Sleep better, feel better: Tips for relieving menopause insomnia

It’s easy to treat sleep as the luxury you might indulge in when you have enough time - even though you know that sleep makes everything feel better. It really does make everything better, not just your mood and energy levels. These are the outward signs designed to make you want more of it. And yet, somehow, we keep pushing it down the to-do list.

There are countless reasons why more sleep is a good idea in midlife and here are just a few:

• Lack of sleep stresses your body out more, and this increases blood glucose levels.
• Blood glucose ramps up your cravings.
• Lack of sleep increases insulin resistance, which means you are likely to have more severe menopause symptoms and weight will start creeping on.

Sleep is a game-changer for your metabolic health and, consequently, your menopause.

This is all well and good, but…

Why am I not sleeping?

There can be so many different reasons you're not sleeping; it would be almost impossible to list them here. As a woman in midlife, you'll know that all kinds of woes begin to happen as you hit perimenopause.

There could be other reasons but I'm betting the real problem lies with your broken midlife metabolism. This is a combination of what's happening with your lady hormones, your stress hormones and your master metabolism hormone insulin. At this time in your life, it really is so much more than just oestrogen and hot flushes.

Stress

Too much stress is one of the most common reasons my clients struggle to sleep. It doesn't have to be 'big' stuff like divorce, bereavement or a house move. It could equally be the relentlessness of daily life - like work issues, family or relationship worries or even traffic jams. Regardless of the source, stress triggers the hypothalamic-pituitary-adrenal (HPA) axis in the central nervous system and puts you in fight or flight mode; essentially, a sense of high alert.

Prolonged stress means more stimulation of this HPA axis and, potentially, higher levels of stress hormones at night. If you've ever felt tired but wired (exhausted physically but your mind is whirring), this is it. Until you can dial down those stress hormones, you'll have little chance of nodding off. In midlife, your 'bonus' is that declining oestrogen means more pressure on your adrenal glands so you are less resilient and handle stress less well.

Blood sugar imbalance

I've often seen clients with blood sugar imbalances created by consuming too much sugar, starchy carbs and refined foods, and this creates poor sleep. Be aware, this is not just a thing for people with a penchant for junk foods; it can happen to you even if you are genuinely trying to do good things with your diet - like eating a low-cal bowl of cereal for breakfast or opting for a 99 calorie diet snack bar (if you’re being ‘good’) or a few bananas between meals.

The result is a blood sugar rollercoaster or peaks and troughs and, if your glucose levels drop too low at night (a hypo) and, if you're in a light sleep cycle, this can easily wake you up. Really. Insulin resistance is an unpleasant slap in the face for women who are pretty sure they've been doing everything 'right'. Yep, this was me…

Perimenopause 

Declining oestrogen in the transition to menopause can cause a wealth of hormonal issues, including night sweats and hot flushes, both of which are detrimental to a good night's sleep. You likely don't need me to tell you that. Oestrogen also helps promote deep sleep, while progesterone (another retreating hormone at this stage of life) has a calming and sleep-inducing effect. When their levels fluctuate, it can disrupt the normal sleep-wake cycle and lead to sleep disturbances.

Add to that, hormonal fluctuations can also affect mood and increase stress levels. Anxiety, irritability, and mood swings are common symptoms during perimenopause. These emotional changes can make it challenging to relax and fall asleep, leading to an increased likelihood of insomnia or disrupted sleep.

Sleep apnoea

Sleep apnoea is a common sleep disorder characterised by repetitive pauses in breathing or shallow breaths during sleep. These pauses (or apnoeas) can last for several seconds to minutes and can happen multiple times throughout the night, waking you up from sleep and, therefore, disrupting your normal sleep pattern. They might be so brief you don't fully remember them, but they can fragment your sleep enough that you wake feeling unrefreshed.

Menopause bonus: As you age, all your muscles get a big saggy, and this can make sleep apnoea suddenly appear on the radar. And snoring. Big time.

Ageing

As you get older, there is a natural shift in the 'sleep architecture'. That means a change in the pattern of the different sleep stages discussed earlier. Typically, older adults would experience a decrease in N3 deep sleep and a higher prevalence of lighter sleep stages. These changes can make sleep feel less restorative and more fragmented.

Age is often associated with an increased risk of medical conditions that can also affect sleep - like arthritis, respiratory disorders, and neurological conditions that can cause pain, discomfort, or breathing difficulties that interfere with sleep. Older adults commonly take more prescription drugs, some of which have sleep disturbance as a side effect, such as alpha or beta blockers for prostate problems and high blood pressure, ACE inhibitors used for blood pressure and heart problems, some antidepressants, and corticosteroids for inflammation.

