Another wakeful night, tossing and turning while worrying about tomorrow’s exhaustion. A lack of sleep can leave anyone feeling desperate for relief. When an extra cup of coffee is not enough, a deeper look at your overall health may provide answers. Whether you are looking for a place to start or hoping for truly restorative sleep, Salus Integrative Medicine understands that good sleep is essential to your well-being.
Heat rises up your face, causing you to rip the sheets off and stare at the ceiling. What time is it? How do you cool down quickly before your sleepiness wears off and you’re up half the night? Hot flashes and poor sleep go hand-in-hand for many women around perimenopausal and menopausal age, which can start in the early 40’s. October is Menopause Awareness Month, which happens to be a topic we’re passionate about here at Salus Integrative Medicine. When it comes to sleep, Perimenopause (the hormonal transition time prior to menopause) can cause havoc to rein over your sleep routine. We’re here to help!
Hot Flashes and Fluctuations
The biggest sleep-disrupting-factor for most premenopausal women is hot flashes. While research is uncertain whether hot flashes cause women to wake up or there is a prior hormonal shift that causes both hot flashes and wakefulness, the feeling of waking up dripping in sweat is a common occurrence. Women who experience hot flashes report three times more sleep disturbances than those who do not (3). Stable sleep routines can become incredibly difficult to manage as hormones impact energy levels and change the body’s need for rest or support.
Managing the hormonal impact of hot flashes first might improve sleep quality and help perimenopausal symptoms decrease overall as the body is better able to recover and manage fluctuating hormones in the future (3). Since sleep is crucial for most repair processes, it is not surprising that regular sleep disturbances can impact energy levels, memory, weight mantenence, clarity, immune defences, gut health, heart health, and even skin elasticity. More women report frequent wakings throughout the night with hot flashes, compared to trouble falling asleep or early waking (3). This disruption is particularly hard on the body’s repair systems, as they most often occur with the deepest stages of sleep. A combination of hormonal support, symptom support, and healthy sleep habits can make a massive difference for those managing any hormonal shift, but especially perimenopause.
The Mental Toll
Disturbances in sleep and hormonal shifts also increase the likelihood of mood changes, depression, and anxiety to surface for perimenopausal women. Often, they worsen sleep by increasing racing thoughts, disrupting motivation signals, and tanking energy levels. Perimenopausal women are up to four times more likely to develop major depressive disorder than pre-menopausal women. Those who have a history of PMS or Postpartum Depression are at a higher risk for developing perimenopause-related mental health conditions (3). Lack of sleep shows a stronger relationship with depression than hormonal shifts alone. While both hormones and sleep disturbances have an impact on depressive symptoms, quality sleep might be more effective at improving depression during perimenopause (3).
The type of sleep disturbances, however, change the common effects on perimenopausal women. “Recent data showed that hot flashes and depressive symptoms were associated with different sleep disturbance patterns; hot flashes being uniquely associated with frequent awakenings and depression uniquely associated with difficulty falling asleep and waking up earlier than desired” (3). Depending on which sleep disturbances you suffer from, your highest need for support and intervention might change. Prioritizing your sleep might start with prioritizing your mental health or hormones first, depending on which symptoms are most impacting your life.
Stress and Sleep
Stress and sleep disturbances reinforce each other: higher stress leads to worse sleep, while poor sleep makes stress harder to handle (3). This two-way impact can make it especially difficult to know where to start. While there are some habits and adjustments within your control, there are also certain factors that need professional help. Managing hormonal shifts or side-effects with medication might help some women improve their ability to manage anxiety or depression symptoms, get better sleep, and navigate stressful situations. Many women hold healthy habits and coping mechanisms prior to perimenopause that simply stop being effective due to the way perimenopause affects their mind and body.
Common contributors to stress, like financial strain, relational strain, health changes, grief, and job satisfaction, can peak at typical perimenopausal ages. It’s no wonder, then, that higher education level, socioeconomic status, and marriage satisfaction are associated with lower sleep disturbances (4). “Peri-menopausal women have higher levels of psychological distress compared to pre-menopausal women and employment, depressed mood, and poor perceived health are among the most significant factors causing stress in midlife women” (3).
A great support system and appropriate expectations paired with well-rounded medical treatments can help you find a good night’s sleep again. Many women find a combination of hormone replacement therapy, sleep and symptom medications, cognitive-behavioral therapy, and/or self-management strategies help provide relief from sleep disturbances (3). Dr. Lisa Mainier can help you create a plan to manage all these factors and more, through proven medical testing, expert hormonal support, and healthy sleep management. Contact Dr. Lisa Mainier to schedule an appointment!
Sources:
- Baker, F. C., Lampio, L., Saaresranta, T., & Polo-Kantola, P. (2018). Sleep and Sleep Disorders in the Menopausal Transition. Sleep medicine clinics, 13(3), 443–456. https://doi.org/10.1016/j.jsmc.2018.04.011. Viewed from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6092036/
- Kravitz, H. M., Zhao, X., Bromberger, J. T., Gold, E. B., Hall, M. H., Matthews, K. A., & Sowers, M. R. (2008). Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women. Sleep, 31(7), 979–990. Viewed from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2491500/#sec23