At any age, women are more prone to experience insomnia than men.
Under 45 years of age women experience insomnia more frequently than men of the same age but, as women grow older, it’s even more likely. Some women experience insomnia due to hormonal fluctuations during menstruation, pregnancy, and menopause.
How menopausal hormone changes affect sleep
During perimenopause and menopause women experience hormonal changes, and this can have an effect on sleep. For instance, oestrogen and progesterone production decreases, starting in perimenopause. Oestrogen affects emotional well being, while progesterone helps to promote sleep. When you decrease production of these hormones, it is more difficult to get to sleep and to stay asleep, and more difficult to deal with the emotional stress of lifestyle and physical changes.
Overall, menopausal women tend to take longer to get to sleep, and have a lower quality of sleep when they do. Although hormone replacement therapy can improve sleep difficulties, it is no longer a common practice.
Hot flushes and sleep quality
Other changes in menopause include hot flushes, with three out of four women experiencing them. With hot flushes, you experience a higher body temperature and night sweats. This can make it difficult to cool down, fall asleep, and stay asleep.
In addition, as you age other factors may interfere with your ability to sleep through the night, such as incontinence and reduced bladder control.
What you can do to sleep well during menopause
With hormonal sleep difficulties and hot flushes, it’s not surprising it can be a challenge to get enough sleep. While you can’t stop hot flushes or hormonal fluctuations, you do have other options.
Start with good sleep hygiene
If your sleep habits were bad going into menopause, they certainly aren’t going to get better if you don’t make some changes. Practice good sleep hygiene, maintaining a regular sleep and wake schedule, practicing a regular bedtime routine, and avoiding steep pitfalls such as caffeine and screens before bed.
Create a cool sleeping environment
Turn the temperature down in your home and consider a fan for your bedroom, or even just on your side of the bed.
Consider switching to a mattress that can help regulate your temperature, such as a firm innerspring mattress or airbed. Wear breathable pyjamas, and use minimal, cool, and breathable bedding, such as a cotton sheet set without the use of a comforter. It can help to keep cool-down items next to your bed, including an extra pillow and pyjamas. These are useful if you sweat through your pillow and pyjamas at night.
A cool glass of water and a washcloth in a bucket of ice can be refreshing as well.
Try relaxation exercises
Some people are able to relieve insomnia with meditation, acupuncture or breathing exercises. A white noise machine or smart phone app can help you manage stress and feel more restful.
Be sure to get exercise throughout the week. Exercise can improve your mood and make your body more tired, so it’s easier to fall asleep at night. However, you should avoid exercising just before bed, instead doing some at least a few hours beforehand. Exercising too late in the day can make it difficult to fall asleep and can raise your body temperature.
Pay attention to what you eat before bed
Stay away from alcohol, caffeine and other stimulants before bed, as they can interfere with falling asleep and even trigger hot flashes. You should aim to eat dinner two to four hours before bed.
Address sleep disorders and talk to your doctor about treatment options
If you have existing untreated sleep disorders, such as sleep apnea, be sure to talk to your doctor about how they can be treated. For women who continue to experience poor sleep that affects quality of life during menopause, doctors may recommend hormone replacement therapy, combination birth control pills, or low-dose antidepressants.