Sleep Problems

Sleep disturbance is a common problem of perimenopause, and sleep deprivation may worsen other menopausal symptoms.

Sleep problems are not uncommon in our community but the percentage of women reporting difficulties increases dramatically around menopause.

What causes it?

We know that hormonal changes are a factor in sleep problems at perimenopause, and not just sex hormones… other hormones including melatonin, prolactin and cortisol are also involved. But hormones are not the complete story; many aspects of a woman’s life and physical health will impact on her sleep quality, such as:

• The presence of hot flushes or sweats at night;
• Anxiety or other mental health disorders;
• Pre-existing sleep disorders such as insomnia or sleep apnoea;
• Stress related to work, relationships, children, finances, ageing parents, etc.
• Chronic diseases, pain or disability;
• Restless legs or movement disorders;
• Poor sleep routines;
• Excessive caffeine, alcohol or other drug use;
• Screen time or other stimulating activities near bedtime, or
• A snoring partner (or pet!)

What can be done about it?

A wholistic approach is needed in the assessment and treatment of sleep problems at perimenopause. Your GP or menopause specialist should take a thorough history so they can target their advice and treatment options to your specific needs.

For example, hot flushes and anxiety may be improved by treatment with hormonal therapy or antidepressant medication. Anxiety and stress may respond well to counselling, relaxation training, meditation, mindfulness or even e-health resources like Apps (eg. Calm, Smiling Mind). It is important to work with your GP to treat any co-existing health problems as well.

It’s generally best to avoid sedative drugs like benzodiazepines unless absolutely necessary. If medication is needed your GP should be able to suggest a range of alternatives, such as melatonin which supplements your body’s own hormones to help prepare you for sleep.

Sleep hygiene

Sleep hygiene simply means optimising your chances of getting a good night’s sleep. General sleep hygiene advice includes avoiding caffeine after midday, getting some vigorous exercise during the day so that you are tired at night and avoiding blue-lit screens in the two hours prior to sleep. If you do need to use your computer in the evenings it’s a good idea to red-shift the screen so it’s less stimulating to your brain. You can download an App like f.lux if you computer doesn’t have this function built in.

Here is a list of things you should know about good sleep habits from the Sleep Health Foundation:

• Many things can help you have a better night’s sleep
• Keep regular times for going to bed and getting up
• Relax for an hour before going to bed
• Avoid going to bed on a full or empty stomach
• If you’re not asleep after 20 minutes, go to another room until you feel tired again
• Many poor sleepers spend too long in bed
• Keep distracting things out of the bedroom
• Getting some sunlight during the day
• Most adults of all ages need 7-9 hours of sleep a day
• An evening nap can make it hard to sleep at night

If you can’t find the right health professional to treat your perimenopausal symptoms then book a telehealth consultation with a female WellFemme menopause doctor. Half-price consultations are available for women in regional, rural and remote areas who agree to complete short questionnaires for WellFemme’s Pilot Study.

Not sure if Telehealth is for you? Free trial consultations are available to find out how WellFemme can help with your menopausal symptoms.