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Does Menopause Keep You Awake At Night?

Stephanie Gore, MD, MPH, FACOG
Stephanie Gore, MD, MPH, FACOG Photo Credit: CareMount Medical

Hormones affect your mood and sleep, especially as you age. In fact, about 61 percent of women who are past menopause (the one-year anniversary of your last period) and almost 80 percent of women who are in perimenopause (when your body starts to transition toward menopause) report sleep problems. Why? Because your ovaries are slowing down their production of the sleep-promoting hormone progesterone, and also because you might be overcome with major sleep disrupters such as hot flashes or night sweats due to lower estrogen levels. 

When estrogen levels begin to decline rapidly, as is the case during the transition from perimenopause to postmenopause, the thermoregulatory system within our bodies experiences dysfunction. Vasomotor symptoms, such as palpitations, night sweats and hot flashes, can occur at any time during the day, however, hot flashes occur most commonly at night.

Estrogen is not the only hormone that declines with age. Melatonin – yes, the same melatonin you see on the shelves at the drug store, also declines with age. Melatonin has been shown to contribute to sleep disorders associated with transitioning from perimenopause to postmenopause. Unlike estrogen, melatonin levels gradually decline over time, thus, often worsening sleep dysfunction when a woman has already entered the postmenopausal phase.

Lastly, other illnesses that either accompany aging or were pre-existing contribute to sleep dysfunction in the postmenopausal phase. Depression, including bipolar disorder, leads to a decrease in melatonin secretion. This is also true in women who have obstructive sleep apnea and chronic obstructive pulmonary disease (COPD).

There are some steps you can take to get yourself a good night’s rest. Here are some tips:

• Avoid naps during the day.

• Stay cool during hot flashes by wearing loose clothing to bed; choose cotton sheets and cotton clothing instead of synthetic.

• Keep your bedroom well-ventilated and cool. The ideal sleep temperature is 65 degrees Fahrenheit.

• Avoid certain foods that might cause sweating (such as spicy foods) especially right before bedtime.

• Exercise daily; avoid vigorous exercise three hours before bedtime.

• Avoid caffeine, alcohol and nicotine throughout the entire day.

• Do not go to bed until you are tired.

• Do not watch television, eat or read in bed.

• Follow the same bedtime routine each night.

• Avoid using sleeping pills.

When the lifestyle changes above fail to remedy insomnia, talk to your doctor. He or she can rule out other conditions that may be causing your sleep issues. Alternatively, your doctor may prescribe temporary medicine to help you sleep and get you sleeping regularly. You may also want to talk to your doctor about taking hormone replacement therapy (HRT) which may help alleviate symptoms of insomnia. Melatonin supplementation may also be added to traditional HRT.

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