Why Can't I Sleep at Night Anymore - Menopause? | Stella
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Why can’t I sleep anymore – is it menopause?

byDianne Vanstone

It’s stressful and lonely lying awake at night desperately wishing for elusive sleep and dealing with exhaustion the next day. Many women are often left wondering, does menopause make you tired? It’s a common experience during menopause with nearly half of women experiencing sleep issues. If you’re struggling with sleep, we’ve got some sound ideas to try.

Perimenopause sleep is a nightmare. I sometimes wake up every hour in the night in pools of sweat, absolutely soaked! Plus my throat gets really dry, so I snore loudly”

Anne

Does menopause make you tired?

Menopause symptoms have a habit of appearing when you need them to stay away the most. It is understandable that many women wonder, does menopause make you tired? After all you may be dealing with night sweats, joint pain or going to the loo several times at night. It can mean you are counting more sheep than you thought humanly possible. 

The good news is that sleep issues during menopause are usually temporary and there are treatments available to help you get to sleep more quickly and stay asleep – yes, there is hope! Find out more about the stages of menopause.

Top five things for a better night’s sleep

  1. Getting to sleep: Keep a regular routine, watch your diet, make your bedroom as dark as possible, avoid screen time and avoid tempting lie-ins that disrupt your body clock 

  2. Staying asleep: If you find yourself awake, don’t stress yourself out. Get out of bed, do a relaxing activity and then try again

  3. Hot flushes/night sweats: Avoid triggers, such as caffeine, alcohol or nicotine and spicy food. Increase your aerobic exercise, buy menopause-friendly bedding and nightwear and try a cooling face spray and fan

  4. Mood changes, anxiety and depression: Listen to calming music, meditation, an audio story or try stretching and yoga to release tension

  5. Fatigue during the day: Get outside for some exercise and only take a short daytime nap if you have to as it takes the edge off your sleepiness come night time

     

    Having trouble sleeping? Stella offers support for managing symptoms during menopause

What do we mean by sleep issues?

There is a difference between having a bad night’s sleep, sleep issues and Insomnia. Insomnia is likely if you are having trouble sleeping at least three nights a week for three months or more. 

Whether you have sleep issues or insomnia, not being able to sleep night after night is frustrating and can leave you feeling desperate. When you do finally drop off, waking up is difficult and it’s hard to function the next day at work and deal with the day-to-day.

Find out more about menopause and sleep in our symptoms library.

I dreaded going to bed and dreaded the alarm after what seemed like an impossibly short time asleep. There is nothing like that feeling of panic when you realise sleep isn’t coming”

Kim

Your sleep issues checklist

  • Difficulty getting to sleep: Unable to fall asleep within 30 minutes of going to bed
  • Difficulty staying asleep: Fewer than six hours of sleep several times a week
  • Awakening several times a night: Lying awake and not getting back to sleep
  • Early morning awakening: Waking early but feeling unrested
  • Poor quality of sleep: Feeling tired during the day and finding it hard to concentrate 

Why can’t I sleep at night anymore?

Having issues with sleep is a common menopausal symptom with nearly half of women experiencing difficulties sleeping, some worse than others. 

Menopausal symptoms can make it hard to fall and stay asleep, and it’s all to do with our fluctuating hormone levels. The three main culprits are melatonin, oestrogen and progesterone, which all play a vital role in giving us a restful sleep. Your lifestyle and genetics also have a lot to do with your ability to sleep well too.

We’re at the mercy of our hormones and genes, but it is temporary and the quality of sleep for most women will improve postmenopause.

How much sleep do you need?

The optimal amount of sleep for a healthy adult is said to be around seven hours, although some people need more or less sleep.

It’s important to know that you don’t need to catch up on every hour of missed sleep, as your body will compensate. However, getting quality sleep is vital for a healthy mind and body. Keeping a sleep diary may help you identify any patterns.

Disrupting night sweats

Waking up feeling like a human hot-water bottle and drenched in sweat can really play havoc with your sleep quality. It is very common, with around 75-85% of women during perimenopause and postmenopause experiencing night sweats.

