#10.0 SLEEP

The power of sleep should not be underestimated. Sleep restores our mind and body and taken in the right doses it protects us from disease, aids immunity, helps us manage our weight, stay sharp and live longer.

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In our modern world many of us do not get the recommended amount of sleep and our sleep often isn’t of the best quality. As a population the amount of sleep we get has reduced. We could question whether there is a connection between this and the rise in obesity, stress levels and anxiety.

When perimenopause hits, one of the most common symptoms women experience is sleep disturbance. There are numerous reasons for this and we will explore them in this section and see what changes we could make to help us sleep better.


You may have experienced problems with your sleep even before entering the peri-menopause as around 2 to 3 adults struggle to get adequate sleep. Of course, if you have had children you will have definitely experienced broken sleep before this! However, many women report that their sleep disturbances worsen when perimenopause arrives, almost like a light bulb going on, leading to around 40% of women reporting sleep issues in their 40s and 50s.

The change to our sleep pattern can be driven by hormonal changes but also by how we are choosing to live our lives and by what is happening in our lives at that particular time. Women who are suffering with night sweats, restless legs, skin irritation, anxiety or stress etc. will be at more risk of experiencing poor sleep and periods of wakefulness. Women with other midlife related worries such as concerns about older parents or older children who are out partying! While you have one ear open listening for them to come home! Work stresses, financial worries, relationship issues, health concerns, working shifts or making poor nutritional choices all contribute to sleep disturbances. So once again, we cannot just blame our changing hormones!

Sometimes we get off to sleep well only to be woken by a night sweat or by something else that disturbs us. Then we find that we just can’t get back to sleep. Our brain springs into action and about a thousand thoughts start going round like a roundabout!

There is nothing more frustrating than lying awake, tossing and turning or being wide awake after you have slipped into bed after dozing on the sofa 10 minutes before because you felt so tired! Lack of sleep can contribute to weight gain, reduced cognitive function, low mood, gut health problems, stress, brain fog, being less productive and of course fatigue.

Sleep experts say that we should give ourselves an 8 hour window to sleep each night. Knowing that we won’t actually sleep that long, it is recommend that we get at least 7 hours good quality sleep a night and that sleep is essential to our overall health and wellbeing. We all differ and we may think that we can manage on less sleep but the reality is that, in a stage such as midlife when life can be so busy and wearing, we really do need that 7 hours of sleep!

The general rule is that if you set an alarm and you know you would sleep longer if it didn’t wake you, you are not getting enough sleep.

Like all other very annoying and frustrating menopausal symptoms there are things we can do to improve our sleep quality. So before giving up and deciding your ‘sleep life’ is over consider whether there are things that you could try that could help. Some of us can tolerate things that others can’t so of course, it’s all about how you respond to things. As always, take one step at a time and see what works for you best but give yourself time to form new habits and routine and be patient. If you know you have habits that could be disrupting sleep try to change them, take control. If you still find that you are struggling badly or that you are lying awake for hours on end, do seek help.

We have looked at options for improving troublesome symptoms throughout this program. Many typical menopausal symptoms contribute to poor sleep. In helping to minimise these symptoms you can really help with sleep patterns and lessen the disturbances you may be experiencing.

If you are suffering with stress or feelings of anxiety there is every chance this will be disrupting your sleep. We have looked at stress hormones such as cortisol and how imbalances in cortisol production can interfere with the natural patterns of sleep. We discussed cortisol earlier in the program and its affect on your sleep. With the potential challenges we face at our menopausal stage of life we may have higher levels of stress hormones. So managing stress and anxiety is a priority as it can heavily influence our ability to fall asleep and to sleep soundly.

Sleep experts believe that going to bed and waking at the same time each day is a good aid to improving sleep. If you need to make changes to your sleep schedule do it gradually until you achieve the desired timing. Shift the time a little at a time until you establish a satisfactory pattern.
It may be difficult for you to achieve this, especially if you work shifts or life just doesn’t allow, however it’s worth getting as close as you can to a regular pattern.

If you wind down and ensure that you are ‘sleep ready’ you stand a better chance of sleeping well. Try getting ready for bed an hour before you intend to tuck up, clean your teeth, put your PJs on, take off your makeup and then enjoy the last hour of your day before sliding into bed. Children usually have a wind down routine so why not create one as an adult? Wind down with some gentle music, relaxation or a bath and deep breathing to focus your mind on sleep. Use an app such as the calm app or insight timer or similar where you can listen to meditations. Use visualisations to help you feel relaxed. Dimming the lights leading up to bedtime is also beneficial.

Avoid screens and blue light before bedtime for a couple of hours. Also avoid over stimulating yourself with television programs or reading material or conversations that are going to heighten your senses. Try to avoid having any tech in the bedroom. Blue light glasses can help if you really can’t manage without looking at your iPad or phone in the hour before bed or you can use an app to change the light on your devices.

The hormone melatonin influences our circadian (sleep/awake). Natures natural light patterns influence our melatonin levels. In a nut shell, daylight stimulates our ‘awake’ state and dim light our ‘sleepiness’, therefore dimming the lights leading up to bedtime is beneficial.