12 tips for a more restful sleep

1. Watch your caffeine and alcohol

Caffeine has a very long half-life, and it can take six to eight hours for half the caffeine in your cuppa to leave your body. Consider that any caffeine after 2pm (if you go to bed at 10pm) will have a deleterious effect on the quality of your sleep - even if you cannot feel it.

Some people are genetically predisposed to be even more susceptible to the effects of caffeine and/or it can take them longer to clear it from the body. I am one of those for whom both apply, and I also love coffee so, while it would be a good idea for me to skip it altogether, I do ensure my morning cuppa is very early in the day.

Similarly, even one alcoholic drink can wreak havoc with your sleep. Although you may fall asleep quicker (which seems like a good thing), scientists now recognise a couple of important things concerning sleep and alcohol:

• It kills your REM sleep, which is the sleep phase important for processing the day.
• The kind of sleep you get after a few glasses is more akin to unconsciousness than actual rest.

2. Get plenty of natural light

Getting outdoors during the day - whatever the time of year - can help regulate the circadian rhythm. Spending time outside or near a window can help, as can using a light therapy box during the winter months. Getting out for a morning walk is a great way to start the day and wake your body up on every level imaginable. 

3. Exercise every day

Try to do some kind of exercise every day. There is evidence that regular exercise improves restful sleep. This includes stretching and aerobic exercise. A brisk walk ticks both boxes.

4. Dim lights in the evening

At the other end of the day, you want to encourage your body to make more of the night-time hormones, which means reducing the amount of bright light. If you have dimmer switches, use those. Or use side lights instead of the main overhead lights. These subtle lighting changes can make a difference.

5. Avoid screens before bed

You learnt earlier that blue light from electronic devices can interfere with the circadian rhythm and make it harder to fall asleep. Think about what else you could do to avoid using things like smartphones, tablets, and computers for at least an hour or so before bedtime. Consider real books or a Kindle (which has a different type of light to a tablet).

6. Take time to wind down

Establishing a relaxing bedtime routine can help signal to the body that it is time to sleep. This is exactly what we do with babies, and there's no reason why you cannot adopt some of this for yourself: warm bath, read a book, lights out. You might find it helpful to practise relaxation techniques like yoga or try some guided meditation.

7. Don't engage in stimulating activities

Like playing a competitive game, watching an edge-of-the-seat film, or having an important conversation with a loved one. Even watching the news can be triggering.

8. Keep the bedroom dark, quiet, and cool

Creating a comfortable sleep environment helps promote better sleep. This includes keeping the bedroom dark, quiet, and cool, and using comfortable bedding and pillows. Use your bed only for sleep and sex. This may help you completely switch off. Since the sleep hormone melatonin likes it dark, if you don't live in the middle of nowhere and you don't have blackout blinds, a generously sized silk eye mask is a good option to create a dark environment.

9. Ditch that smartphone alarm clock

Consider getting a traditional alarm clock so your smartphone can stay out of the bedroom - this will also help remove temptations to check messages and/or social media. Better still, work out how much sleep you need by going to bed 15 minutes earlier until you find that you wake up naturally before your alarm. That's your personal sleep requirement.

10. Stick to a consistent sleep schedule

Going to bed and waking up at the same time every day can help regulate the circadian rhythm. This means avoiding staying up late on weekends or sleeping in too much on days off.

11. Make sleep really matter

Sleep is free and you could choose to get more sleep (in theory) at any time you like, and this is why people typically don't make this a priority. The same goes for other free and health-enhancing activities like drinking more water. If you are someone who struggles to sleep enough or wakes up feeling unrefreshed, I invite you to make sleep a real priority this week. Throw everything at it for a whole week - make it your number one job - and then see how you feel.

Most of the tips you've read in this article you will almost certainly have read or heard before and for good reason. They're established facts. The trouble is, it can feel mighty difficult to do them consistently. So, once again, do every single last one you can for a week and experience what life could be like for you.

Choose a week without much going on; just the regular stuff rather than a week filled with social engagements or a busy work week. Let's call it the 'sleep experiment'. Put it in your diary as though it were an important engagement. Getting into good habits (people often refer to this as 'establishing good sleep hygiene') is one of the very best gifts you can give yourself.

12. Get expert help

I know that you get that this period of your life is a seismic change. You should always talk to your doctor about menopause symptoms you are particularly concerned about, but there is such a lot you can do to feel more energised than you do right now. If you're ready to prioritise your health and unlock the potential for a vibrant life, visit my profile page to see how you can apply to work with me.