Women, Menopause and Sleep

Women generally suffer from insomnia more frequently then men do, and at no time is this more true than during menopause and the period immediately preceding menopause, which is known as perimenopause. During menopause a woman’s hormonal balance goes through tremendous shifts.  During the day, these shifts manifest emotionally and psychologically as extreme irritability and mood shifts, memory loss and an inability to concentrate. Physically women are exhausted and experience hot flashes, periods of extreme heat that are characterized by a flushing of the skin and sweating. All of these daytime events are physically and emotionally exhausting, yet women going through menopause are often beset by insomnia. Over seventy five percent of women who are going through menopause report having troubles getting to sleep. Once asleep they are not able to maintain it, waking up frequently during the course of the night and then finding themselves unable to fall back to sleep. These problems can start years before actual menopause sets in, and can go on for years afterwards. One of the biggest sleep problems that women going through menopause experience is that of night sweats or hot flashes that occur in the middle of the night. Though hot flashes occur during the day, they are less disruptive than nighttime hot flashes. This is because the hot flash is preceded by an arousal of the brain. The surge in hormones awakens the sleep center to a high level of activity. This pulls the sleeper out of the restorative periods of their sleep. The heart rate is elevated, the sleeper’s body temperature rises rapidly, and they start to sweat as the body tries to cool itself down. Not only does the woman wake up soaking wet, often to the point of having to change their sheets, but they also find it nearly impossible to calm themselves down physically in order to return to sleep. Their sleep center is as alert as if they had just run a 5K race. The combination of physical symptoms with the emotional upheaval that accompanies menopause all contribute to a consistently poor sleep quality and possibly even sleep deprivation. Some women have found that using an estrogen supplement to replace the hormone that their body has lost is helpful; it helps them to fall asleep more quickly and sleep more deeply, without waking up in the middle of the night. Interestingly, though progesterone levels are also depleted during menopause, supplementing with additional progesterone has not been shown to have a positive impact on sleep. Some women who suffer from menopause have also found that certain herbs have helped them overcome their symptoms; these include ginseng, red clover, evening primrose oil and black cohosh root. Others have found that increasing their soy intake has helped. Though none of these remedies have been scientifically proven, some women prefer them to estrogen, which has been found to elevate breast cancer risk. As with most insomnia problems, daily exercise has also been found to alleviate symptoms and aid in getting a good night’s sleep.