Check Medication Side Effects
Sleep trouble is a common side effect of many medications and supplements. While some medical conditions require medication that is non-negotiable, others are optional or may be replaced with something similar that has fewer side effects. Check the label on any supplements or medications youre currently taking. If insomnia is listed as a side effect, talk to your doctor about an alternative option.
Insomnia And Menopause Is A Link That Can Be Broken
Just because you happen to experience insomnia and menopause at roughly the same time, does not mean that they are truly linked. If worries, concerns, thoughts and feelings are keeping you awake at night, it may have nothing to do with hormones at all.
This is not to discount the physical realities of menopause. But if you have done everything you can to help balance yourself physically, but are still suffering from sleepless nights, its time to take a different approach.
That means you keep up the physical care and nurturing of your body but you also begin to address the mental and emotional causes of your insomnia. Forget about menopause for a moment. What can you do to help yourself relax and let go of all stress, worries and mental restlessness that keeps you tossing and turning at night?
Now, of course this site is about insomnia, not menopause. And that is why I recommend the self help tutorial to begin the cognitive behavioral therapy program that is so effective for dealing with insomnia.
Prescription Treatments To Help Sleep
Estrogen levels fluctuate significantly throughout the menopausal transition, then eventually fall to low levels, where they remain throughout a womans post-menopausal life. Like many symptoms of menopause, such as mood swings, hot flashes can be treated with hormone replacement therapy , which in turn can help with sleep difficulties. Hormone therapy delivers estrogen to your system through a patch, pill, or vaginal cream to deal with your hormonal changes.
Speak to your doctor about taking conventional sleep medicines as many of these have side-effects and can only be used short-term.
Like many symptoms of menopause, hot flashes can be treated with hormone replacement therapy , which in turn can help with sleep difficulties. HRT delivers estrogen to your system through a patch, pill, or vaginal cream.
However, there is a downside to hormone replacement therapy. Even though doctors are now prescribing HRT in low doses and for shorter periods of time, HRT has an increased risk of heart disease, breast cancer, blood clotting, and stroke. There are non-hormone options available that do not carry the same risks. One of them is FDA approved for the treatment of hot flashes and is called Brisdelle® . Other treatments include antidepressants such as Effexor® , Paxil® , Prozac® , and Lexapro® . If symptoms are severe, there are other sleeping medications that can be temporarily used to provide relief.
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Hot Flashes And Sleep Problems
One cause of menopause-related sleeplessness is hot flashes. Fluctuating levels of estrogen and progesterone that occur during perimenopause and menopause can cause hot flashes in about 85 percent of American women. When they strike during the night, they can wreak havoc on sleep, explains Michael Decker, PhD, RN, an associate professor of nursing and a sleep disorder specialist at Georgia State University in Atlanta. Typically, hot flashes that occur during the night can be associated with drenching night sweats that lead to awakening from sleep. Some women even have to change clothes or bed linens. This amount of activity occurring in the middle of the night makes it difficult to resume sleep, resulting in insomnia, Decker adds.
Is Insomnia Treated Differently When Its Related To Menopause
If your insomnia is related to menopause, you may find relief through balancing your hormone levels. There are several options for this, including:
- Hormone replacement therapy. This therapy can supplement your estrogen levels while the natural levels decline during perimenopause and menopause.
- Low-dose birth control. A low dose may be able to stabilize hormone levels, which could ease insomnia.
- Low-dose antidepressants. Medications that alter your brain chemicals may help you find sleep.
You may also consider taking melatonin. Melatonin is a hormone that helps control your sleep and wake cycles. It can help restore your sleep cycle.
If your doctor suspects that your recent insomnia is the result of a medication or a side effect of medication interactions, they will work with you to find better medication options that dont affect your sleep.
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Change Your Environment And Routines
Keep your bedroom cool. You have a very sensitive hot flash threshold during menopause, so you want to keep your body as cool as you can without being uncomfortable. Anything that raises your body temperature can trip the switch, so keep your bedroom temperature a few degrees lower at night.
Moderate your body temperature to minimize night sweats. Wear light pajamas, and keep a cool rag or cold pack in a zip plastic bag next to the bed. Put the cool pack on your face and chest as soon as you notice a hot flash coming on, and do deep breathing until the flash passes. Try to stay relaxed while you do this. Practice slow, deep breathing during the day so that when you wake with anxiety or a hot flash, you can use the technique to calm and relax. Progressive relaxation, cognitive behavioral therapy, biofeedback, or self-hypnosis are all techniques that will serve you well during periods of insomnia and other distressing moments.
