Insomnia

Menopause

During menopause, disturbed sleep and poor sleep quality can be a big problem. Oestrogen levels go down, which can cause night sweats, heat intolerance, insomnia and occasional nightmares.

What happens to sleep at the Menopause?

There are different ways that sleep may be affected during perimenopause and menopause- you may have difficulty getting to sleep, problems staying asleep with frequent waking through the night, early morning wakening or less restorative type (deep) sleep.

During menopause, we spend less time in stage 3 restorative sleep, so a common complaint from women is that they suddenly seem to feel much less refreshed in the morning despite seemingly sleeping most of the night.

Mood disorders are well known to cause early morning wakening, and anxiety can interrupt our ability to shut off our minds and drift off to sleep.

Oestrogen has been shown to improve deep sleep and reduce the number of awakenings through the night. Oestrogen is also associated with other substances in the brain (neurotransmitters) that regulate the sleep cycle. In addition, Oestrogen helps to control the body temperature at night and keeps the body cool, improving sleep. Unfortunately, the reverse is that without adequate oestrogen levels, you are more likely to have lighter sleep with more spontaneous wakeups through the night.

Unfortunately, the symptoms associated with oestrogen deficiency can have a part to play- hot flushes, joint aches, and multiple trips to the toilet to pass urine are not the secret to a restful night of snoozing.

Melatonin is a hormone that helps our body to know when we need to sleep and helps us to stay asleep. Melatonin production is linked to oestrogen and progesterone, so as these two hormone levels fall, so does melatonin.

What is ‘normal’ sleep?

Sleep Patterns

Difficulty falling asleep or falling into a deep sleep quickly only to be wide awake a few hours later – or intermittent waking throughout the night – often due to night sweats – are typical experiences during menopause. Lack of sleep can play havoc with our wellbeing, quickly leading to anxiety and stress. All other menopause symptoms and life worries feel worse without good restorative sleep.

The best kind of sleep is non-REM (rapid eye movement), which consists of three separate stages (1, 2 and 3), which follow in order, upwards and downwards, as the sleep cycle progresses. A cycle lasts, on average, 90 minutes, and each process occurs four or five times a night, depending on how long you sleep.

Stage 3 is the most valuable. This is deep sleep and usually occurs during the first half of the night; our brain activity, breathing, heart rate and blood pressure are all at their lowest. It’s the time when we are most likely to dream, too. This restorative sleep is essential for the body and mind to heal and repair.

There are two types of sleep- Non-REM and REM sleep, and there are four stages of sleep, which we cycle through several times throughout the night.