5 Ways Menopause Messes With Your Sleep

by Leslie Goldman Health Writer

Getting sweaty between the sheets can be wildly fun—or deeply unpleasant, in the case of menopausal night sweats (a.k.a. hot flashes at night). You may also have a harder time falling asleep, staying asleep throughout the night, and waking up with your alarm. “Poor sleep is second only to hot flashes as the most frequent complaint of women in this phase of life,” says Stephanie S. Faubion, M.D., medical director of the North American Menopause Society (NAMS). These five bandits may come to you like a Zs-thief in the night, but we have expert advice to help you reclaim your rest.

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Culprit #1: Undulating Hormones

Your ovaries are starting to release less and less estrogen and progesterone (or, in some cases, wonky amounts of one or both). These hormones play a role in everything from sexual functioning to bone protection to mood regulation. They also interact with certain brain chemicals that help to promote sleep. As their levels dip, so does your ability to sleep soundly.

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Culprit #2: Sleep Apnea

Postmenopausal women are three times as likely to develop moderate-to-severe obstructive sleep apnea (OSA) compared with premenopausal women, according to multiple large studies. OSA is a sleep disorder that causes intermittent periods of breathing cessation throughout the night due to the airway collapsing. Between 47% and 67% of post-menopausal women are thought to have OSA, per a 2017 Journal of Sleep Disorders study. You may associate the gaspy snores typical of OSA with men, but menopausal weight gain can alter the anatomy of a woman’s upper airway, boosting the risk to much higher than what it was pre-menopause.

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What If You Do Have Sleep Apnea?

If you share your bed with a partner, ask them if you snore loudly or tend to gasp, choke, or stop breathing during sleep. All are possible indicators of sleep apnea. Concerned? Talk to your internist, who may prescribe a sleep study, which usually involves an overnight stay at a sleep center. Treatments for sleep apnea include lifestyle changes such as weight loss and alcohol avoidance; a continuous positive airway pressure (CPAP) mask that fits over your nose and mouth and gently blows air into the airway throughout the night; dental appliances that reposition the lower jaw and tongue; and more.

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Culprit #3: Stress

Menopause doesn’t happen in a bubble; life is still swirling and churning around you. Maybe you’re going through a divorce, lost a parent, or had a child move away to college. Don’t underestimate the impact of changes like these on you p.m. routine, says Dr. Faubion, a professor of medicine at the Mayo Clinic and medical editor of The Menopause Solution. During daytime hours, you may be so busy that the stress doesn’t have time to sink in, “but when you’re lying in bed at night trying to get some much-needed rest, the anxiety can take over, making it very difficult to sleep.”

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Culprit #4: Your Sleep History

The study: Researchers from the Perelman School of Medicine at the University of Pennsylvania analyzed the sleep patterns of 255 women participating in the Penn Ovarian Aging Study. The findings? Women in their late 30s and 40s who have trouble sleeping pre-menopause are more than three times more likely to experience sleep issues during menopause compared to women who’ve never really had much trouble sleeping. What luck!

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Culprit #5: Aging

Older adults tend to spend more time in the lighter stages of sleep, compared to the deeper ones. According to the National Sleep Foundation, changing sleep patterns can render it more challenging to fall or stay asleep. Think about it: How many 60-year-olds do you know who can sleep in on a Sunday morning with the same ease and enthusiasm as a teenager?

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Doctor-recommended Sleep Strategies

Talk to your physician about your sleep troubles. She can discuss your options, including hormone therapy (to help those ebbs and flows) or cognitive behavioral therapy (for stress management and sleep-specific techniques). Insomnia can also be eased by nutritional tweaks, like avoiding caffeine (including caffeine-containing food, such as chocolate—boo), eating sufficient protein during the day (it’s been linked with less difficulty falling asleep), and following a low-fat, low-cholesterol diet (associated with less non‐restorative sleep and less daytime sleepiness).

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Establish a Bedtime Routine

You’ve heard the advice about adopting good sleep hygiene—now’s the time to finally do it. Stick to the same bedtime/wake-up schedule, even on weekends; keep your bedroom as cool and as dark as possible; and power off all digital devices at least an hour before bed. Oh! And stop using your bed for your TV or work lair; it’s meant for sex and snoozing.

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Keep Your Cool

You want to be prepared when night sweats strike. Keep a small fan near the bed, even during the winter! And arm yourself with sweat-wicking PJs and bed linens that draw heat and moisture away from you skin. When shopping, look for words like “cooling,” “moisture-wicking,” and “breathable.” Good pajamas for sweaty peeps include Soma’s Cool Nights PJ sets and Lusomé’s line of nighties and camisoles.

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A Relaxing Rubdown

One of our favorite slumber strategies comes from Octavia Cannon, D.O., an ob/gyn in private practice in Charlotte, North Carolina, and past president of the American College of Osteopathic Obstetricians and Gynecologists. “Try massage before bed, preferably with a partner because then it can double as foreplay.” Massage is a powerful anti-stress tool on its own, and if it ultimately ends up with you having an orgasm, your brain and body will be flooded with prolactin, a hormone that makes you feel drowsy and relaxed. No partner? No problem. Orgasms achieved via masturbation have the same, dreamy effect.

Leslie Goldman
Meet Our Writer
Leslie Goldman

Leslie Goldman is a health and wellness writer who regularly contributes feature stories and essays to O: The Oprah Magazine, Women’s Health, Parents, Better Homes and Gardens, and more. She has authored and contributed to several books, including Locker Room Diaries: The Naked Truth About Women, Body Image, and Re-Imagining the “Perfect” Body and Brave Girls: Raising Young Women with Passion and Purpose to Become Powerful Leaders. Leslie also speaks at colleges and universities on the topics of body image, media literacy and female empowerment.