Sleep problems often belong to menopause. Up to around 1 in 2 women sleep worse around the menopause than before (Santoro, 2016). Often it is down to hot flushes, night sweats and fluctuating hormones. With the right approach there is usually something to improve.
I notice that poor sleep exhausts women the most in this phase. You lie awake, your thoughts keep churning and during the day you feel wrecked. Below you read where it can come from and what seems to help.
Why do you sleep worse in menopause?
In menopause your oestrogen and progesterone fall, and that affects your sleep in several ways. Progesterone has a calming effect, so less progesterone can make falling asleep harder. On top of that, hot flushes and night sweats give broken nights.
The four most common causes:
- Hot flushes and night sweats that wake you
- Less progesterone, which normally gives rest
- More worrying, stress or a restless mind
- Needing to urinate more often or physical discomfort
Does cortisol play a part?
Cortisol is your main stress hormone and has a daily rhythm: high in the morning, low in the evening. With long-term stress that rhythm can become disturbed, so you are wide awake in the evening instead. In menopause, stress and hormonal fluctuations often run together.
A disturbed cortisol rhythm can contribute to trouble falling asleep or waking early.
A blood test gives a first impression here. The Menopause Check brings your cortisol and estradiol (E2) into view, among others, so you can see what plays a part.
Poor sleep and your weight
Sleep and weight are connected. With little sleep your hunger and fullness hormones go out of balance, so you crave sweet and fatty food more often. So poor sleep in menopause can also feed weight gain.
It sometimes works like a vicious circle.
Do you also have trouble with gaining weight alongside sleep problems? Then read our article on weight gain in menopause and what helps.
Poor sleep and brain fog
You notice a few bad nights during the day: you are forgetful, your concentration falters and your head feels fuzzy. This is commonly called brain fog. Poor sleep is one of the best-known drivers of it.
Often your head improves as soon as your sleep improves.
Do you mainly recognise forgetfulness and concentration problems? Then read our article on brain fog in menopause.
What helps with better sleep?
There is no quick fix, but a calm evening routine and a cool bedroom help many women. It comes down to letting your body settle and limiting triggers. What works differs per person, so give it time.
What helps many women:
- A cool, dark bedroom, pleasant with night sweats
- Less caffeine and alcohol, especially in the evening
- A fixed sleep rhythm, also at the weekend
- Screens and worrying thoughts out of the bedroom as much as possible
Want the whole picture of menopause first? Then read our pillar on perimenopause, symptoms and solutions. If the complaints persist, discuss it with your GP.
When to see your GP?
An occasional bad night is normal. It becomes more important if sleep problems last long and affect your daily life. Then it makes sense to look beyond your sleep hygiene alone.
Consider a conversation or check if you recognise this:
- You have slept poorly for weeks to months
- You are exhausted during the day and find it hard to concentrate
- Alongside sleep problems you also have low mood or anxiety
- You want to know whether you are in menopause
An abnormal blood result is not a diagnosis, but a starting point for a conversation with your GP.
Frequently asked questions
Does poor sleep really belong to menopause?
Yes, it is a common complaint. Up to around half of women sleep worse around the menopause, often through hot flushes, night sweats and hormonal fluctuations.
Does melatonin help with sleep problems in menopause?
In some women it seems to help, in others not. Discuss its use with your GP or pharmacist, certainly if you take other medication. There is no solution that works for everyone.
Can a blood test explain my sleep problem?
A blood test does not explain sleep on its own, but it can show whether for example your oestrogen or cortisol plays a part. So you get a more focused starting point for a conversation with your GP.
References
- Santoro N. Perimenopause: From Research to Practice. J Womens Health (Larchmt). 2016;25(4):332-339.
- NHG-Standaard De overgang (Menopause). Dutch College of General Practitioners.
- Thuisarts.nl. I am going through menopause. Available via thuisarts.nl.
- Thuisarts.nl. I sleep poorly. Available via thuisarts.nl.
Every blood test result through Lunara includes a professional assessment by a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
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