How Perimenopause, Menopause and Midlife Impact Sleep

Hormones

Any woman struggling through a night of hot flashes and night sweats knows her hormones are disrupting her sleep. But scientists now know that rapid hormone fluctuations begin as early as your late 30s, and can disrupt sleep even before signs such as hot flashes emerge.

“Ten years ago, you’d be hard pressed to find research on menopause and sleep,” Dr. Wytrzes says. “Today, we’ve learned that estrogen loss indeed affects sleep. People are taking this seriously and looking for ways to solve the problem.”

Mental Health

Depression, anxiety and a number of other mental health conditions can affect the quality of your sleep. Women with a history of these problems, particularly depression and postpartum depression, may find that their symptoms flare up as hormonal changes occur.

“It’s not that women are depressed about menopause,” Dr. Wytrzes says. “But this tends to be a time where these issues can re-emerge.”

Lifestyle

Sandwiched between aging parents and growing children — not to mention balancing a career and household duties — middle-aged women have complicated lives. With busy schedules, it can be harder than ever to maintain healthy habits like home-cooked meals, regular exercise and relaxation techniques. As the stress snowballs, reliance on caffeine and alcohol increase as well. All of these factors can influence the ability to fall into a deep, restful sleep.

Try to avoid consuming caffeine after 2 p.m. and refrain from drinking alcohol two to four hours before bed, Dr. Wytrzes recommends. Turning off cell phones and the TV at least one hour before bedtime will also help you fall asleep faster.

Underlying Health Conditions

Many health conditions, including obesity, diabetes, addictions, thyroid disorders and more, can affect sleep. Women in their 40s are also more likely to develop primary sleep disorders such as obstructive sleep apnea and restless leg syndrome, both of which can be exacerbated by stress, weight gain and an unbalanced diet.

Getting Relief

The first step in addressing sleep issues is to determine whether sleep loss is truly a problem. Although experts strongly recommend an average seven to eight hours of sleep a night for most adults, not all people need that much sleep, especially as they get older. Although rare, some do well on as little as six hours a night. The key, Dr. Wytrzes says, is whether a person has daytime complaints as well. Unusual irritability, memory loss, falling asleep during the day and an overall lack of energy are all signs that a person is not getting enough sleep.

Anyone with a sleep problem should begin by exploring likely causes. Ask yourself these key questions about your lifestyle, emotions and sleep routine.

Questions to Ask Yourself

• Am I experiencing more stress in my life than normal?
• What circumstances have changed in my life lately?
• Have I been exercising on a regular basis? If so, how vigorously and for how long?
• Do I feel more agitated that usual? If so, why might this be the case?
• What does my caffeine and alcohol consumption look like? Do I drink coffee in the afternoon or evening? Do I drink alcohol close to bedtime?
• Do I practice relaxation techniques to help myself decompress in the evening?
• Do I have a soothing bedtime routine?
• Do I work or spend time on the computer or my smart phone late into the evening?
• Is my bedroom dark, cool and quiet at night?
• Does my sleep partner snore? If so, do I use earplugs?
• Am I watching television in my bed at night?
• Do I wake up and go to bed at the same time every day?
  

The answers to these questions can help you evaluate your personal habits that may be impacting sleep. According to Dr. Wytrzes, many people find significant improvement in their sleep by carefully following a checklist for a better night’s sleep. She advises people practice good sleep hygiene for at least a month. During that time, keep a sleep log, noting the hours of sleep, the number of times you wake up, the time of your wakings and any other information that may be relevant. If after six weeks sleep problems persist, visit your primary care physician. Be sure to bring the sleep log as a helpful starting place. 

“The good news is that there is almost always something that can be done to improve sleep,” Dr. Wytrzes says. Medication, psychiatry services and relaxation techniques can be utilized to help you fall asleep.”

“I think people used to think that sleep problems were something you just had to handle on your own,” she says. “We now know how critical sleep is to our health and have a variety of ways to help.”