hormone replacement therapy.
Menopause and Sleep Hygiene
Your doctor may also encourage you to practice better sleep hygiene or improve your diet plan and exercise routine. Some of the ways you can improve your sleep routine include:
- Set a sleep/wake cycle and stick to it every day, including weekends.
- Limit or eliminate use of stimulants, such as caffeine or nicotine, especially after noon.
- Avoid alcohol several hours before bedtime. This may help you fall asleep initially, but it can disrupt sleep as the body metabolizes the alcohol.
- Set a relaxing bedtime routine.
- Avoid naps that last longer than 20 minutes.
- Associate your bedroom with sleep and try not to read, watch TV, listen to music or eat in bed.
- Make sure you have a pleasant and relaxing bedroom at an adequate temperature.
For more information about the connection between menopause and insomnia, call The Los Angeles Sleep Study Institute at 1-855-690-0563.