Many women will tell you that the idea that menopause can wreak havoc on their sleep isn’t news to them. Indeed, a study in Sleep published in April 2017 reported that “sleep disturbances become very common during menopause, with an estimated 40 percent to 60 percent of menopausal women reporting poor sleep quality and about 25 percent meeting criteria for an insomnia disorder.”
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A New Way to Look at Menopausal Sleep Problems
What is news comes from a study published in the journal Menopause in December 2019 titled “Effects of Menopause on Sleep Quality and Sleep Disorders: Canadian Longitudinal Study on Aging.” Many studies have looked at the effect of aging on sleep, but very few have delved deeper into the issue by looking at menopause status and by looking at exactly what kind of sleep problems are associated with menopause. In the Canadian Longitudinal Study on Aging, researchers studied 6,100 Canadian women between ages 45 and 60, dividing participants into two groups: pre/perimenopausal and post-menopausal. They also tried to figure out what sleep disruptions are caused by menopause and what is caused purely by aging.
Sleep Issues for Midlife Women Need More Attention
“We under-address sleep issues in midlife women in general. This study brings much-needed attention to multiple issues concerning sleep disturbances. Poor sleep is associated with poor health [cardiovascular disease, diabetes, depression, and anxiety] so it’s not something to just blow off,” says Stephanie Faubion, MD, the medical director of the North American Menopause Society and the director of the Mayo Clinic Center for Women’s Health.
After Menopause, Women Are More Apt to Have Certain Sleep Problems
The research team discovered that post-menopausal women required more time (over 30 minutes) to get to sleep and were more apt to develop sleep-onset insomnia disorder (trouble falling but not staying asleep) and possible obstructive sleep apnea (OSA) than women who had not reached menopause.
But Menopausal Status Had No Impact on These Sleep Problems
The Link Between Menopause and Types of Sleep Trouble
“We have confirmed that the sleep disruption is related to menopause, and not age, and that the problem lies mostly in falling asleep, not staying asleep. Something may change in the biology of the brain that makes these women lose the drive to sleep,” says a coauthor of the study, Ron Postuma, MD, a professor in the department of neurology at McGill University in Montreal.
Root Causes of the Sleep/Menopausal Status Connection Are Still Unknown
Does the sleep trouble relate to hormones? So far, the connections between sleep and menopause are associative, but not causal. “We don’t yet know the mechanism driving it. It is difficult to study because when you’re having menopause, you’re also getting older; how do you disentangle the menopause from aging?” says Dr. Postuma.
Help for Sleep Trouble Is Available
“Treatments for various sleep issues are generally the same, no matter what is causing it,” says Dr. Faubion. If you want to get some better z’s at night, here are some ideas from the National Sleep Foundation:
- Avoid large, spicy meals before bedtime. They can trigger hot flashes.
- Reduce your consumption of caffeine and alcohol, especially later in the day.
- Quit smoking.
- Exercise regularly.
- Keep your bedroom temperature cool and wear light, breathable pajamas.
- Night sweats and insomnia related to menopause are best addressed by estrogen therapy (ET) or hormone therapy (HT). Discuss with your physician whether this is right for you.
Therapy Can Help With Insomnia, Improve Sleep
If you just cannot fall asleep at night, don’t immediately start seeking out over-the-counter or prescription medications. Postuma points out that the first-line treatment for insomnia is cognitive behavioral therapy, which teaches you how to change your sleep habits and reframe any negative thoughts on the subject, with specific techniques for falling asleep. If there is no sleep clinician in your area, you can find online resources to guide you through the process.
Sleep Trouble: When You Need More Help
If you suspect you may be dealing with something more complicated, such as obstructive sleep apnea, restless leg syndrome, or REM sleep behavior disorder, see a sleep clinician. You can find one in your area at the American Academy of Sleep Medicine.