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Menopause Insomnia

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Menopause is a major life transition that comes with many potential body changes. Some women have more common menopause symptoms like mood swings or hot flashes, while others may experience insomnia, or difficulty falling or staying asleep.1, 2

Menopause symptoms can be tough to deal with, but you’re not alone. Menopause is a natural part of aging for women that typically starts between ages 45 and 55, lasting anywhere from seven to 14 years.1 During this time, your period stops, causing your hormones to change (and potentially throw your sleep off balance). However, that doesn’t mean you have to be stuck with sleepless nights.

If menopause insomnia is keeping you up at night, there are steps you can take to promote healthy sleep habits and of course, restorative sleep. 

What Is Menopause Insomnia?   

Menopause insomnia is exactly as the name sounds — trouble falling or staying asleep at night during the menopausal transition.3

Struggling to sleep during menopause is often due to hormonal changes and their side effects.4 Changes in mood and depression, or hot flashes that lead to night sweats, can make it tough to get quality sleep or even sleep comfortably. Menopause medications, such as hormone therapy, also have the potential to cause side effects that can lead to trouble sleeping.5

Still, it’s important to remember that many women have no menopause symptoms at all, meaning you may go through this transition in life with no changes to your sleep.1

How Menopause Affects Hormones 

As you transition into menopause, your estrogen and progesterone levels decrease.1 These hormones each play a different role in the changes that your body might go through. Here’s a quick breakdown of these two hormones and how they can impact female health and sleep.

  • Estrogen decreases: Estrogen hormones play a key role in sexual and reproductive development.6 For most women, estrogen levels decrease between the ages of 45 and 55, or when the menopausal transition begins. Hot flashes are a common cause of reduced estrogen levels, which can disrupt sleep and contribute to menopause insomnia.1
  • Progesterone decreases: Progesterone is a hormone that supports menstruation and the early stages of pregnancy.7 During menopause, progesterone drops, also contributing to hot flashes and night sweats, both of which can contribute to poor sleep.

How Is Insomnia Diagnosed? 

To diagnose insomnia, your OBGYN or healthcare provider will go over your sleep history and possibly your medical history as well, including any medications you are taking.8 You might also be asked to keep a sleep journal to track your sleep patterns.

If your doctor suspects breathing problems, such as sleep apnea, are contributing to your menopause insomnia, a sleep study might also be recommended.8 A sleep study is generally conducted in a lab where you stay overnight, but some studies are now offered at home.

How Is Insomnia During Menopause Treated by Doctors?

  • Sleep aids and medications – For some women, menopause insomnia is treated the same way as traditional insomnia. Doctors may recommend over-the-counter sleep aids or prescription sleep medications for short-term use for more severe cases of menopause insomnia.4 A doctor might also suggest making lifestyle changes to promote better sleep.
  • Treating underlying causes – Other women may benefit from treating the root cause behind menopause insomnia, says Dr. Michael Tahery, a Los Angeles-based OBGYN. “Hormonal therapy usually is the most effective treatment in most patients,” he explains. “Hormonal changes can cause hot flashes or chills disrupting sleep.” Some women might have vaginal dryness and irritation during menopause that can cause urinary frequency and urgency, Dr. Tahery continues, which can lead to nighttime awakenings. “Local treatments such as vaginal estrogen or hyaluronic acid capsules and creams, as well as laser and radiofrequency treatment options, are very effective in treating dryness,” he says. Another potential cause of sleep troubles during this time is sleep apnea. According to the Woolock Institute of Medical Research, postmenopausal women are two to three times more likely to develop this sleep disorder compared to premenopausal women.9 For women with sleep apnea, treatment is critical and may consist of a combination of lifestyle and professional treatments, such as a continuous positive airway pressure (CPAP) therpay.
  • Addressing mental health – Anxiety and depression can also disturb sleep in menopausal years. “Menopause is usually a time of social and family change that can bring with it significant psychological and emotional issues,” Dr. Tahery says. “Addressing the root causes with therapy and medication is very helpful.”

Sleep Tips if You’re Experiencing Insomnia During Menopause 

Whether you’re seeking medical help for treating insomnia during menopause or making lifestyle changes to promote better sleep, there are numerous steps you can take at home (and on your own terms) to help alleviate sleep loss. 