Avoid alcohol in the afternoon and evening. Alcohol is often thought of as a great sleep aid but it has a negative on your sleep and fragments your sleep, often making you feel you haven’t slept well when you wake in the morning. It also deprives you of your REM sleep which is a necessary stage of sleep.

Avoid caffeine in the afternoon and evening if you know that you are not sleeping well. Caffeine stays in our system for many hours after we have had any so it is recommended that if you like a coffee or cups of tea that you have them in the morning only. Try replacing your afternoon coffee with something else you can enjoy, this is a great time for exploring all the wonderful caffeine free teas you can buy now. Even decaffeinated drinks can give you problems too so if you truly want to discover if you are better without either it is better to avoid both.

Our body temperature needs to drop one degree ideally to help us to go to sleep – this would explain why the hot flushes we may experience are not conducive to sleep, along of course with the fact they can make us feel so unbearably uncomfortable!

When we eat a large amount of food, especially if it contains sugar it raises our body temperature so if you need to eat anything later in the evening, having had your dinner early it is best to choose something high protein with some fibre, for example Greek yoghurt with berries, oat cakes with sugar free peanut butter or almond butter with apple. We shouldn’t go to sleep hungry but neither should we go to sleep full.

Have a warm drink but not caffeine in the run up to bedtime such as a camomile tea or ‘sleepy’ tea or whatever works for you. As children do you remember the warm milk that soothed you to sleep? Caffeine affects people in different ways and working out whether drinking it affects your sleep. Caffeine has been shown to have some health benefits (the coffee bean contains antioxidants) so it’s more about the timing of drinking it than cutting it out.

Make sure your place of sleep is welcoming. Think about the temperature of the room, around 18 – 18.5 degrees Celsius is considered optimal – if you have night sweats you won’t want un unventilated room that is already too warm. Make sure your bedlinen, pillows, nightwear (if you wear any) and bed are all comfortable to sleep in. Consider scents that will help sleep – I have mentioned herbs such as lavender previously.

For most of us, exercising regularly and taking the right type of exercise at the right time can contribute to good sleep. Usually it would be wise to avoid highly stimulating exercise late in the evening and to do something that is calming. Taking plenty of fresh air can aid sleep too.
If you are exercising regularly and at a suitable level, you are likely to reduce the risk of aches and pains that can keep you awake at night.

Exercise also helps us maintain a healthy weight. Apparently we are more prone to snoring and sleep apnea once we reach this stage of life and being overweight can promote snoring. None of us want to be accused of being a snoring old lady!!

Whilst exercise is important it is not recommended that you wake yourself early to fit in your exercise. If you naturally rise early and have had adequate sleep that’s fine but the fact remains that sleep is even more important to our long term health well-being than exercising.

How and when we eat can have an effect on how we sleep. I have previously mentioned caffeine, sugary foods and alcohol being sleep disruptors and that if you need something in the evening it is best to stick with protein and fibre. Foods rich in carbohydrates can make you feel drowsy but evidence shows that they also affect sleep quality, giving us more awakenings in the night and less deep sleep. Studies have shown that lacking certain nutrients such as magnesium, calcium, potassium, vitamins A, C D, E and K can affect sleep too. The Mediterranean diet is beneficial to health but also to sleep.
Following a well-balanced diet and taking notice of any food or drink that triggers poor sleep will be beneficial.

There are many supplements, lotions and potions available that are all marketed for their beneficial properties for sleep. Herbal remedies can work well but I think it’s a case of exploring what works for you. Always check before taking supplements if you are on any other medication that they are suitable.

As you have probably concluded by now, if you take a holistic approach to your health and well-being in menopause and try to create good habits across the board, one thing will help another. Sleep is no exception, if you live well, eat well, move enough and manage any stress your sleep should be better!

It is normal to spend a small percentage of time awake in the night but when it starts stretching to longer stretches of time it isn’t natural. Here are some tips that may help!
If you lie in bed trying to get back to sleep for over 25 minutes it has been shown that your brain starts to associate your bed and your bedroom with the place you are awake. This sets up a pattern which we want to avoid. To help your brain relearn that bed is the place for sleep it is better to get up, do something such as gentle stretching, relaxing, reading in a dim light or meditation until you feel sleepy again then return to bed. Don’t check your phone or have anything to eat though!

Advice is not to count sheep but to do something such as ‘take yourself on a walk’. Envisage your walk, slowly ambling along and before you know it you may be hearing your alarm!
Count backwards! Choose a number to count backwards from and visualise the number as you breathe out. If your thoughts wander then start again - this worked for me!

Remove all clock faces! Being aware of the time can be unhelpful.
Try not to get stressed if you lie awake – use the tip of getting up. If this doesn’t appeal try deep breathing, progressively relaxing your muscles or going on that walk or using visualisations that will promote sleepiness. Take your mind off your mind – ruminating is not going to promote sleep – though we all know things seem 100 times worse at night. This is why addressing issues in your life is essential if you can so that you don’t have to take them to bed with you. Perhaps have a note book by the bed so that you can jot anything down and offload it from your mind.

If you are having night sweats you may feel better if you have a warm shower then go back to bed so that you feel comfortable & clean as you drift off. Again this worked for me!

I am sure that there are hundreds of other tips and ideas you could explore and many great reads and podcasts you could listen to. If you are really struggling to sleep please seek help.