Sleep and the menopause
Many women going through the menopause often experience insomnia, an inability to fall asleep or stay asleep at night. This is a normal side effect of the menopause and is usually caused by symptoms of the menopause, such as hot flushes.
I am not sleeping well at night. Do I have insomnia?
Symptoms of insomnia can include one or more of the following:
- Difficulty falling asleep
- Waking up frequently during the night, with difficulty returning to sleep
- Waking up too early in the morning
- Non-refreshing sleep (feeling tired upon waking and throughout the day)
Tips to prevent insomnia linked to menopause
There are many steps you can take to get yourself sleeping soundly through the night. Here are some tips:
- Do not nap during the day, unless you find having a nap helps you sleep at night
- Exercise daily, but not late in the day
- Reduce or avoid caffeine, alcohol and nicotine throughout the entire day
- Keep your bedroom cool to aid sleep and help reduce night sweats
- Wear light clothing
- Do not go to bed until you are tired
- Have a warm bath or shower at bedtime
- Do not watch television, use a laptop, eat or read in bed. Do these activities in another room until you feel sleepy
- Follow the same bedtime routine each night and get up at the same time every morning
- Avoid taking sleeping pills
- Reduce stress levels
- Avoid things that may disturb sleep, including spicy food, caffeine, smoking and alcohol. Alcohol may help you relax and fall asleep, but it should not be used as a sleep aid because it does not induce a natural form of sleep, and it has a rebound effect. It can disturb your sleep later and can cause you to awaken in the middle of the night.
- Try warm milk before bed. Milk contains a substance called tryptophan. The body uses tryptophan to make serotonin, a chemical in the brain. Serotonin helps control sleep patterns, appetite, mood, and other functions. Milk does not contain enough tryptophan to change sleep patterns, but drinking a glass of milk before bed may help you relax.
When lifestyle changes fail to cure insomnia, seek medical advice. There may be other options that can help. The doctor may be able to recommend medication on a short-term basis to help you sleep and get you sleeping regularly. In addition, your doctor can rule out other conditions that may be causing your sleep problem. Sleep disturbance may also be due to anxiety. If depression is causing sleep problems, a doctor may recommend counselling or an antidepressant.
If your insomnia is a result of menopausal symptoms, you may also want to talk to your doctor about medication for menopause symptoms that may be contributing to the sleep problems.
HRT can be effective in treating menopause symptoms, including hot flushes and night sweats.
Tibolone is a synthetic hormone treatment.
Clonidine is a drug that reduces hot flushes and night sweats in some menopausal women.
Although antidepressants are not licensed for treating hot flushes, some medications may be helpful.