Menopause & Sleep
by Leah Larwood, 24th August 2022
“Sleep is like a cat: It only comes to you if you ignore it.” - Gillian Flynn, Gone Girl
(If you can’t ignore sleep, we’ll share with you other ways and means of getting that much-needed shut-eye you need during menopause.)
What You Need to Know About Menopause and Sleep
Menopause can be a time of unsettled hormones, bodily changes and psychological modifications for many women. Quite frankly, all that change can wreak havoc on our sleep and energy levels. Rest assured, if you’re going through the menopause and noticing your sleep quality has changed, you’re not alone.
Sleep disorders affect 39 to 47 percent of perimenopausal women and 35 to 60 percent of postmenopausal women (1). Women reach menopause one year after their periods have stopped (2), which can be around age 52. Though this can vary for each woman.
Sleep issues can start before the menopause, during perimenopause, which is when the ovaries start to decrease production of oestrogen and progesterone, this can take around seven to ten years before menopause (3). It’s these hormonal changes that contribute to sleep issues, and for some women, they continue post-menopause.
Among menopausal women, the most common sleep problems include hot flashes, insomnia, sleep-disordered breathing and other mood and sleep disorders. With that said, not all women going through the menopause will experience sleep disturbances, and actually, it’s pretty standard for our sleep patterns to change as we get older - this includes both men and women.
Recognising any changes and being aware of what’s occurring can be a helpful way to tune into your sleep. However, there are some sleep disturbances very specific to the menopause, and these can start during perimenopause. The key is determining between perimenopausal and menopausal sleep disturbances and clinical insomnia.
It’s therefore super important to get enough sleep during menopause. If we don’t get enough sleep the body won’t want to exercise, our ability to think clearly reduces, and it can impact our decision making on every level.
What Causes These Sleep Disturbances?
During perimenopause, menopause and post-menopause, poor sleep doesn’t just appear out of thin air. There are some good reasons why sleep, might at times, be disturbed. Sometimes sleep can be impacted by hot flushes or night sweats. Hot flushes affect 75 to 85 percent of women around menopause. This is when your body temperature rises, creating a heating sensation that wakes you up. Adrenaline can also kick-in, which can make it tricky to get back to sleep.
Even if you manage to get back to sleep, the quality of sleep can suffer due to the frequent wakes, resulting in tiredness then next day. Insomnia is usually a term used to describe having difficulty falling or staying asleep more than three nights a week. This sleep deprivation can lead to anxiety and irritability (4). If you have insomnia during menopause, you will miss out on overall sleep or wake up early, and often feel sleepy and tired during the day. The risk of insomnia during menopause increases to 61 percent of post-menopausal women reporting insomnia symptoms (5).
Sleep apnoea and snoring can also be more common in post-menopausal women. The former is when someone experiences temporary pauses in breathing, which lead to gasping, snoring, and choking sounds, along with poorer sleep quality. Once perimenopause begins, the risk increases by four percent each year (6).
Research shows that lower progesterone levels, like those in post-menopausal women, may contribute to the development of sleep apnoea. Other sleep disorders might include restless leg syndrome, periodic limb movement disorder, which can impact sleep. A lack of sleep can cause or contribute to low mood, anxiety and depression.
The Biology of Sleep
Good sleep is essential to our overall health and the key to the unfolding of menopause. Research shows that as we head into our sixties we need between seven to nine hours sleep a night for our bodies and minds to transition into the next stage of life. As we go through menopause, progesterone comes down and oestrogen spikes, causing more overgrowth.
Fluctuating oestrogen levels can lead to night sweats, hot flushes and urinary issues. These can all impact sleep, as can, stress, low mood and anxiety. Early morning waking and unsettled nigh time sleep can all contribute. That’s why progesterone can be supportive for sleep. This hormone increases the production of GABA (gamma-aminobutyric acid), another chemical in our brain that works to help sleep, according to Dr Louise Newson, author of Menopause (7).
Low testosterone can also impact the length of sleep you get during the menopause, and melatonin, a hormone that regulates sleep, can be impacted by changing oestrogen and progesterone levels. Also, for those that experience mood changes during menopause these can often be linked to hormonal changes.
