One of the most common complaints I hear from peri- and menopausal women is that they don't sleep well anymore. The inability to sleep impacts every part of your life - women experience more irritability, have more brain fog, don't have the energy to exercise - and women can't figure out how to break the negative cycle. As women's hormones decline into menopause, sleep disturbances - trouble falling asleep, frequent awakening, and/or early morning awakening - increase. Common symptoms like hot flashes and night sweats only make the matter worse.
In a natural sleep cycle, your body temperature drops, facilitated by melatonin. Most women know that as they transition from reproductive age into menopause their estrogen (specifically estradiol) levels drop to near zero in full menopause. Unfortunately, melatonin levels decrease with decreasing estrogen and progesterone. Without the ability to naturally drop their body temperature, it is difficult for women to get the deep sleep that they need to feel rested and restored. Some women also wake up in the middle of the night, in part, because they don't ingest enough calories during the day.
I recommend that older women try a few of these tips to improve sleep, check their results, and then move down the list if symptoms persist.
Have good sleep hygiene. Keep the bedroom below 68 degrees. Get comfortable bedding and pillows. Limit daytime napping. Consider a dehumidifier if you live in a humid area. Add essential oils to the air (research shows lavender has a positive effect.) Avoid screens before bedtime. Make sure the room is as dark and quiet as possible - use blackout curtains, sleep masks, ear plugs, etc.
Wake up and go to bed as close to the same time each day as possible.
Spend some time in the sunlight every day.
Stop caffeine intake by noon. Limit alcohol intake, especially before bed. Caffeine and alcohol are known sleep disrupters.
Take a hot bath/shower before bed. (Yes, it seems counterintuitive but your body temperature quickly expels the heat and your core temperature drops once you get out.) Settle your nervous system by doing some deep breathing when you get into bed - inhale for 4 seconds, hold for 1 second, exhale for 4 seconds. Repeat 5-10 times.
Drink 8 oz. of ice-cold tart cherry juice 30 minutes before bedtime. The juice stimulates natural production of melatonin. Additionally, the coldness lowers your body temperature. (If you use tablets, take them with ice-cold water.)
Eat a small snack before bed. Try a casein protein shake - casein digests slowly - 40g is a good place to start. Other good options include Greek yogurt with berries or apple slices with nut butter. After dinner, avoid foods with high glycemic index - pastries and breads, for example - because studies show they increase insomnia.
If your sleep disturbances persist, talk to your doctor about whether supplements, adaptogens, and/or menopause hormone therapy (MHT) might help. Future blog posts here will address some of these options.
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