One of the most common and most devastating symptoms of perimenopause is undoubtedly sleep disruption.
Studies have shown that up to 70% of women suffer from significant sleep disturbances during this period. Depending on the person, this can look like difficulty falling asleep or staying asleep, poor quality sleep, or an inability to sleep altogether.
There is a reason sleep deprivation was used as a torture technique in the darker chapters of humanity’s history; it affects a person’s ability to function on every level, causing cognitive problems, motor problems, and when experienced over an extended period of time, can lead to a wide range of serious conditions including depression and other mental health disorders, diabetes, and cardiovascular disease.
So why is it that so many women have problems with sleep during perimenopause?
The reasons are complex, as is the treatment.
Hormonal Fluctuations
A key factor in all perimenopausal symptoms is the fluctuations in hormone levels. During a pre-menopausal woman’s cycle, levels of progesterone and estrogen follow a set pattern, increasing and decreasing according to the phases of her cycle.
During perimenopause, this is still true, but now the overall levels of these hormones is steadily decreasing. Estrogen in particular has many different functions throughout the body. Aside from playing a crucial part in the menstrual cycle, it also helps regulate body temperature, helps maintain bone density, promotes healthy blood vessel function, and influences metabolism and insulin sensitivity levels. As its levels decrease, so does its ability to regulate these functions, and as a result, symptoms related to each of these body systems start to affect many perimenopausal women.
Vasomotor Symptoms
Hot flashes and night sweats are a common perimenopause symptom, and both can cause sleep disturbances due to the discomfort they cause for the person experiencing them. Once awake, falling back asleep can be difficult for perimenopausal women, even once the hot flash or night sweat passes.
Mood Disorders
Mood disorders such as mood swings, anxiety, and depression are a perimenopause symptom experienced by many women. These issues can contribute to sleep disturbances due to their impact
on women’s ability to fall asleep, get back to sleep once awakened, or achieve restful sleep. A heightened state of anxiety may also bring on nightmares, which in turn can lead to more frequent wakings and thus affect sleep quality.
Age Related Sleep Problems
As we age, we experience natural changes in our sleep patterns, changes that affect men and women alike. Sleep tends to become lighter, and nocturnal wakings tend to increase. This isn’t related to perimenopause, but when added to perimenopausal symptoms impacting sleep, the combination can be devastating to sleep quality.
Sleep Disorders
Perimenopause can exacerbate sleep disorders such as sleep apnea or restless leg syndrome, further impacting sleep quality.
Improving Sleep during Perimenopause
If you’re struggling with poor sleep quality during perimenopause, there are a number of things you can do to help improve your rest.
Lifestyle Changes
Lifestyle impacts perimenopause symptoms in a big way, so here are some ways to improve not just your sleep, but potentially all your perimenopause symptoms:
1. Reduce caffeine. Did you know that caffeine has a half life of six hours? That means that six hours after you drink your cup of coffee, half of the caffeine you consumed is still in your bloodstream. Another six hours after that, a full twelve hours after that cup is gone, a quarter of the caffeine is still in your system. And since caffeine is known to impact sleep for most people, it’s a good idea to reduce your caffeine intake and limit it to the morning.
2. Check your diet. A balanced diet rich in antioxidants and protein has been shown to be instrumental in minimising menopausal symptoms.
3. Exercise. Regular exercise is crucial during perimenopause. Not only does it improve sleep, but it also helps maintain muscle mass, mobility, and bone density, reduces breast cancer risk, and reduces stress and maintains mental well-being.
Supplements
There are various supplements that may help achieve more restful sleep. Among them are Valerian, 5-HTP, tart cherry, and magnesium. Each of these have different effects and are generally safe to use at recommended dosages.
Medication
If your symptoms persist despite healthy lifestyle changes, it pays to discuss the possibility of Hormone Replacement Therapy (HRT) with your health practitioner. Evidence suggests that early introduction of HRT can help prevent some of the long-term effects of low estrogen, such as osteoporosis, as well as minimise symptoms such as sleep disturbances along the way.
Other options for treating sleep disturbances include certain medications to help induce sleep; your GP can offer you more advice on these.
Summary
Sleep deprivation is a devastating consequence of sleep disturbances during perimenopause, and one to be taken seriously. If you have trouble sleeping, I hope these tips have given you some ideas on things you can do to try and get a better nights’ rest. And please do speak to your doctor if problems persist; you cannot function if you do not sleep.
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