Menopause is often, and unfortunately, associated with unwanted symptoms like hot flashes, night sweats, anxiety, and vaginal dryness due to hormonal fluctuations.
When the ovaries produce less and less hormones during this phase of a woman's life, this can trigger emotional, mental, and physical symptoms.
Though every woman experiences this transition differently, there are a multitude of little and bigger shifts that can occur that can impact metabolism, bone health, heart health, mood, and energy.
Sleep disturbances also make the list of possible symptoms that are associated with menopause.
Sleep complaints affect around 12 percent of women however this number jumps up to 40% by the time women reach their late 40's (1) The most sleep problems among women are reported during perimenopause and menopause.
What is insomnia?
Known as one of the most common sleep complaints, insomnia affects as many as 35% of adults (2).
Insomnia is a type of sleep disorder that interferes with an individual's ability to achieve good quality sleep.
Acute insomnia may arise for a few days at a time however chronic insomnia occurs more than 3 nights per week over a period of a month or more.
In addition to chronic insomnia interfering with quality of life it can also increase the risk for medical problems such as cardiovascular diseases, chronic pain syndrome, depression, anxiety, diabetes, obesity, and asthma (3).
What exactly causes insomnia during menopause?
The declining levels of progesterone and estrogen during menopause can affect the sleep-wake cycle and potentially make it more difficult for women to fall asleep and stay asleep.
The drop in estrogen can cause your body temperature to rise, increasing the risk of hot flashes and changes in sleep.
Lower estrogen levels have been associated with increased anxiety and depression, two significant risk factors for insomnia (4)(5).
Another way that low estrogen can disrupt sleep is by inhibiting magnesium uptake and utilization (6).
Magnesium is one of the most important minerals for a good night's sleep and is often recommended as a supplement. Low magnesium intake may increase the risk of disrupted sleep.
At the same time that estrogen is dropping, progesterone is also declining. Known for its calming and even sedating properties, progesterone acts as a natural sleep aid because it interacts with GABA, our calming neurotransmitter.
Research has found that the use of progesterone in postmenopausal women can help to restore normal sleep and may provide a therapeutic strategy in the treatment of sleep disturbances (7)(8).
In addition to reproductive hormones, other hormones that may get disrupted during menopause and interfere with sleep-wake patterns, include melatonin, testosterone, and follicle-stimulating hormone (9).
How to get better sleep during menopause
Although the causes of insomnia are multifactorial and bio-individual, there are several dietary and lifestyle adjustments that can make a big difference to your sleep quality.
Stress management
Stress can interfere with sleep by favouring cortisol over melatonin, making it harder to fall asleep. An overactive mind can also make it challenging to get some Z's and keep you up tossing and turning.
Adopting relaxing and calming practices before bed can make a world of difference to the state of your mind and body. Set the stimulating activities to the side and experiment with slow practices such as yoga, stretching, reading, or meditation.
Your lifestyle should be emphasized first and foremost, however supplementation can also help to transition the body into a calmer state. Some examples include adaptogens, magnesium, GABA, and melatonin.
Dietary choices
There are certain foods and drinks that can disrupt your circadian rhythm and interfere with sleep such as sugar, alcohol, and caffeine which should be avoided especially in the evening.
On the other hand, there are foods that have been shown to help you sleep better and fight insomnia which include kiwifruit, spinach, cherries, almonds, turkey, bananas, wild salmon, coconut oil, and sweet potato.
Time your meals right
It's not just what you eat that can impact your sleep, its also when you eat that matters.
Because our bodies are programmed to respond to natural light and dark cycles, adopting an eating schedule that involves eating when it is light out and fasting when it is dark is ideal if possible.
Eating your heaviest meals meals earlier during the day can not only support the body's sleep-wake cycle but also additional physiological benefits such as improved blood sugar and insulin balance, supporting a healthy body composition and metabolic health (10).
Eating too close to bedtime, especially heavy meals, sugar, and processed foods, is associated with worsened sleep patterns as well as metabolic disturbances (11)(12).
The research is pretty clear; eating earlier during the day and avoiding late night eating can not only prove beneficial for sleep but also for overall health.
It can take some experimentation to figure out what eating schedule works best for your lifestyle while supporting your sleep cycle as best as you can.
If you do find yourself getting hungry later at night, try keeping your dinner within 2 hours of bedtime or adding a light snack to keep you satisfied.
Start your day right
Get ready for bed the moment you wake up by receiving natural light exposure.
Why does this matter?
The body follows the natural rhythm of the sun which means that when it is exposed to daylight in the morning it is triggered to produce hormones that help you to feel awake during the day and sleepy at night (13).
This is the body's natural day-night cycle however when we add in artificial lights and sitting indoors all day long, this pattern can become disrupted and negatively impact energy during the day and the ability to fall asleep at night.
This is why starting your day with a morning walk or simply sticking your head outside can make a big difference in your energy and sleep.
For those winter days that start in total darkness however, you can work around this by using light box therapy for about 20-30 minutes daily. Simply turn on the light box while you are getting ready or eating breakfast to wake up your system and signal your brain that it's time to seize the day. Light therapy has been shown to be effective for symptoms of insomnia (14).
The simple act of getting your morning dose of light can help to regularize the patterns of sleep and wakefulness and improve sleep.
Adopt a sleep friendly bedtime routine
How you start your day will influence your sleep just as much as how you end your day. For many, their day starts and ends on electronic devices however this is especially harmful for sleep when we do this later in the evening.
When the body is exposed to blue light at night time, instead of winding down it gets the message to stay alert and produce cortisol rather than melatonin, which can leave you with that all too familiar wired but tired feeling.
Light at the wrong time can throw off the body's internal clock and not only make it harder to fall asleep but also make it more challenging to feel awake the next morning.
Blue light exposure can result in decreased sleep quality and sleep duration and increase the risk of sleep disturbances like insomnia (15).
The best way to minimize the negative effects of light on sleep is to avoid bright lights and electronics in the evening as much as possible and especially before bed.
Additional modalities such as acupuncture, massage, and aromatherapy may also be supportive in menopausal symptoms including insomnia.
Dietary and lifestyle choices are often at the root of sleep issues however there are sometimes additional factors involved that may be addressed. Due to the hormonal changes happening during menopause you may find relief through additional modalities that aim at supporting hormone levels which should be explored with your trusted health care provider.