Between the sheets: the menopause and sleep

By Kirstie Newton

Ask anyone to list the symptoms of the (peri)menopause, and the usual suspects will turn up like bad pennies: hot flushes, mood swings, achy joints, insomnia. This last culprit can be exacerbated by any one of its aforementioned bedfellows, let alone all of them at once.

Our sleep patterns can become more disrupted as we age, and the menopause doesn’t help. Fluctuating hormones can result in body temperature changes, sleep-disordered breathing and anxiety, all of which can feed into insomnia. This lack of sleep has a raft of consequences of its own: ‘brain fog’, impaired cognitive functioning, lowered immunity, lack of focus. You might feel tired and irritable during the day, when you need to be on form, yet unable to sleep at night – leading to a vicious circle of poor health.

Tanja, 51, still menstruates but has been experiencing perimenopausal symptoms for the past three years. Once like clockwork, her periods have become more erratic and painful, with sudden rages “like a banshee”, often followed by tears - and anxiety, “which I never used to have – it affects my self-esteem and confidence”.

Night sweats have been particularly trying. “I half wake up but not enough to do anything. I get cold, because I’m wet, but worry that if I get up and get changed, I’ll be wide awake and unable to get back to sleep. I don’t really know what the best thing to do is, so I just lie, and drift, and suffer.

“Because I’m not sleeping properly, I’m over-tired and can’t get off. I’m a single mother and I work full-time, so there’s a lot going on in my head – I’m a terrible over-thinker anyway. Because of a history with blood clotting, I can’t take HRT. I have tried lavender spray on my pillow, and have cut out alcohol and caffeine; I also avoid drinking anything after 9pm, even herbal tea, to avoid waking in the night needing to pee.”

According to Janice Jenner, of sleep experts Hunrosa, there are things you can do to improve the situation, during the night and day, without the need to resort to sleep medication. “In fact, Tanja is already practising a lot of good daytime habits, such as cutting sleep disruptors such as caffeine and alcohol out of her diet,” she says. “But there are other things.”

“For example, I wonder if she has thought about her pyjamas or bedding – natural fibres can help combat night sweats. And it’s important to carve out time (even in a busy schedule) for exercise, which plays an important role in feeling tired at the right time.”

There are two key approaches to the kind of nocturnal anxiety that keeps you lying in bed awake at 3am. “You could get up and do something very dull with no purpose for 30 minutes,” says Janice. “This should distract you from the negative thoughts and take you back to sleep mode when you go back to bed.” However, avoid your phone. The blue light from phones can be detrimental to health and "doom scrolling" on social media can cause more anxiety.

Alternatively, if you prefer to stay in bed, work out whatever ‘negative’ thought is bothering you - eg. “I will never cope tomorrow if I don’t sleep now” – and concentrate on the positive factors that can help you, such as good habits and stress management. “Try practising meditation or mindfulness techniques during the day, then employ these when you wake during the night,” Janice explains. “When a pesky thought comes into your mind, recognise it as a thought, label it as such and then let it float away.”

Liskeard actor Nina Hills, 52, is using theatre to get audiences talking about the menopause. Her one-woman comedy show, Peri-meno… what now?, is set to tour venues across Cornwall; the title refers to the fact that while a woman is deemed menopausal after a year of no periods, the symptoms we associate with The Change can start some time before that, a stage known as the perimenopause.

Nina still has monthly periods, and had previously put her various symptoms - migraines, anxiety, period pain – down to depression, or to a change in birth control. “I didn’t understand how it could be ‘The Change’ if I was still having periods,” she says. “It was the first I’d heard of the perimenopause. How did I get to the age I am without knowing about it? No one talks about it.” Now on HRT, she has also built meditation, exercise and cold-water swimming into her routine. “A friend who suffers terribly from menopausal insomnia says she gets her best night’s sleep after she has been swimming,” says Nina. “All those ‘horrible’ healthy things do actually help – and it’s ultimately about finding what works for you.”

Janice agrees. “While the menopause can be hugely disrupting for our sleep, sleep can be mended,” she says. “It’s important to take time for yourself and prioritise good sleep health. Sleep really is as good as what you do during the day.”

Positive sleep habits

· Go to bed and wake at the same time every day

· If you need to nap, do so in the early afternoon and for less than 30 minutes

· Don’t drink too near to bedtime

· Don't take your phone to bed with you and try avoiding using it in the hour before bedtime.

· Wear cotton/ natural clothing in bed, and use cooling bed linen such as bamboo

· Keep your bedroom cool (16-18 C) but not too cold

Positive daytime habits

· Exercise regularly - this improves menopause symptoms and supports healthy sleep

· Try yoga to combat stress, or meditation.

· Avoid excessive caffeine, alcohol and nicotine

· Eat regular meals and avoid spicy foods before bedtime

· Practise mindfulness. Notice your breath as you inhale and exhale for 30 seconds (longer as you become more practised), or try body scanning - acknowledge each part of your body in turn, starting with the feet and moving up to the head, noticing how each part of the body softens as you move on to the next.

If you want to learn more Janice Jenner of Hunrosa and menopause women’s health expert Dr Jane Davis will conduct a one-hour Zoom webinar on Wednesday, June 15 2022, offering expertise, advice and will be responding to questions. The course starts 7pm and costs £40. This course is provided by Hunrosa and is not a Kensa Health Course.

Book at Eventbrite. https://www.eventbrite.com/e/sleep-menopause-june-tickets-331078142637

NOTE: This article is a guest post provided by Hunrosa. Kensa Health has not been paid for this post or to endorse this course.