Practice good sleep hygiene. Go to bed at a regular time, and use your bed only for sleep and sex. Relax before bed. Remove the television from the bedroom, and don’t eat for at least two hours before bed. Also, keep your bedroom dark. You want to send your brain the message that nighttime is for sleep, as light cues you to wake up and stay up.
Menopause And Sleep Apnoea
Sleep apnoea is a sleep disorder in which your breathing stops and starts during sleep. The most common type of sleep apnoea is obstructive sleep apnoea , which occurs when muscles in the back of the throat relax too much and obstruct the airflow and normal breathing.
It can disturb sleep by rousing the person after a bout of not breathing but often these periods of rousing do not lead to full awakenings. Sometimes this can happen many times over the course of a night and in severe cases there can be hundreds of episodes in just one period of sleep.
Often, the person experiencing OSA will not even know that something is happening with their breathing during the night but might:
- feel excessively tired the next day
- wake with headaches
- have low mood and feel irritable.
Other times, the episodes may fully awaken the person, who may have sensations of choking, gasping for air or snorting. When the person is fully roused from sleep in this way, it can make it harder for them to fall back asleep.
How does this relate to the menopause? Quite surprisingly, around 20% of women are estimated to experience sleep apnoea during the menopause.9 The incidence of OSA is known to increase in peri-menopause and during the transition through the menopause,10 peaking in post-menopause.
Thereâs also data to suggest that oestrogen â or a combination of oestrogen and progesterone â can improve symptoms of sleep apnoea in menopausal women too.4
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Q: Does Having Panic Attacks Mean You Have Panic Disorder
A: Not necessarily. Those with panic disorder have frequent panic attacks. And, in between, they worry about when the next one will strike and try to adjust their behavior to head it off. But a single or a few isolated panic attacks dont mean you have a panic disorder.
Women who were prone to anxiety in the past or who had postpartum depression are sometimes more likely to have a panic disorder during menopause. But any woman can develop one.
Panic disorders can be hard to identify because somesymptoms, such as sweating and palpitations, mirror those that many womenexperience anyway during perimenopause and menopause. But, just because a panicdisorder is not easily diagnosed, that doesnt mean that it doesnt exist orthat you cant treat it.
Treatments For Poor Sleep
There are some fundamental tenets that contribute towards healthy living in general that can help you sleep well:
- Maintaining health relationships and being socially active
- Intellectual stimulation.
However there are also times when you cannot control things and you need a little help. At all ages, hypnotics have been used for sleep disturbance, but there are specific treatments to consider for menopausal sleep disturbance.
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Other Menopausal Sleep Disruptors
At this stage of life, women can also develop sleep disorders such assleep apnea, which may come from a loss of reproductive hormones like estrogen andprogesterone. These can go undiagnosed because women often attributesymptoms and effects of sleep disorders to menopauseitself.
Postmenopausal women are two to three times more likely to have sleepapnea compared with premenopausal women, Pien says. Before we becomemenopausal, we’re fairly protected, but the protective effect of hormonesseems to be lost with menopause. Furthermore, women often have more subtlesymptoms of sleep apnea than men. Thus, they may be less likely to seekevaluation for sleep apnea. Their health care providers may also be lesslikely to recognize sleep apnea as a possibility, further delayingevaluation and diagnosis of sleep apnea.
Sleep Problems And Menopause: What Can I Do
The years of the menopausal transition are often a time when there are other changes in a womans life. You may be caring for aging parents, supporting children as they move into adulthood, taking on more responsibilities at work, and reflecting on your own life journey. Add symptoms of menopause on top of all this, and you may find yourself having trouble sleeping at night.
Some women who have trouble sleeping may use over-the-counter sleep aids such as melatonin. Others use prescription medications to help them sleep, which may help when used for a short time. But these are not a cure for sleep disturbances, such as insomnia, and should not be used long term.
Not getting enough sleep can affect all areas of life. Lack of sleep can make you feel irritable or depressed, might cause you to be more forgetful than normal, and could lead to more falls or accidents. And research now suggests that waking from sleep itself may trigger hot flashes, rather than the other way around.
Developing healthy habits at bedtime can help you get a good nights sleep.
