Sleep issues are common in menopause bringing disruption to busy lives. At our recent webinar sleep psychologist Myrthe De Vos shared insights into sleep.
For a busy sandwich generation, the seeds of disrupted sleep are sown in the years leading up to menopause. Problems with sleep, pre-menopause, are an early indicator of sleep problems in menopause. Nipping problems in the bud will pay dividends later.
Going into perimenopause (from approximately 45 onwards), the main reproductive hormones, oestrogen, progesterone and testosterone, fluctuate before flatlining and affecting the quality and quantity of sleep for some.
When you see what oestrogen, the hard-working hormone does, it’s obvious how sleep can be affected when levels decline. It helps to:
· Increase the REM sleep that’s so important for memory, mood and cognition
· Reduce the time it takes to fall asleep
· Reduce the number of incidences of waking up after going to sleep
· Increase sleep time
· Regulate body temperature during sleep (bringing hot flushes & night sweats
Progesterone also has a part to play, helping to make you feel sleepy and with oxygen flow. So, when levels fluctuate during perimenopause it may impact on the quality of sleep, causing you to wake up several times.
The three different sleeps -deep, light & REM all have their different functions. As we fall asleep we’re in a light sleep that transitions into the restorative deep sleep of about 4 hours that we need to feel rested. REM sleep uses a lot of energy with rapid eye movement looking for light, dreaming and processing the day. If you have too much REM sleep, you might not feel so rested. Aim for around 7 hours of sleep.
The first step to tackling sleep problems in menopause is to have more awareness of the issue. Tracking sleep by keeping a journal to record the previous night’s sleep disturbance can be very helpful, recording:
· time going to bed
· total time in bed
· how much time is spent asleep and awake?
· foods eaten, coffee & alcohol intake before bed
We all have our own circadian rhythms. These physical, mental, and behavioural changes follow a 24-hour cycle and respond primarily to light and dark. They change through life but can be reset through introducing the brain to routine, to include:
· Getting up at the same time each morning – early is better to make you sleepier at night
· Eating breakfast to signal to the brain that it’s morning
· Getting natural light in the morning to reset melatonin levels (the sleep hormone)
· Avoiding screens at night that interfere with sleep by suppressing the production of melatonin
· Supplementing melatonin but talk to GP to see if this is appropriate to ensure it doesn’t cause long-term disruption
Prevention is better than cure! To reduce the chance of waking up, cut back on stimulants. Caffeine takes a long time to break down in the body, so best avoided after 3pm. Drinking alcohol can lead to more REM sleep and less restorative deep sleep.
After being awake for twenty minutes or more, get out of bed and go and sit in a different room and do something relaxing. This change of room will help to break the connection associating the bed with sleeplessness.
It might be hard to resist the urge to catch a bit of shuteye in the afternoon, but it’s not recommended. There’s only so much deep sleep that the body can manage within a 24-hour period and this may exacerbate sleeplessness in the night.
However, if you are going to sleep, make it for no more than one hour and make sure you’re awake by 3 pm.
Exercise not only helps the body and mind - it can also help with getting a deep night’s sleep, particularly if done at the beginning of the day. There may be some improvement in sleep quality on the same day. Exercising just before bed is a no-no, as exercise releases endorphins which can keep you awake.
Medication can reduce the quality of sleep and reduce the amount of REM sleep, which is important for learning, memory, emotional processing and dreaming. Far better to tackle the underlying cause of sleeping difficulties.
Our sleep webinar ended with a guided Nidhra sleep meditation, a deeply restorative and healing practice which promotes deep sleep. Something to try?
https://www.theinsomniaclinic.co.uk/cognitive-behavioural-process
https://test.sleepyheadprogram.com/sf/cbba53a4
https://www.nhs.uk/conditions/insomnia/pages/treatment.aspx/treatmentoptions.aspx
https://www.sleepstation.org.uk/articles/sleep-clinic/nhs-options-for-insomnia-treatments/
Nidra by Swami Satyananda Saraswati
Yoga Nidra for Complete Relaxation and Stress Relief by Julie Lusk
Radiant Rest - Yoga Nidra for Deep Relaxation & Awakened Clarity by Tracee Stanley
Yoga Nidra Made Easy: Deep Relaxation Practices to Improve Sleep, Relieve Stress and Boost Energy and Creativity by Uma Dinsmore Tul and Nirlipta Tuli (coming out May 2022)
