Sleep Issues Can Emerge During Menopause

Dorian Martin Health Guide
  • Every morning, like many people I check my smart phone. One thing I keep noticing is how many of my middle-aged female friends end up texting, posting on Facebook or making the last move on Words with Friends during the middle of the night.

    Their predicament shouldn’t be surprising. It turns out that women experience the most issues with sleep as they go through the menopausal transition.  The reasons that women can’t sleep in mid-life can vary, but can include hot flashes, sleep apnea, snoring, depression and anxiety.  One of the most prevalent is insomnia, which 61 percent of menopausal women report having. These issues can interfere not only with the amount of sleep but also with sleep quality. They may awaken frequently during the night and then feel groggy the next day.

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    So could something we’re doing to help us with those hot flashes and other menopause symptoms make a difference in our sleep. A new study out of Finland looked at melatonin levels in menopausal women. The researchers pointed out that melatonin levels taper off naturally with age, but also may be affected by the menopausal transition. The researchers also wanted to delve into whether the addition of hormone therapy can cause disruptions in melatonin.

    Before I get into the results, let me give a quick refresher course on melatonin. This natural hormone, which is made by the pineal gland, is one of the important parts of the sleep process. The pineal gland is inactive during the day, but is activated by the part of the brain called the supra-chaismatic nucleus (SCN) when it gets darker; this normally happens around 9 p.m. The SCN is a part of brain that alerts different parts of the body to make adjustments that help us stay awake or want to sleep.  Melatonin levels remain high for about 12 hours, but drop as morning begins. They reach daytime levels, which are barely detectable, by 9 a.m.

    The Finnish study involved 17 women who were earlier in the menopausal transition as well as 18 women who had reached menopause. The women were assigned to one of two groups. The first group took hormone therapy while the other group took a placebo. The researchers sampled serum melatonin at 20 minute and one-hour intervals at the start of the study and then again at the six-month mark.

    Interestingly, the researchers found that the postmenopausal women who took hormone therapy had while melatonin levels stayed the same, the melatonin had a later peak time – about 2-1/2 hours.  The researchers aren’t sure what impact this change has in women, although it may have an impact on a woman’s mood and depression.

    Therefore, it’s really important for menopausal women – especially those who are taking hormone therapy -- to take steps each day that are conducive to sleep. Here are some suggestions:

    • Make your bedroom into a sanctuary where you can sleep. Use blackout curtains, if you’re not already. Remove all technology from your bedroom (or at least turn it off when you go to bed).
    • Try to go to bed at the same time every night and wake up at the same time every morning.
    • Avoid eating a late dinner right before bedtime.
    • Avoid foods and beverages that can trigger hot flashes in the evening. For some women, that could be spicy foods. For other women, it could be acidic food. In my case, hot flashes at night seem to show up when I drink some types of alcohol (especially beer), although I don’t experience the same issues when drinking wine.
    • Watch the temperature in the room. I’ve learned that I tend to sleep better when it’s cooler. You may want to experiment to determine what’s the best room temperature for you to sleep soundly.
    • Avoid napping, especially in the afternoon.
    • If you wake up in the middle of the night and can’t get back to sleep, trying counting backwards by 3 starting at 500.

    Hopefully, these tips will help you get to sleep at night and sleep soundly throughout the night.

    Primary Sources for This Sharepost:

  • National Sleep Foundation. (ND). Menopause and sleep.

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    Toffo, E., et al. (2014). The effect of hormone therapy on serum melatonin concentrations in premenopausal and postmenopausal women: A randomized, double-blind, placebo-controlled study. Maturitas.

    National Sleep Foundation. (ND). Healthy sleep tips.

    National Sleep Foundation. (ND). Melatonin and sleep.

    National Sleep Foundation. (ND). Menopause and sleep.

Published On: March 19, 2014