How Does Menopause Affect Sleep?
The transition towards menopause is different for us all, and it’s likely that we’ll all experience some of the 48 symptoms to varying degrees as perimenopause progresses. Amongst other symptoms during this time, fluctuating hormones are likely to bring us hot flushes, sleepless nights, and anxiety. Joys! But how exactly does menopause affect sleep, and what can we do to maximise our time between the sheets? We spoke to registered nutritional therapist, Thalia Pellegrini, to find out.
Thalia has been practising for over 20 years, and specialises in women’s hormonal and menstrual cycle nutrition at all life stages, with a particular expertise in perimenopause and menopause. She works with Wild Nutrition’s expert consultation team, supporting women with nutrition, supplement and lifestyle advice, and has clinically supported thousands of women over her career.
Knowledge is power - so who better to put our questions to, to find out as much as we can about menopause and sleep? Let’s dive in.
What role do hormones play in sleep disruption during perimenopause?
We wanted to know more about exactly how our hormones are comronuting towards sleep disruptions. Thalia told us,
"Poor sleep in perimenopause can be caused by a myriad of hormonal fluctuations. Let’s start with progesterone. In early perimenopause, this hormone starts to dip. As it does so, women may start to notice that the quality of their sleep changes. This is because progesterone has a calming effect (declining progesterone is the same reason women can feel more anxious) and as it drops it can be harder to sustain a deeper sleep.
“As we go through perimenopause our oestrogen levels rise and fall (and rise and fall!). When oestrogen drops, there can be an impact on our thermoregulation which can lead to night sweats or just a rise in body temperature at night that can disrupt sleep. These two hormones playing their not-so-merry dance have a knock-on effect in different ways throughout the perimenopause transition. Lots of women in perimenopause will tell me that they can fall asleep without too much trouble, but they wake in the night, particularly around 3-5am and struggle to get back to sleep. One reason for this can be low blood sugar, so try having a small snack before bed to see if it helps.”
How do hot flashes affect sleep, and what remedies can help ease this symptom?
“Hot flashes typically feel like intense heat which can come on slowly or very quickly,” Thalia told us. “Some women will experience them as sweating, burning skin or night sweats - any or all of which can interfere with sleep. There are lots of ways to try and help ease hot flashes. Firstly, it can be really helpful to try and work out your triggers so you can try and avoid them. The main culprits are hot drinks, caffeine, spicy foods, sugar and alcohol, especially if consumed in the evening.”
So, are there any supplements we can take to ease hot flushes? Over to Thalia:
“Black cohosh may be helpful for hot flashes but the jury is out on whether or not it works for everyone. In a small study of 80 women, black cohosh taken for 8 weeks reduced the severity and frequency of hot flashes. Another herb that can ease the misery for some is sage. My tip is to infuse sage leaves in boiling water and allow to cool. Drink the chilled tea throughout the day.”
Any other lifestyle changes we can implement? Luckily, yes:
“Phytoestrogens, especially soya, have been shown to improve hot flashes. Consider incorporating tofu, tempeh, miso, natto and edamame beans into your diet. And don't forget the power of movement. Yoga has been shown to help reduce the frequency of hot flashes.
We also recommend investing in some good quality sleepwear too, which is why we created our new menopause friendly pyjamas! Made using cooling and breathable Lyocell (a plant based fabric sustainably sourced from Eucalyptus trees), our new Jersey Sleep T-Shirt Dress and Jersey T-Shirt and Shorts set are designed to help lower body temperature by up to 2.5°!
How can symptoms of anxiety be relieved naturally?
Thalia touched on anxiety earlier, but we wanted to delve a little deeper. Anxiety is a really common PMS symptom too, as well as one of the most commonly experienced menopause symptoms. So what causes it?
“Anxiety is probably the symptom I hear about most from my clients in perimenopause,” Thalia agreed. “My top tip for helping relieve anxiety is balancing your blood sugar. Dips in blood sugar can make you feel worse when anxiety hits. I recommend eating three meals a day and including protein, fibre and some healthy fats with each meal. Women in perimenopause will often tell me that they are intermittent fasting and not having breakfast. For some, the gap between dinner and the first meal of the following day is too long and can exacerbate anxiety because their blood sugar is too low.
“When it comes to relieving anxiety, what we leave out can be as helpful as what we add in. Alcohol and caffeine are both stimulants. They can ‘spike’ your blood sugar. If anxiety is an issue for you, consider cutting back on both. Try herbal teas and opt for a botanical spirit as a swap for your regular tipple.”How about supplements to help with anxiety?
“A few of my supplement go-to’s for anxiety in perimenopause are magnesium and KSM-66 ashwagandha. Magnesium is nature’s chill out mineral. Taken at night, it can help reduce anxiety and improve sleep.“Food sources of magnesium include black beans, avocado, dark chocolate, dark green leafy vegetables and seeds. Ashwagandha, also known as ‘withania somnifera’, is an adaptogenic herb traditionally used to support the body’s resilience to physiological and psychological demand. Taken in the morning it may help manage a stressful day ahead, or taken at night, it can help with sleep.
“I always suggest the 4-7-8 breath to perimenopausal clients struggling with anxiety. Even if we’re busy, this is a helpful, free and easy way to help manage the overwhelm. It takes just a few minutes. Breath in through your nose for a count of 4. Hold the breath for the count of 7. Release through your mouth for a count of 8. It can take a few attempts but it will act as a brake to your stress and activate your parasympathetic nervous system.”
The bottom line on menopause and sleep
Yes, menopause can deeply impact sleep quality - with hormonal shifts contributing to night sweats, insomnia and anxiety. But while these issues are certainly challenging, there are things that you can do to make the journey a little less bumpy. Implementing lifestyle changes can help - cut down on caffeine and alcohol, keeping your blood sugar stable and breathing exercises can help. When it comes to hot flashes, keep clothing cool and loose, and go for natural fibres for bedding and sleepwear.
If symptoms begin to impact your day to day life, speak to your GP about possible treatment options.
