How good is your sleep?
We all know that high quality sleep is critical to our health and wellbeing. As humans we are programmed to spend, on average over the course of our lives, one third of it asleep. This equates to 8/24 hours, or eight hours a night – I know, right? But remember this is an average and is measured over the course of a lifetime (remember how much teenagers and babies sleep!). Much of the complexity of sleep is still being studied, but sleep is essentially time during which our body heals and regenerates. And yet, if you’re a woman in peri-to-post menopause, a good night’s sleep often seems impossible to come by. Because as if it wasn’t enough to have our raging hormones leaving us fatigued during the day, they can often prevent us from sleeping well at night too. Night sweats, hot flushes, restless legs and constant trips to the loo are all symptoms of perimenopause. And then of course, there’s good, old-fashioned insomnia. There’s nothing more rage-inducing than feeling tired yet wired at 3am, unable to sleep while your partner snores gently beside you.
The science of sleep
At its core, sleep is not simply a period of passive rest. It’s a highly active and essential biological process that allows your body and mind to repair, restore, and consolidate information. Think of it as vital maintenance for your entire system.
Scientists are still uncovering all the details of sleep, but we know it plays crucial roles in:
- Physical Restoration: During sleep, your muscles relax, tissues repair, and energy is conserved. Growth hormone, important for tissue repair and muscle growth, is primarily released during deep sleep (this is why children and teenagers – despite what they say – need more sleep than adults).
- Cognitive Function: Sleep is vital for learning, memory consolidation, and problem-solving. During sleep, your brain processes information gathered during the day, strengthens neural connections, and clears out metabolic byproducts.
- Emotional Regulation: Adequate sleep is essential for maintaining a stable mood and managing stress. We all know how sleep deprivation can lead to increased irritability, anxiety, and difficulty regulating emotions.
- Immune Function: Your immune system relies on sufficient sleep to function optimally. During sleep, your body produces cytokines, proteins that help fight inflammation and infection. Chronic sleep deprivation can weaken your immune response.
- Hormonal Balance: Sleep plays a critical role in regulating various hormones, including those involved in appetite (ghrelin and leptin), stress (cortisol), and reproduction. As we all know hormonal balance is particularly relevant during the menopausal transition.
Understanding that sleep is an active and necessary process, rather than just “downtime,” can shift your perspective and motivate you to prioritise it.
Your body’s internal clock, the sleep-wake cycle
Imagine an internal 24-hour clock ticking away inside you and inside every cell – that’s your circadian rhythm. This biological clock regulates a wide range of bodily functions, most notably your sleep-wake cycle. It’s primarily influenced by light cues (or lack of) from your environment.
Here’s how it generally works:
- Light as the Primary Cue: When your eyes detect light, particularly blue light (emitted from electronic devices and the sun), signals are sent to a region in your brain called the suprachiasmatic nucleus (SCN). The SCN acts as the master clock, co-ordinating other biological clocks throughout your body. (This is important when we discuss a sleep routine).
- Melatonin Production: As darkness falls, the SCN signals the pineal gland to start producing melatonin, a hormone that promotes feelings of drowsiness and prepares your body for sleep. Melatonin levels typically peak in the middle of the night and decline towards morning. This is why melatonin is often taken to help individuals sleep, perhaps when travelling across different time zones.
- Other Rhythms: Your circadian rhythm also influences body temperature (which naturally dips during sleep), hormone release (including cortisol, which is typically highest in the morning), and even appetite.
The impact of menopause on the circadian rhythm
During perimenopause and menopause, fluctuating and declining levels of oestrogen and progesterone can significantly impact your circadian rhythm. These hormonal shifts can lead to:
- Altered Melatonin Production: Some studies suggest that lower oestrogen levels may be associated with reduced melatonin production, making it harder to fall asleep and stay asleep.
- Increased Sensitivity to Light: Changes in hormone levels might affect how your body processes light cues, potentially disrupting the natural rise and fall of melatonin.
- Disrupted Body Temperature Regulation: Hot flushes and night sweats, common symptoms of menopause, are directly linked to disruptions in the body’s temperature regulation, further interfering with sleep.
- Increased Stress Response: Hormonal changes can sometimes heighten the body’s stress response, leading to increased cortisol levels at night, which can inhibit sleep.
Understanding how your internal clock works and how hormonal changes can affect it is crucial for developing strategies to support a healthy sleep-wake cycle.
Common sleep problems experienced by women in peri-to-post menopause
Let’s look at some of the key sleep challenges you might be facing:
- Increased Insomnia: The hormonal rollercoaster of perimenopause and the lower oestrogen levels of postmenopause can directly impact neurotransmitters in the brain that regulate sleep and wakefulness. This can manifest as difficulty falling asleep (taking longer than 30 minutes), difficulty staying asleep (waking up frequently and struggling to fall back asleep), or early morning awakenings (waking up too early and not being able to go back to sleep).
- Night Sweats and Hot Flushes: These sudden sensations of intense heat, often accompanied by sweating and a rapid heartbeat, are a hallmark of the menopausal transition. They can jolt you awake multiple times throughout the night, leading to fragmented and poor-quality sleep.
- Increased Anxiety and Worry: Fluctuating hormones can influence mood and anxiety levels. Increased anxiety, particularly in the evening, can make it difficult to wind down and relax enough to fall asleep. Racing thoughts and worries can keep your mind active when it should be resting.
- Restless Legs Syndrome (RLS): While not exclusively a menopausal symptom, RLS, characterised by an irresistible urge to move the legs, can be exacerbated or newly onset during this time. The uncomfortable sensations often worsen at night, making it difficult to fall and stay asleep.
- Sleep Apnoea: While more common in men, the risk of obstructive sleep apnoea (a condition where breathing repeatedly stops and starts during sleep) can increase for women after menopause, potentially due to hormonal changes and weight gain. Symptoms can include snoring, gasping for air during sleep, and feeling tired despite sufficient time asleep. It can be serious, so if you think you are suffering from sleep apnoea then it is wise to seek professional advice from your GP or a sleep clinic.
Now, I know this is a lot of information and I honestly don’t want to overwhelm you (we all know how easy it is to feel overwhelmed at this stage in our lives), but understanding how sleep might be affected by peri-to-post menopause can help you appreciate the complexity of sleep and the various way it can be disrupted. Knowledge is power, and this knowledge is the first step to empowering you to take control of a situation in which many women often feel helpless.
Reclaim Your Rest: The Seven Day Sleep Solution for Women in Midlife
It’s important to remember that you are not alone in facing these sleep challenges. Many women go through similar experiences during this significant life stage. It’s important to be honest and open with friends, and while sharing a problem doesn’t necessarily guarantee you a better night’s sleep, the realisation that you are not alone might ease some anxiety around the issue.
It’s equally important to know that you can recalibrate, you can reset and you can get a good night’s sleep. And you can start within seven days. Reclaim Your Rest, The Seven Day Sleep Solution for Women in Midlife is a course I designed to support women in peri-to-post menopause struggling to sleep.
I can’t promise to totally solve your sleep problems immediately, but my sleep course can show you tools and protocols to put you on the right path to feeling more rested – and hopefully incentivise you to keep going. This course provides a comprehensive and actionable approach to improving sleep for women in midlife, addressing various factors that can influence sleep quality. It allows you to take control of your sleep habits and build a foundation for long-term sleep as you navigate the unique challenges of peri-to-post menopause.
If you’d like to sign up, and start to improve your sleep today, you can do so here.
