Challenges with sleeping is one of the main symptoms for peri and menopausal women. Sleep expert, aka ‘The Sleep Geek’ James Wilson and leading GP Dr Zoe Williams, who are working with online menopause community Issviva, (www.issviva.com) discuss the connection between sleep and menopause, and share their expertise about how to get better quality shut eye.
James Wilson: When you are going through the menopause, your sleep is mostly impacted by two things: hot flushes and hormonal changes. Hot flushes disrupt your sleep by waking you up, and causing you to need to change your clothes and bedding. It can also cause a lot of stress and upset. Hormonals can also disrupt your sleep. The decline in oestrogen, progesterone and testosterone can change your biochemical pathways, which impacts sleep.
When you sleep, you relax, and so your heart rate drops and your core temperature is cooler. So when your hormones impact how you can unwind, and your hot flushes affect your body’s temperature, it’s not surprising you are finding it difficult to sleep.
Dr Zoe Williams: Women who have always been good sleepers can struggle to sleep – which can cause anxiety and stress, which in turn can impact our sleep. Sleep issues are often one of the first things that women report as a perimenopausal symptom.
James: Every single night, we all wake up three to six times, but we have to be awake for five minutes to remember it. When we start going through the menopause, we may be awake for 10 minutes, while we used to be awake for three minutes. These small differences can make a big difference in how we feel. You may have always got away with not winding down before bed. You may have never used to remember waking up at night. Now, decompressing before bed is vital. Allow yourself some space to prepare the body for sleep. We all know not to drink coffee or use our phones, but I think it’s important to find out what works for you. Work out what relaxes you, and ensure your targeted sleep time is right for you. A lot of people go to bed when their partner does, but that might not fit your body’s natural rhythm. Have a compassionate conversation with the person who you might share a bed with, and find a routine that works for both of you.
James: Screens aren’t necessarily bad, but be aware of what you are looking at. Are you watching something stressful, or relaxing before you go to sleep? While blue light can impact how you sleep, it is becoming more apparent that if we get natural daylight early in the day, which is brilliant for sleep, it sets the body clock, and the blue light impact is not that great.
James: If you have a deficiency then supplementing can be helpful. Vitamin B5 and B6 can be helpful for sleep, and is a good place to start. The relationship between nutrition and sleep is well-documented. If you have a meal that is hard to digest, that raises your core temperature. So if you have a heavy or spicy meal within the three hours before bed, you will struggle to sleep.
Dr Zoe: I would balance the cost and the benefit it will give you. Give it a try for a few months, and really take note of the difference it makes. If you feel better and it’s affordable, then continue. But if it doesn’t, then it’s worth stopping and trying something else. There isn’t a magic pill for sleep. It takes time to build your suite of tips, techniques, supplements and products that actually work for you. Taking control helps you sleep better. You can’t force sleep, but you can do things that actively help you sleep.
James: Alcohol is not helping you sleep. It sedates us, so knocks us out. This impacts the quality of REM sleep. REM sleep is like an overnight counselling session. It helps you improve your emotional resilience, and deal with challenging hormonal changes. And alcohol makes that a lot more difficult. People going through the menopause often find that drinking the slightest bit of alcohol causes significant awakenings in the night. This is because alcohol can stimulate you. A lot of symptoms of a hangover is actually sleep deprivation. You crave junk food, you want to nap, you can get emotional. We have to change our lifestyles to manage the impact of the menopause and sleep. We often minimise the role alcohol plays in our overall health.
Dr Zoe: You might think a couple of glasses of wine will help you fall asleep. But the quality of that sleep isn’t as good, and you will be getting into the habit of relying on alcohol. Alcohol dependence can kick in much more easily than people realise. One of the concerns that people have about taking HRT is there is a very slight increased risk of breast cancer. If you drink two glasses of wine a night, this is an equivalent risk. So if you’re not taking HRT because your worried about the possibility of cancer, but you’re drinking a couple of glasses of wine a night to help with your menopause symptoms, you might want to re-evaluate, and perhaps have a chat with your GP.
There are other things you can do to help with your symptoms, like being physically active, and getting a better diet.
Dr Zoe: The quality of sleep is just as important as the amount of sleep. We’re obsessed with getting 7 to 9 hours, aren’t we? But actually you can be laid in bed for 7 to 9 hours, drifting in and out and not having good quality sleep. You’re better off having 5 or 6 hours of solid, good quality sleep.
James: Once we realign our ideas about what our sleep needs are, it’s a game changer. Sleep isn’t about hitting a number, it’s about how we feel.
Dr Zoe and James are working with Issviva, a platform aimed at helping to build a better menopause experience for women everywhere. The hub aims to break barriers for women going through the menopause and empower them to thrive and not just survive during this transitional period in their lives. The platform enables women to seek education, share advice and network with like-minded people.