Sleep interruptions can be a frustrating part of the transition to menopause. Not only is this time of life busy and full—you might have an active career, kids going off to college, aging parents, and endless things to juggle—sleep interruptions make everything harder.
With 75% of women experiencing night sweats and some women experiencing symptoms for up to 14 years, it’s worth taking stock of how to sleep better during this time.
Menopause isn’t actually an event you can pinpoint while it’s happening—it’s more like a continuum, with its official classification being one year without periods. Thus, women don’t know until it’s complete that they’ve hit menopause. Instead, “perimenopause” is used to refer to the transition of shorter cycles and skipped periods. Most women in the U.S. will reach menopause between ages 51 and 52 years old.
But, if you’re currently experiencing the hot flashes, the night sweats, the countless hours of interrupted sleep, you probably don’t really care what it’s called. You just want to know how to make it stop!
We sat down with Reverie Sleep Advisory Board member Dr. Amelia Bailey to give you some advice on feeling more rested during this time of discomfort. Here’s what she has to say:
Why you’re not sleeping during the transition to menopause
Yes, your body is going through some unpleasant changes and the symptoms are rough and you’re certainly not alone. The majority of women will experience hot flashes or night sweats. Your ovaries are changing, and as they age they become less able to produce estrogen and progesterone.
The decrease in progesterone makes it harder to fall asleep and stay asleep, while the decrease in estrogen results in hot flashes and night sweats. These lowered estrogen levels actually put a glitch in your body's temperature regulation—it’s as if you set your house thermostat to a comfortable 70 degrees but the thermostat is actually reading the house temperature at 62 degrees. The heat goes on full blast to compensate and now you’re sitting in an 80 degree house sweating profusely. Hot flashes are caused by the difference between what your body's thermostat thinks you need versus what it is actually feeling (and some women actually feel cold flashes when their thermostat misreads in the opposite direction!).
Hot flashes happen both day and night, but it’s the interruption of sleep during the night that really starts to impact your day-to-day functioning (as the sleep interruptions begin to affect memory and energy levels). So when they happen, what can you do to alleviate the discomfort?
Here are some practical solutions:
How to sleep better during the transition to menopause
All your habits and behaviors that contribute to a good night’s sleep apply even more so during the shift of perimenopause to menopause.
Set your bedroom up for speedy temperature relief. That means sleeping in what you might think of as “summer pajamas” made of linen or cotton. Look for bedding that breathes and bedding with cooling properties. Add an extra fan to your room to increase airflow on demand.
Optimize your bedroom for sleep. Make sure it’s dark, cool, and quiet. Blackout shades or eye masks make a big difference.
Listen to a meditation or play calming music as part of your bedtime routine. Combat the effects of your decreased progesterone production (which makes it harder to fall asleep) by building in a wind-down routine to help prep your mind to turn off.
Exercise during the day. This helps burn your energy up and prepare your body for sleep that night. Exercise also helps you fight off the pounds from a slowing metabolism (another side effect of this time).
Limit caffeine after lunchtime. Caffeine stays in your system for a long time, even after the initial jolt of energy. Consuming caffeine much past lunch could further delay your bedtime, as caffeine blocks signals your body sends to say “I’m tired.”
Add some space between dinner and when you go to bed. Give your system a few hours to digest, especially if you have a larger, heavier meal in the evening.
Stay away from spicy food. Spicy food sometimes makes hot flashes more severe, so cut down in that area.
Limit alcohol close to bed. A known disrupter to deep sleep, avoid drinking too much in the evening to further protect your sleep quality.
Of course, continue seeing your OBGYN for annual exams, and your primary care doctor for mammograms and colonoscopies.
If you feel like something has changed that you don't really have an explanation for, it’s completely reasonable to talk to your doctor. Write down your symptoms, including what time of day they occur and if there are any triggers. If you can keep a journal for a few weeks before your visit, this will help tremendously in figuring out the best solution for you.
When your day-to-day functioning starts being affected by the side effects of menopause, definitely see your doctor. Hormone replacement therapy, topical estrogens, and certain medications can alleviate these symptoms, and a medical professional can help you navigate your options.
In the meantime, practicing good sleep health and overall wellness will protect the quality of your sleep and set you up for a more energy-filled day.
Dr. Amelia P. Bailey is a reproductive endocrinologist and infertility (REI) specialist in Memphis, Tennessee. She is the Director of Minimally Invasive Surgery for her practice and an Assistant Clinical Professor at the Vanderbilt University School of Medicine. She completed residency in Obstetrics and Gynecology at the University of Virginia Health System in Charlottesville, where she served as Chief Resident, followed by a fellowship in Reproductive Endocrinology and Infertility at Brigham and Women’s Hospital in Boston. While in Boston, she was a Clinical Instructor at Harvard Medical School and conducted joint research projects between Boston Children’s Hospital and the Massachusetts Institute of Technology.
As an REI, Dr. Bailey treats patients who are having difficulty conceiving or who have complicated gynecologic conditions and follows women throughout early pregnancy. Her expertise in sleep and women’s health, including pregnancy, stem from professional as well as personal interests. As the mother of two young children, she knows how important it is to get a good night’s rest and has used the Reverie Sleep System throughout both of her pregnancy and postpartum periods with excellent results.
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