How Does Menopause Affect Sleep?

Any woman who’s been through menopause will understand what a challenging and turbulent period it can be. Rather cruelly, menopausal transition usually coincides with a host of other life events, too. You may be caught up in taking care of your elderly parents or relatives, supporting your children through the early stages of adulthood, or taking on more responsibilities within your career.

If you’re going through menopause, you may also be finding it difficult to get to sleep. Wondering why this is? Read on, as we address how the symptoms of menopause can often cause insomnia, along with some suggestions for treatment.

What is menopause?

Menopause is a normal part of ageing for women that usually occurs between the ages of 45 and 55, and is officially reached when you haven’t had a period for 12 months. The menopausal transition period (perimenopause) can last anywhere from 7 to 14 years, during which, you’re likely to experience:

• Changes in the monthly cycle — periods may happen close together, become heavier, lighter, or last longer than a week. This is usually the first sign that the transition into menopause has begun.
• Hot flushes — a sudden feeling of heat usually occurring in the upper part of the body. Sweating and shivering may follow afterwards, along with red blotching of the skin.
• A loss of bladder control (incontinence) — the need to urinate more frequently, urine leaking during exercise, laughter or sneezing, or the complete inability to control the bladder.
• Changes in vaginal health and sex drive — it may be harder than usual to become sexually aroused, and the vagina may be drier than usual. This can make sex painful, and lead to a lack of interest in sexual intercourse. However, the inverse may also be true — some women may find they feel more inclined to have sex now that they’re unable to become pregnant.
• Mood changes — hormonal changes during menopause can affect your mood, and irritability and mood swings are two of the most commonly reported symptoms.
• Bodily changes — you may find that you gain weight more easily, or that certain parts of your body seem to become larger, such as the waist or thighs.

Along with the symptoms mentioned above, some women will also experience difficulty sleeping.

How can menopause affect your sleep?

Poor sleep quality is a common symptom of perimenopause but isn’t mentioned or discussed as often as it should be. An inability to sleep properly can cause a major disruption to your life.

Hot flushes

Hot flushes are the most common cause of sleeplessness during menopause. This is an unpleasant ‘flash’ of extreme heat which comes on suddenly, usually across the upper body and face. During a hot flash, your skin may redden, and many women report breaking into a sweat, too.

Hot flushes can occur at any time, but if they happen at night, they’re likely to wake you up. Other symptoms of hot flushes include:

• Rapid heartbeat
• A chilly feeling as the hot flash recedes
• Anxiety or a feeling of panic

Hot flushes can last anywhere from 1-5 minutes, and episodes may vary in intensity.

Other menopausal sleep disorders

Once you’ve reached menopause and your period has completely stopped, you’re at an increased risk of developing a sleep disorder. Similar to hot flushes, this is thought to be due to a change in hormones.

During menopause, the levels of oestrogen, progesterone, and cortisol in your body change dramatically. This may lead to insomnia, sleep apnoea, restless leg syndrome, and as a result, increase the risk of mental health issues such as depression or anxiety. This can lead to a kind of feedback loop, where the severity of your sleep disturbance grows over time, leading to secondary conditions such as depression — for example, following this pattern:

1. Anxiety, restless legs, or hot flushes disrupt your sleep
2. As a result, the frequency and persistence of disturbed sleep increase.
3. As sleep disturbance increases, insomnia is formally diagnosed
4. Persistent insomnia leads to depression

If left unaddressed, the issue of disrupted sleep can spiral — and can start to impact other areas of your life.

How can you get a good night’s sleep while going through menopause?

Menopause might be an unfortunate inevitability for women, but this shouldn’t mean you have to suffer through it without getting a good night’s sleep.

So, what can you do to combat menopausal sleep disruption? Thankfully, there are several options available.

Lifestyle changes

If you’re having trouble sleeping but aren’t suffering from a diagnosed sleeping disorder, try the simple steps mentioned below:

• Ensure your bedroom is at a comfortable temperature and is well-ventilated.
• Make your room as dark as possible — draw the curtains, turn off all the lights and wear a sleep mask.
• Avoid eating too much (especially spicy foods) before bedtime.
• Cut back on your consumption of alcohol, nicotine, and tobacco.
• Establish and maintain a strict bedtime routine — eventually, this will train your brain to wind down as your bedtime approaches.
• Sleep in comfortable, loose clothing.
• Avoid the temptation to use your phone before bedtime — the blue light emitted from its screen can trick your brain into believing it’s still daytime. This can play havoc with your sleep schedule.
• Get plenty of exercise every day, but try to wind down at least an hour before you go to bed.
• Take some time to relax before you go to bed. Take a bath, read a book, or meditate.

Medication and therapy

In cases where menopausal symptoms are causing an extreme disturbance in your day-to-day life, therapy or prescribed medication may be required.

For example, many of the debilitating, sleep-disrupting symptoms associated with menopause can be relieved through hormone replacement therapy (HRT). HRT works to replace the hormones that are lost during menopause.

There are over fifty different HRT preparations available, and choosing one that matches your needs can be tricky. This is why HRT is only available after a professional diagnosis from your doctor. After this, your doctor will help you to select the most appropriate treatment option for your needs.

HRT can take the form of pills, patches, rings, implants, gels, or creams. The HRT treatments available from The Independent Pharmacy are:

• Elleste Solo 1mg tablets
• Elleste Solo 2mg tablets
• Elleste Duet 1mg tablets
• Elleste Duet 2mg tablets
• Elleste Duet Conti tablets
• Evorel patches
• Femoston
• Kliofem
• Kliovance
• Livial tablets
• Novofem
• Premarin 0.625mg tablets
• Premarin 1.25mg tablets
• Premique Low Dose tablets

In cases where insomnia has also been diagnosed, your GP may recommend that you undergo cognitive behavioural therapy (CBT). CBT is widely regarded as one of the most effective treatments for insomnia during the menopause. CBT may even help with hot flushes, restless leg syndrome, and sleep apnoea.

If you dread going to bed every night due to the effects of menopause, consider seeking help. While it may be an inevitability of growing older, this doesn’t mean you have to put up with the debilitating effects it can have on your sleep. Remember — sleep disorders that manifest during menopause can linger well into your post-menopausal years too. As with any condition, it’s best to begin treatment sooner rather than later.