Sleep patterns during menopause: what solutions exist?
Sleep patterns during menopause: what solutions exist?
The difficulty in falling asleep or waking up at midnight are some of the most common symptoms during menopause. We will analyse why the sleep cycle changes and what strategies can help regain quality rest. During the menopause, due to hormonal changes, various patterns can be altered, such as sleep.
Why does insomnia occur during menopause?
Insomnia is a sleep disorder characterised by difficulty or inability to fall asleep or to stay asleep. During menopause, the fluctuations in the levels of oestrogen, progesterone, and testosterone affect mood, energy, libido (sexual desire), cognition, and also sleep.
In relation to this, melatonin levels, the natural sleep hormone, also play a role. Although melatonin does not decrease directly with menopause, it does with ageing. As we age, the body produces less melatonin, which alters the circadian rhythms that control the onset and maintenance of sleep.
Hormonal changes that affect sleep
The hormonal changes during menopause, especially in the levels of oestrogen and progesterone, can have a crucial role in the emergence of changes in sleep patterns. Various clinical reviews have found the following:
- Female sex hormones, primarily oestrogens and progesterone, not only regulate the reproductive cycle, but also have a significant influence on the circadian system (our internal biological clock) and the mechanisms controlling sleep. Both hormones interact with different areas of the brain involved in regulating the sleep-wake cycle, affecting the onset of sleep, its maintenance, and the overall architecture of sleep.
- The drastic decrease in oestrogen and progesterone levels can have a considerable impact on sleep patterns, leading many women to experience difficulties in sleeping for the first time or exacerbating pre-existing issues.
- Insomnia: This is a common complaint, manifesting as difficulty to fall asleep or maintain sleep, or waking up very early. Hormonal changes disrupt the natural mechanisms that induce sleep.
- Hot Flushes and Night Sweats: These symptoms, directly linked to hormonal fluctuations, are a major cause of nighttime awakenings and fragmented sleep, as the rise in body temperature interrupts deep rest.
- Sleep Apnoea: The prevalence of obstructive sleep apnoea increases in postmenopausal women. This is thought to be partly due to the loss of the protective effect of oestrogens and progesterone on the upper respiratory tracts, resulting in interruptions in breathing during sleep.
- Restless Legs Syndrome (RLS): Some women may experience the onset or worsening of RLS during this stage, characterised by an uncontrollable urge to move the legs at night, making it difficult to initiate sleep.
Menopausal symptoms linked to insomnia
Insomnia does not occur exclusively during menopause nor is it suffered only by women, as it is common in other life stages and in both sexes. In fact, according to the Spanish Society of Neurology, between 20 and 30% of the Spanish population suffers from difficulty in initiating or maintaining sleep.
The most common insomnia symptoms during menopause include difficulties in falling asleep, frequent awakenings during the night or waking up early in the morning, as well as hot flushes and night sweats.
The impact of insomnia on the health of menopausal women
Not getting enough rest during the night, particularly in menopause due to all the hormonal changes women experience during this stage, negatively affects their mood and overall quality of life. Insomnia leads to lack of concentration and memory difficulties and can impact other areas of life, causing women to feel irritable and lacking energy, as well as increasing the risk of developing cardiovascular and diabetes.
Physical and emotional consequences of poor sleep
Any imbalance in sleep patterns can exert negative effects, such as in the case of insomnia, both physically and emotionally. Physically, if you do not rest well, it is common to feel a fatigue that does not go away, that your immune system does not function properly, and in some cases, that your risk of cardiovascular problems increases. Emotionally, it can trigger irritability, mood swings, easily forgetting things (memory) and having intellectual performance below 100%.
Natural solutions that promote the quality and quantity of sleep during menopause
There are daily habits that can help alleviate insomnia during menopause, such as:
Sleep hygiene and healthy habits
It is important to establish a healthy sleep routine, going to bed and waking up at the same time every day, to help the body regulate its internal clock. It is also recommended to avoid using screens and mobile devices before bedtime, as blue light from these devices may hinder the onset of sleep.
Diet and supplements for menopausal insomnia
There is a direct relationship between certain foods or supplements and the quality and quantity of sleep. To ensure restorative sleep, it is important to dine at least 1 or 2 hours before going to bed, avoid heavy meals and drinks with caffeine and alcohol. Furthermore, consuming fruits, vegetables, fibre, and some proteins (especially those containing the amino acid tryptophan), among others, promotes the quality of sleep, particularly the deep sleep stages.
Another great ally, alongside nutrition, is some natural ingredients present in dietary supplements. Let’s see below which ones can help alleviate insomnia:
Valerian
The valerian is a traditional herb originating from Asia and Europe. Its root is commonly used as a natural solution and is known worldwide for its properties related to rest, which are beneficial during menopause. Its activity helps maintain sleep quality and mental wellbeing.
Passionflower
The passionflower, also known as Passiflora incarnata or maypop, is a popular herbal option for its positive properties on sleep patterns. It has traditionally been used to promote nighttime rest and is linked with positive effects on sleep initiation and relaxation.
Lemon Balm
Lemon balm is a plant that has traditionally been used because it supports the balance of the nervous system, as it contributes to achieving optimal relaxation, maintaining healthy sleep, and ensuring good rest, according to EFSA.
Tryptophan
The tryptophan is an amino acid that plays a role in the production of serotonin in the brain, which is the hormone involved in the regulation of sleep, among other functions. Furthermore, It is recommended that it be taken according to the recommended doses and that it also has a good safety profile
Isoflavones
The soya isoflavones are compounds similar to oestrogen.Isoflavones can help women alleviate symptoms associated with menopause, such as hot flushes, and maintain normal sleep patterns.
Melatonin
The melatonin is a hormone produced naturally by our body, and is responsible for regulating the sleep cycle. Various studies report that melatonin supplementation contributes to reducing sleep onset time. Moreover, its action is not limited solely to inducing sleep; it regulates all phases of the cycle and is a key hormone for maintaining a healthy circadian rhythm.
Ashwagandha
The ashwagandha is a well-known herb used in Indian medicine (Ayurveda). It is a plant that has been popularised for its positive effects on the nervous system. Furthermore, ashwagandha contributes to optimal mental and cognitive activity and helps with sleep initiation.
Physical exercise to combat insomnia
Exercising physically is beneficial for overall health, and specifically, the relationship between exercise and sleep has been widely studied. It has been shown that regular physical activity helps improve sleep, prolong its duration and shorten the time taken to initiate sleep.
Studies have demonstrated that in just four weeks, individuals with chronic insomnia who begin exercising regularly can fall asleep up to 13 minutes faster and remain asleep 18 minutes longer.
When to consult a sleep specialist
If, despite implementing hygienic-dietary measures and supplementing with dietary supplements, insomnia symptoms persist. It is recommended to consult a sleep specialist. Depending on each case, the specialist may recommend one course of action or another:
- Cognitive behavioural therapy for insomnia (CBT-I): this is a therapy aimed at identifying, managing and replacing negative thoughts and worries that hinder the initiation of sleep.
- Hormone replacement therapy (HRT): also known as hormone replacement therapy, this involves administering oestrogens and progesterone to compensate for the hormonal decline that occurs during and after menopause.
- Specific pharmacological treatments, always under the supervision of a professional.