  • Invest in cooler bedding: Cool, breathable bedding can wick away moisture and help alleviate pesky night sweats. If you constantly find yourself overheating at night, invest in a cooling mattress or cooling mattress topper made out of latex or gel foam. Cotton and bamboo sheets also tend to be the most breathable.
  • Keep a set sleep schedule: Going to bed and waking up at the same time every day can help train your body to know when it’s time for sleep. 
  • Have a relaxing nightly routine: A relaxing nighttime routine can help your brain and body wind down before bed (potentially helping you fall asleep easier). This is especially helpful during menopause when fluctuating hormones can cause mood changes. Reading a book, taking a warm bath, or doing gentle yoga are great nighttime options.
  • Turn off the electronic devices before bed: While it may be tempting to scroll through Instagram or binge-watch a good TV show before bed, you’re better off avoiding electronic devices an hour or two before sleep.10 That’s because electronic devices like smartphones, tablets, computers, and TVs emit blue light, which can disrupt melatonin production (the hormone that supports sleep) and contribute to menopause insomnia.11
  • Don’t take long naps: A long nap can leave you feeling groggy and make it harder to fall asleep at night. If you do want to nap, make sure it’s before 3:00 p.m. and limit it to 30 minutes or less.
  • Keep away from caffeine and alcohol: While caffeine is a well-known stimulant, alcohol’s effects are somewhat less known. According to research, high alcohol consumption is linked to worse sleep quality and shorter sleep duration.12 If you’re experiencing menopause insomnia, consider avoiding both or limiting your caffeine intake to one cup in the morning.
  • Don’t eat a large meal before bed: Eating a large meal just before bed can disrupt your sleep by causing indigestion, heartburn, or acid reflux.13 Try to eat dinner at least a few hours before bed, and if you’re truly hungry at night, opt for a small, healthy snack, like apples and cheese.
  • Get regular exercise: Regular exercise is excellent for boosting low moods and busting stress, both of which can lead to insomnia.14 Still, be careful to avoid vigorous exercise just before bed, which can leave you wired and unable to fall asleep. Instead, get your high-intensity workouts in during the morning or early afternoon hours.

Frequently Asked Questions About Menopause and Insomnia

Does menopause insomnia go away?

Menopause insomnia may go away in some cases, but in others, it could last throughout the menopausal transition and after menopause.15 Fortunately, there’s care available for chronic insomnia, and the good news is that menopause insomnia is more often temporary.

How long does menopause insomnia last?

Menopause insomnia looks different from person to person. Some women won’t experience it at all, while others could experience menopause insomnia for a few weeks. Chronic insomnia, or insomnia that lasts beyond three months, is less common but possible in menopausal women.15

Does insomnia occur during perimenopause?

Perimenopause, which is the time when you’re transitioning into menopause, is typically when menopause insomnia strikes. This is because your hormones gradually drop, leading to symptoms like hot flashes or poor sleep.

Final Word of Advice

Menopause insomnia is often temporary, but that doesn’t mean you have to spend night after night sleepless. Menopause insomnia can be treated, and practicing good sleep hygiene can go a long way in setting up a successful foundation for sleep — both before, during, and after menopause. If menopause insomnia lasts more than three months, a doctor can help.

Experiencing menopause symptoms? Consider browsing our picks for the best mattresses for menopause.

The Advisor Says

Menopause insomnia can be managed with medical care or lifestyle changes to promote better sleep, or a combination of the two.

Katie Harris

Katie Harris

Content Writer

About Author

Katie writes content at Sleep Advisor, where she has finally found people who appreciate her true passion for sleep. Based in Austin, Texas, she graduated with a degree in Communications and enjoys combining creativity with research to improve the world’s sleep, starting with her sleepwalking husband.

Combination Sleeper

References:

  1. “What Is Menopause?”. National Institute on Aging. Last modified September 30, 2021. 
  2. “Insomnia”. Cleveland Clinic. Last modified on February 13, 2023.
  3. “Sleep Problems and Menopause: What Can I Do?” National Institute on Aging. Last modified September 30, 2021.
  4. Conroy PhD, Deirdre. “3 Reasons Women Are More Likely to Have Insomnia”. Michigan Medicine. 2016.
  5. “Menopause: Medicines to Help You”. U.S. Food and Drug Administration.
  6. “Estrogen’s Effects on the Female Body”. John Hopkins Medicine.
  7. “Progesterone”. Cleveland Clinic. Last modified on December 29, 2022.
  8. “How Is Insomnia Diagnosed?” Stanford Medicine. Webpage accessed July 15, 2024.
  9. “UNTANGLING THE MYSTERIES OF SLEEP IN MENOPAUSE”. Woolock Institute of Medical Research. 2023.
  10. Pham, Hue Thi., et al. “Electronic Device Use before Bedtime and Sleep Quality among University Students”. Healthcare. 2021.
  11. “Blue Light Has a Dark Side”. Harvard Health Publishing. 2020.
  12. Zheng, Dandan., et al. “Alcohol consumption and sleep quality: a community-based study”. Public Health Nutrition. 2020.
  13. Olsen, Jeff. “Mayo Clinic Minute: Timing snacks to avoid heartburn”. Mayo Clinic. 2017.
  14. “More evidence that exercise can boost mood”. Harvard Health Publishing. 2019.
  15. “How Does Menopause Affect My Sleep?” John Hopkins Medicine. Webpage accessed July 15, 2024.