Night sweats are caused by declining hormone levels which can affect the part of the brain that controls body temperature, the hypothalamus. The body becomes confused and incorrectly identifies a rise in temperature, which dilates blood vessels and causes sweat breakouts. Waking up suddenly can cause adrenaline to surge, making it difficult to get back to sleep once you’ve woken up.

How can I get to sleep and stay asleep?

Lifestyle changes

Small lifestyle changes can make a big difference to managing sleep better. Maintaining a regular sleep pattern will help stabilise your body clock. Sunday morning lie-ins, although wonderful, are not a great idea as they may delay the production of melatonin leading to lighter sleep. Many people rely on lazy mornings but, despite what you’ve been told, this is not a quick fix for catching up on sleep debt! 

There are many factors that can affect the quality of your sleep. Stimulants such as caffeine, nicotine and alcohol can interfere with your shut eye, so avoid them if you can, or try to reduce your use. Bedtime routines, exercise and diet can also have an impact too.

Read more about why the fun police is on about your menopausal lifestyle.

Cognitive Behavioural Therapy for Insomnia (CBTi)

CBTi has proven to be effective as a long-term solution, and is recommended as a first-line treatment by the National Institute for Care and Excellence (NICE), as well as the British Menopause Society and the National Institute for Health. 

This type of therapy can help you work through factors, such as stress, that contribute to you getting poor sleep.

Hormone replacement therapy (HRT)

Recent studies show that HRT can help your sleep during menopause, especially in controlling night sweats which can reduce sleep disturbance. The addition of progesterone may have an added benefit. The long-term effects of HRT can vary depending on your specific lifestyle and medical history, as well as the preparation you choose and the number of years it is used. Topical oestrogen creams can help with vaginal dryness to stop discomfort and the urge to urinate in the night.  Read more about the latest science on HRT.

Non-hormonal therapy

Sleeping tablets need to be prescribed by a doctor and may help you in the short term. However, you might want to weigh up the side effects, which include daytime drowsiness and the risk of dependency. Doctors rarely prescribe them and will suggest trying other treatments first.

You may have another underlying cause or contributing factor to your sleep problems, such as depression and therefore be treated with antidepressants for that as well as helping your sleep.

I don’t sleep as much as I used to, but if I can’t sleep I’ll get up and read or pray or do some crafts. It’s good to catch up on the ironing and writing in my journal. I think it’s important to accept it and not worry or consider it as something abnormal”

Liz

Do supplements work for sleep issues?

The easy answer is we don’t know. There are some supplements used for sleep which you may find are effective, such as Magnesium, Valerian and hops, but the clinical evidence is limited.

What about diet and phytoestrogens?

Phytoestrogens are chemical compounds found naturally in plants that are chemically similar to oestrogen found in our bodies and can weakly act like it. Isoflavones are a type of phytoestrogen, found in soy. 

There is some evidence that phytoestrogens provide some relief but more research is needed, especially into long term effects. Have a chat with your doctor before taking them. 

Can taking Melatonin help?

Melatonin is a hormone that naturally occurs in your body and makes you feel sleepy when it gets darker at night. As we age, your melatonin levels decline, which is why you can be left wondering, “Does menopause make you tired?”

Taking melatonin is only a short-term solution, and has a downside of suppressing your natural ability to produce it. This means it can actually make your sleep worse long-term. Pop to your doctor’s and chat about whether melatonin is safe for you to take, and what dosage is best for you. 

Menopause symptoms that make sleep difficult 

  • Night Sweats. For deep sleep, our bodies need to cool down. Night sweats make it difficult to stay asleep and get back to sleep once you’ve woken up
  • Pain. Studies have shown that menopause can cause an increase in chronic pain which can affect sleep
  • Urinating during the night. Lower levels of oestrogen can cause a drying of the genital tract. You may need to get up and go for a wee several times, which can disrupt sleep
  • Anxiety. Going without sleep for a long-time has a huge impact on your life. It can, in turn, make you feel stressed and depressed and even magnify the negative effect of hormonal changes. Just one night without sleep can increase anxiety by up to 30%

Find out more about the stages of menopause on our blog.