How’s this for irony? As I sit and write this article, it is 3:47 a.m. I’ve been awake since 2:45 a.m., as my mind inexplicably decided that today, this would be a good time to end its sleep cycle. Two hours prior to that, I had woken up partially, tossed and turned trying to find that ever-elusive “better position”. The red numbers on the clock glared back at me, reminding me that I shouldn’t be awake at this ungodly hour. Time for the usual bed-dance routine; one leg out to regulate body temperature, just the sheet, then off with the sheet and roll into a side curl. Arm falling asleep (lucky ingrate that it is); swing over into a partial side twist. Neck hurts. Adjust pillow. Find covers. Aaaand repeat. This is a familiar process for those of us on the menopause journey. Sleep can be a tricky business during midlife.
Common Sleep Issues in Menopause
Sleep issues are a factor for nearly half of women in midlife. Many of the causes for sleep disturbance are related to our physical and mental changes such as:
- Night sweats and hot flashes
- Emotional health changes (stress, mood changes)
- Increased need to urinate at night
- Changes in hormone levels
Lack of sleep often results in fatigue and worsening of mood and cognitive functioning. As fatigue, mood and cognitive functioning worsen, stress levels rise. It’s like the Bermuda Triangle of midlife. It’s menopausal sleep debauchery. (Wouldn’t that be a great name for a punk rock band?)
Managing Sleep Disturbance in Midlife
In spite of these inevitable shifts in sleep patterns that so many of us face in midlife, there are some healthy ways to cope with the changes.
- Don’t battle with it: As counterintuitive as it might sound, battling with insomnia is futile. We want and need sleep, but if we hold onto a fight-mode trying to get sleep, it turns into an anxiety-based power struggle. Increased anxiety reinforces insomnia.
- Observe non-judgmentally: If we can suspend our automatic responses such as “I should be sleeping right now,” it can be a helpful means of reducing distress. Instead, remind yourself that this sleep disruption is a natural part of your current stage of development. It isn’t permanent and sleep will come eventually.
- Incorporate macronutrients and Vit D into your diet: Our bodies respond favorably to macronutrient adjustments, and this includes improvement in sleep patterns. It may be worthwhile to schedule an appointment with a dietician to review your specific dietary needs based on your overall health profile. Vitamin D is a good supplement for us during menopause and can help with sleep patterns. You can have your Vitamin D levels tested to find out if you are deficient.
- Exercise: Even a moderate amount of exercise can improve sleep patterns. It doesn’t have to be aerobics; find something you enjoy doing. Dancing, spin class or even a simple walk with a friend can help with sleep patterns. Maybe it’s time to break out those bowling shoes.
- CBT: Did you know that there is actually a specific type of therapy for those struggling with insomnia? Cognitive Behavioral Therapy for insomnia (CBT-I) is an evidence-based treatment that incorporates behavioral changes into a plan of action to improve sleep patterns. The Clio app includes a CBT-based course created specifically to help you get better sleep during menopause. It also includes a health tracker that you can use to see how the approach is impacting your sleep.
- Talk about it: Discuss your sleep challenges with friends and family. Sometimes the simple act of talking about a challenge can reduce the impact on our stress levels and create a dialogue that may help reduce distress about the condition.
- Healthy bedtime routine. Reducing exposure to ‘blue light’ sources such as phones, computers and television prior to bed can help improve sleep quality and acquisition. Developing a routine for your bedtime can establish a good habit to prepare for sleep. Try to start the routine at about the same time every night, such as dressing for bed, having a cup of herbal tea, reading a book and then shutting off lights and other distractions. Keep your sleeping area dark and cool for optimal sleep hygiene. Limit daytime caffeine to avoid inducing a sleepless paradox that is based on feeling jittery and wired.
When you’re up at an obscene hour of the morning and cannot seem to access sleep, remember that your sisters in midlife are with you. Imagine a herd of midlife women across the nation, trudging to the bathroom and then plopping onto their couches with sleep nowhere in sight. We’re not alone, and this too shall pass.