In this article I’m focussing on the final element of my healthy menopause plan – sleep. When was the last time you had a really good night’s sleep and woke up feeling fully refreshed? If you are going through the menopause then you may be part of the 40 to 60% of women who report sleep disturbance during this transition, with around a quarter of women experiencing severe sleep problems at this time.
Ideally adults should be getting around 8 hours of good quality sleep every night. And so why can this be a challenge for midlife women?
Once perimenopause starts, which typically is around the mid 40s, oestrogen levels are declining and this may make it more difficult to fall asleep and more difficult to stay asleep. There may also be a complex interaction between sleep quality, and two other menopause-related symptoms, night sweats and mood changes, with each of them potentially affecting the other. So you can see that it’s important to take a holistic approach when tackling poor sleep.
If you’re feeling stressed and take this stress into your evening this can cause raised levels of your stress hormones cortisol and adrenaline making you feel more alert when you should be feeling relaxed and winding down as you get ready for bed. A consequence of raised cortisol can be increased fat deposited around the middle.
There is also some evidence (although based on a small study) that a diet high in sugar is associated with poorer quality sleep and waking up more frequently in the night.
Sleep has been described as the ‘single most effective thing we can do to reset our brain and body health each day’. Around 8 hours of good quality sleep allows our mind and body to rest and recover and supports our physical and emotional well-being, and our ability to function during the day including our cognitive function.
When we are sleep deprived, the consequences can be serious. Reduced quantities of sleep can increase your risk of cardiovascular disease, type 2 diabetes, weight gain and obesity, as well as being associated with lapses in concentration and memory and increased emotional sensitivity.,
A good night’s sleep shouldn’t be an occasional luxury. Here are some practical steps you can take to help improve your sleep. If you’ve already seen my posts on de-stressing and keeping active you’ll notice that there is some overlap and that’s because all three are very much inter-linked.
1. Try to get outdoors during the day, especially in the morning and soak up some natural light to maintain a healthy sleep-wake cycle. Even on a cloudy day the light intensity outdoors is around 20 times stronger than a brightly lit room.
2. Exercise supports sleep quality, especially morning exercise, and yoga may also be helpful.
3. Avoid caffeine in the evening – as well as drinks such as tea, coffee and cola, chocolate (especially dark chocolate) also contains caffeine. Caffeine can take at least 3-7 hours to be metabolised. This varies from person to person, and so for some people it may be best to avoid caffeine after mid-day. Also be aware that decaffeinated drinks usually still contain some caffeine6 (coffee more so than tea) and so if you’re particularly sensitive to caffeine, you might also want to avoid decaffeinated tea and coffee in the afternoon.
4. Avoid alcohol if you’re trying to improve your sleep as it can cause you to wake more often and get less of the deep sleep that helps with rest and recovery. If you do drink in the evening, try to drink before or with a meal in the early part of the evening at least 3 hours before bedtime.
5. Similarly, avoid a heavy meal within 3 hours of bedtime to avoid possible heartburn or indigestion, which will disrupt sleep.
6. Switch off screens (computer, tv, phone, etc) an hour before bedtime. Blue light emitted from screens, especially the small screen of a phone which emits very intense blue light, suppresses production of the hormone melatonin, which is essential for a good night’s sleep. Bear in mind that typically melatonin levels start to rise around 8pm. So if this is when you’re scrolling through your phone, you’ll be blocking this rise of sleep-inducing melatonin. If you can’t avoid looking at screens close to going to bed, you could try wearing amber glasses as there is some evidence that they help to block out the blue light, reduce the impact on melatonin levels and result in improved sleep.,
7. Establish a regular bedtime routine and try to go to bed and wake at the same time each day. Ideally aim to be in bed by 10 or 11pm as you’ll get more of the deeper, restorative sleep.
8. A warm bath can be helpful to wind down before bed, especially if you add in Epsom salts so that you get the benefit of the relaxing mineral, magnesium. A recent small study also suggested that a warm footbath an hour before bed improved sleep quality in post-menopausal women.
9. Create a calm environment in the hour before bed – maybe listen to music, read a book, or drink a herbal tea such as chamomile or lemon balm.
10. Make sure that your bedroom is tech-free, dark, well-aired and cool (not too hot, not too cold).
Breaking the cycle of poor sleep can be difficult if you’re feeling really tired, but try starting with one small action that you can then build on over the days and weeks.
And if you are struggling with poor sleep or other symptoms related to the perimenopause or menopause, do get in touch and I’ll be very happy to set up a free call with you.
Baker, FC et al (2018) Sleep problems during the menopausal transition: prevalence, impact, and management challenges. Nature and Science of Sleep; 10:73-95.
St-Onge, M-P et al (2016) Fiber and Saturated Fat Are Associated with Sleep Arousals and Slow Wave Sleep. Journal of Clinical Sleep Medicine;12(1):19–24.
Walker, M. (2017) Why we sleep. UK, Penguin Books.
Golem DL et al. (2014) An Integrative Review of Sleep for Nutrition Professionals. Advances in Nutrition; 5:742–759.
Schmid, SL et al. (2015) The metabolic burden of sleep loss. The Lancet; 3(1):52-62.
McCusker, R et al. (2006) Caffeine content of decaffeinated coffee. Journal of Analytical Toxicology; 30: 611-613.
Sasseville, A et al (2006) Blue blocker glasses impede the capacity of bright light to suppress melatonin production. Journal Pineal Research; 41:73–78.
Burkhart K, Phelps JR. (2009) Amber lenses to block blue light and improve sleep: a randomized trial. Chronobiology International;26(8):1602-1612.
Aghamohammadi, V et al. (2020) Footbath as a safe, simple, and non‐pharmacological method to improve sleep quality of menopausal women. Research in Nursing and Health; 43: 621–628.