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Sleep And Body Temperature
Oddly enough, a hot flash doesnt need to be severe to interrupt sleep. As Ive pointed out in this article about sleep and body temperature, our internal thermostat plays a big role in helping us to sleep. Specifically, a lowering of body temperature, which takes place naturally when we are in sinc with our daily circadian cycles, is conducive to sleep. This is why its so important not to do any strenuous exercise before bed, and to avoid hot baths directly before bedtime, when you are experiencing insomnia.
Women have more variation in their body temperature due to the natural ebb and flow of estrogen, which also regulates the internal thermostat. This is why some women experience occasional sleep irregularities even before perimenopause in response to the subtle rises and falls of body temperature that takes place during the ovulatory cycle.
When estrogen levels become unstable and imbalanced, body temperature can dance right along with them. The hot flash is the most noticeable result, but many women find that body temperature changes on a larger scalefor example, their base temperature feels hotter in general, in addition to the flashes.
Again, this body temperature change can be quite subtle and still cause the insomnia and menopause connection. Its possible that if youre bothered by middle insomnia or terminal insomnia, hot flashes may be the culprit, even if youre not sweating or even feeling especially hot when you wake up.
Here Are Some More Tips That Might Help You Avoid Hot Flashes Or Sleep Better Through Hot Flashes
- Keep your bedroom cool at night and wear loose, light pajamas made of natural fibers.
- Before bed, avoid spicy foods, which can make you sweat.
- Take it easy on the caffeine, especially later in the day.
It is extremely helpful to visit your doctor to discuss menopausal sleep disorders. The research on the importance of sleep is clear we need it in order to function at our best. Please visit us to discuss your sleeping problems or the other issues associated with menopause.
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Q: Are Problems With Memory And Concentration A Normal Part Of Menopause
A: Unfortunately,trouble concentrating and minor memory problems can be a normal part ofmenopause. Experts dont understand exactly why this happens, but if you arehaving them, talk to your doctor. He or she can at least provide somereassurance.
Activities that stimulate your brain can also helprejuvenate your memory, so spend some time with crossword puzzles or cozy upwith a book. Keep in mind that depression and anxiety may make memory concernsmore noticeable.
The Insomnia And Menopause Link
Sleep disturbances are extremely prevalent and a challenging problem for midlife women, says Steven Goldstein, MD, professor of obstetrics and gynecology at New York University School of Medicine and president of the board of the North American Menopause Society. In fact, according to the National Sleep Foundation, 61 percent of perimenopausal and postmenopausal women report frequent bouts of insomnia.
Dr. Goldstein says its important to figure out why your sleep is disturbed. He explains that sometimes the cause is hormonal changes related to menopause, and sometimes the problem is another age-related health condition such as incontinence or joint pain. Midlife stresses such as anxiety over work and family can also interfere with sleep. And if you werent a great sleeper to begin with, entering menopause can make insomnia even worse.
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How We Can Tip Into Insomnia
Like anything that can wake us in the night, how we handle it could either point us toward insomnia or away from it. If people begin to get anxious about what is waking them or the fact that they aren’t sleeping, this sleep anxiety might tip them into insomnia.
If people remain in bed while they are awake as a result of whatever woke them up, this could also tip them into insomnia.
Menopause Can Also Be An Emotionally Challenging Time
Yet its uncertain and debatable just how much the hormonal disruptions and changes are responsible for that.
Some experts and some women themselves want to blame everything on either hormones or the aging process. Everything is rooted in the physical transition irritability, depression, anger, anxiety. Whatever cant be directly attributed to the drop in estrogen and progesterone is carried over to just getting older.
But others point out that the insomnia and menopause connection may have emotional causes that are separate from the hormonal aspect. They concede that many women are experiencing challenging events in their lives at this point, such as dealing with the adolescence or young adulthood of their children caring for their aging parents responding to the general cultural belief that women over 50 are not as desirable, sexy, feminine or exciting as younger women and wondering what matters most to them and where they should direct their energy and talents at this unique time of life.
Of course its easy to lump everyone in a particular age group together and pretend they all have the same life experiences and problems. But we know that emotional causes of insomnia are entirely individual and almost infinite in number!
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Hot Flashes And Night Sweats
About 75% of women report having hot flashes and night sweats during perimenopause and menopause. A hot flash is characterized by a sudden feeling of heat throughout your entire body. For most women, the feeling of warmth is most intense on the neck, chest, and face. Hot flashes can also cause sweating and reddening of the skin. Night sweats are hot flashes that occur at night, disrupting your sleep.
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