It’s worth bearing in mind that around this time, other life stressors such as caring for aging parents, empty nesting and concerns about your own aging, may also increase stress levels. It can also be commonplace to experience joint pains, body aches, and bladder problems associated with age, which in turn, can also contribute to sleep problems.
Lifestyle & Behaviour Impacting Sleep
A few disturbed nights can cause anxiety around sleep and this can lead to a cycle of anxiety and sleeplessness. So actually, one of the most common factors aside from hot flushes, can be worry, stress and anxiety associated with the menopause, aging or general lifestyle, which can have a knock-on effect to sleep.
Plus, old habits that didn’t used to cause a big problem, such as screen-time before bed, that extra glass of wine with dinner or caffeine, can start to trigger poor sleep hygiene, which is why it can be beneficial to support changing hormones and other conditions through introducing some sleep rituals before bed during menopause.
How hypnotherapy can help
“A ruffled mind makes a restless pillow.” — Charlotte Brontë, English Novelist
There have been various studies to show that hypnotherapy is a compelling approach for clinicians and patients alike partly because hypnotherapy is typically brief yet can provide long-term symptom relief, with two thirds of people reporting that hypnosis benefited their sleep outcomes (8).
During menopause, the higher levels of cortisol may be the reason for sleep changes. You can support these changes by practising relaxing sessions of hypnotherapy to help you lower your stress and manage cortisol levels.
Evidence shows that mindfulness-based approaches (9) and relaxation techniques like hypnotherapy can reduce cortisol levels. Ultimately, hypnotherapy can encourage you to think and feel differently about sleep, to see a different and better way.
Listening to hypnotherapy sessions while lying down is a good way to get yourself ready for sleep. In fact, so many of our community tell us what a godsend our Clementine sleep sessions have been to help them fall asleep or simply rest.
How to Boost Sleep
The truth is there’s no such thing as normal. Yep, you’ve heard it here first. Our sleep will inherently change as we progress through different periods in our lives. So it’s really about maximising your chances of sleep and encouraging some acceptance around changes. You can menopause-proof your bedroom with a few simple ways to boost sleep hygiene. Things like ensuring you have light bedding and breathable nightwear to avoid overheating.
A fan by your bed can also be a soothing way to cool down and the white noise of a fan can be a good way to find the folds of sleep. Avoid screen time before bed and try to keep your bedtime consistent. Finally, you might like to try some journaling before bed to download any thoughts or tasks for your day ahead, to ensure you offload thoughts and worries.
The British Menopause Society found that use of hormone therapy (HRT) improved sleep quality in women who experienced vasomotor symptoms (flushes and sweats) but not in women who did not have such symptoms. The review concluded that flushes and sweats may lead to disturbed or poorer-quality sleep, rather than oestrogen deficiency in the absence of symptoms (10).
HRT is of course one of many options, and there are a number of approaches many women try first. Always consult your GP if you are experiencing symptoms of menopause that are concerning you.
How Our Sessions Help
Play Get to Sleep Ritual: Relax, Sleep, Feel Better about Menopause
Designed to help you let go of the stresses of the day and fall asleep. Using either a night cream or serum as part of your ritual for sleep, we will guide you through a relaxing massage to calm and help you to let go of the day just gone. The session is perfect to help you feel less stressed and anxious about this time of life and to feel more comfortable with the menopause. To be used as and when you need help to get to sleep. For more longer-term mindset change around menopause, we recommended listening at least 3 times a week for a month.
Play Back to Sleep Ritual: Cool down after a hot flush and get back to sleep
Do you throw off the covers and move about in bed to find a ‘cool spot’? Are night sweats or hot flushes a source of stress that impacts how you feel the next day? This session is perfect for you. Designed to help alleviate hot flushes and night sweats during menopause, to improve the quality of your sleep by helping you stay cool and calm, switch off and get back to sleep.
(1) Sleep Foundation
(2) Age of Menopause
(3) Age of Menopause
(6) Sleep disorders in menopause
(7) Menopause by Dr Louise Newson
(8) Hypnosis for Sleep
(9) Mindful Menopause, Sophie Fletcher
(10) British Menopause Society