Tuesday, Apr 02nd 2013

Is Menopause Playing Havoc With Your Sleep?

My husband loves to recount this story: When we were first married, he came down with the flu. One night, he was having a particularly tough time sleeping.

"Honey, wake up. I don't feel well."

I barely moved.

"Honey, please. Wake up. I can't sleep."

Grunt.

The pleading got a bit more insistent until I managed to register that someone was talking to me, and I wasn't dreaming.

Barely awake, I finally spoke.

"Go to sleep. You'll feel better."

And with that, I turned over and fell back into a deep, delicious slumber.

Call me a bad wife, but in those days, nothing got between my pillow and me.
(And in case you're wondering, yes, we're still married.)

But that was the last time I can remember sleep being so simple (for me, at least). First it was pregnancy and all the hormonal shifts that play havoc with your sleep.
Then, there were real, live, needy children in the house, who uncannily took turns waking up on alternate nights right around 3 or 4 a.m. Those children turned into teenagers who kept late hours and whose mother couldn't sleep until she heard the crunch of the gravel in the driveway.

RELATED: Sleep Disorders

The kids eventually moved out. Finally I could get a full night's sleep.

Wrong.

Was it my husband finally getting his sweet revenge?

No.

Enter perimenopause and then menopause.

The years from peri- to post-menopause are when women report the most sleeping problems, says the National Sleep Foundation. In fact, as many as 61 percent report symptoms of—you guessed it—insomnia.

So many things come together at once to cause these sleeping issues. Hot flashes—also known as night sweats when they occur during sleep—start with a rise in your body temperature and end with you throwing off the covers and all your clothes (well, that's what I did). They not only can interrupt your sleep, but may keep you from getting back to sleep. Did you know the average hot flash could last up to three minutes? A few of these each night sure put a cramp in your sleeping style.

Mood disorders that come along with hormonal shifts (remember PMS?) can keep your mind racing at inopportune times. And just the anxiety of knowing that you haven't slept well since who-knows-when can set you into a cascade of more anxiety and worry that you won't sleep again tonight. Also, it's inevitable that you will have other things crowding your mind with worry, among them aging parents, chronic pain, your career, your children or your relationship.

Don't discount those late-night trips to the bathroom, either. As the bladder muscle ages along with the rest of you, its capacity to store urine diminishes.

RELATED: The Truth About Sleep as We Age

Sleep for Menopausal Times

While there's no one-size-fits-all solution to this widespread issue, just knowing what the alternatives are can help you rest better (or at least anticipate a good night's sleep):

1.    Hormone replacement therapy (HRT)
2.    Phytoestrogens in over-the-counter nutritional products such as black cohosh, extract of red clover and ginseng
3.    Sleep-promoting medication

Not for you? There's a lot more to try:

1.    Temperature: The ideal sleeping temperature is about 65 degrees Fahrenheit.
2.    Caffeine: Avoid caffeine after 2 p.m. Fact: Caffeine has a half-life of six hours, meaning that six hours after your last cup, half the caffeine is still in your body.
3.    Alcohol: Avoid alcohol within three hours of bedtime; rather than it being a sedative, it is a central nervous system suppressant and becomes a stimulant in quantities.
4.    Block out light: Keep your bedroom as dark as possible; wear an eye mask if you must. Even those LED lights from your alarm clock are strong enough to seep through your thin eyelids and disrupt your sleep.
5.    Dress for success: Wear loose-fitting, breathable garments, like cotton. Or nothing at all.
6.    Nix the electronics: Computers, TV, iPads, etc., are all sleep-stealers. Aside from stimulating your brain, the blue light they emit can interfere with a solid night's sleep.
7.    Eat right: A bedtime snack high in carbohydrates but low in protein (like whole grain crackers with some peanut or almond butter) speeds the amino acid tryptophan to the brain, which in turn is converted to serotonin (a sleep-inducing neurotransmitter).
8.    Exercise (and if you do, exercise more): A brand-new study just published in the journal Menopause says that higher levels of routine daily physical activity may be a key to a better night's sleep for menopausal women with hot flashes or night sweats. Most experts, however, recommend completing vigorous exercise at least three hours before bedtime because it can stimulate your heart, brain and muscles, as well as raise your body temperature.

I'm sure you've developed your own sleep strategy if you're among the menopausal population struggling with this issue. Feel free to add your own tips; curious minds would love to know!