Sleep affects everything, right? How many of your menopause symptoms do you think could be made better by just getting a good night’s sleep, irritability, confidence, brain fog, anxiety? All these things can be made better or worse depending on the quality of our sleep. So, in this blog (or video if you prefer), I’m going to be looking at what is going on with your sleep in perimenopause and menopause. And crucially, how to sleep better in menopause.
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How to sleep better in menopause
Sleep is all about the hormone melatonin, and melatonin is paired with our stress hormone cortisol. Ideally what happens is that we have nice high levels of cortisol in the morning when we wake to give us the energy to get out of bed and get on with our day.
These high levels of cortisol should fade away throughout the day, and as light fades in the afternoon and the early evening, melatonin begins to rise. Those rising melatonin levels have a very calming effect, and they help to calm the nervous system and prepare the body for sleep.
At the same time, another hormone adenosine it is building up through the day and adenosine can be thought about as our sleepiness hormone.
Good quality sleep looks like:
- 7-9 hours – it’s a spectrum and you will fall somewhere within that spectrum
- 1-2 hours of deep sleep
- Being asleep by 10 PM.
One of the important factors that happens during sleep is called autophagy which is a sweeping up of cellular debris of rubbish and toxin and things that we don’t need. Autophagy happens in the brain between 10:00 PM and midnight. This makes the 10 PM curfew very important for menopause brain fog!
Sleep in Perimenopause v Menopause
What we typically see is in perimenopause issues with falling asleep and staying asleep. And in menopause issues with waking early around 4 – 5 AM.
Though of course, we all have our own unique cycles that may fall outside of these patterns.
Why does sleep become problematic?
It could be a whole host of reasons:
- Low progesterone which interacts with our neurotransmitter GABA causing sleep issues
- Fluctuating oestrogen which can cause disturbances in the sleep centres of the brain
- Blood sugar imbalances
- Too higher stress levels
- Aches and pains
- Bladder issues
- Hot flushes and nights sweats
With sleep, however, it is a two-way street. Whilst the above issues can cause sleep problems, not sleeping can also cause all of those problems.
So, addressing sleep is a bit of a chicken-and-egg scenario which requires a holistic overview.
Sleep and Traditional Chinese Medicine
One of my favourite tools to use when looking at sleep comes from traditional Chinese medicine.
According to traditional Chinese medicine, each organ of the body has a time of day that’s associated with it, and also an emotion that is associated with that organ. That is:
11:00 PM to 1:00 AM is the time of the gallbladder and the gallbladder is all about the emotion irritability. It is also about decision-making, typically, the day-to-day smaller decisions.
1:00 AM to 3:00 AM is the time of the liver. And the liver is known as the seat of our emotions, but it’s typically about anger. Like the gallbladder, it covers decision making, but the bigger, more worldly type of decisions. It is this time that I most commonly see women waking.
3:00 AM to 5:00 AM is all about the lungs. And the lungs are all about grief.
5:00 AM to 7:00 AM which is all about the large intestines.
However, here I see a cross-over into functional nutrition. Typically, I see women in menopause waking at this sort of four to 5:00 AM slot, and the things I would be thinking about would be blood sugar balance and cortisol levels.
Around 4:00 AM-ish, there tends to be a flux in blood sugar. And around 5:00 AM we get a rise in cortisol to give us energy, to wake us up and get on with the day.
And because in perimenopause and menopause, we have greater sensitivity to both blood sugar imbalances and stress, we tend to become more alert to these fluctuations.
Tips to improving your sleep in perimenopause and menopause
If we have high levels of stress hormones throughout the day, it will impact the ability to produce melatonin. Later in the day, the brain will tell the pineal gland, we’re under attack. It’s not safe to go to sleep. So we want to make sure that we are doing everything we can to reduce our stress levels.
That is the daily self-care where we allow the nervous system to calm down and send the message to the brain that it is safe to sleep.
Sleep hygiene, again, is all about the brain. The brain craves consistency. When it has consistency, it feels safe. By having good sleep hygiene, the brain will have consistency, feel safe and want to go to sleep. Sleep hygiene includes:
Wake/Sleep routine – going to bed and waking at the same time every single day
Bedtime routine – taking the same steps every night before bed e.g. reading a book and drinking herbal tea, taking a bath with calming essential oils like frankincense and rose and lavender, meditating or doing a yoga Nidra.
Creating the right environment – your bedroom should be cool, dark, and clutter-free. Cool, because the body has to drop a few degrees in temperature to fall asleep. It should be dark and quiet which is needed for sleep. Clutter-free is again about the brain. The brain will always be making associations, so if it associates your bedroom with a place of chaos, then that won’t be conducive to good quality or quantity of sleep.
Light exposure – reducing exposure to bright lights in the evening, as well as limiting screen time in the evening. Ideally, you stop screen time an hour before going to bed because the blue light admitted from screens, sends a signal to the brain to be awake and alert.
Foods to help with melatonin production include:
- Tart cherry juice
- Foods from the Mediterranean diet, like grape seeds, tomatoes, peppers, walnuts
- White meats like chicken and Turkey
- Magnesium-rich foods – leafy greens, almonds, avocado, cacao
Diets high in sugar and refined carbohydrates are not going to be conducive to good quality sleep.
Extremely low-carbohydrate diets can affect sleep too. If you are eating a really low-carb diet and having problems with sleep, try adding a very small portion of complex carbohydrates to your evening meal to see if that helps.
Ideally, we go to bed satisfied. Not too hungry, not too full. Just nicely satisfy.
Build up Adenosine
Thinking about that building up of adenosine, the sleepiness hormone we want to ensure we are getting enough daily movement.
Also, we need to be tired on a mental, emotional and physical level. So, make sure you’re moving, make sure you’re challenging the brain and your emotional needs are met as well.
Things to avoid
Caffeine – no caffeine after 2:00 PM and if you are sensitive, no caffeine after midday.
Alcohol – it is not good for sleep. It might feel like it is, but it’s actually sedating you, so you don’t get the same restorative benefits from sleep.
Fluoride – Fluoride calcifies the pineal gland where we produce melatonin. Cutting fluoride out of your life could help with your sleep.
It is fantastic for sleep but there are thousands of remedies to choose from and a remedy must be matched to your unique symptoms for it to work. So, it is an area that I would recommend working with a practitioner.
However, you could look at the remedy coffea which is made from coffee. We know that coffee can cause insomnia and in its homeopathic form, it can reduce or improve insomnia, particularly where there’s the nervousness or restlessness that we see in a highly caffeinated state.
Lemon balm and ashwagandha are both great herbs for helping with menopausal sleep. I have written about both of these in this blog here.
Passion flower is another herb which is beneficial for sleep. Both lemon balm and passion flower could be used in herbal tea form together with other calming herbs like chamomile and hops.
L-theanine is an important amino acid that helps with sleep because it helps with GABA function, so it helps to calm everything down, allowing us to want to fall off to sleep.
Magnesium, however, is the most important mineral, as far as I’m concerned, when it comes to sleep. And when we have high levels of stress, like in menopause, we burn through magnesium and unfortunately, most of our foods are very mineral deficient. So whilst we can top up magnesium with the foods that I mentioned above, I do also like a magnesium supplement if there are sleep issues. Magnesium supplements come in many different forms, and the one that I like best is magnesium glycinate.
Sleep – a holistic approach
In my line of work, we have a saying, aetiology over symptomology. So, with that in mind, I always ask my ladies, when did the sleep issues start? If something was going, e.g a big stress, trauma, shock, grief etc, that led to sleep issues, then that is what needs to be treated first.
Next, I will look at what is going on with their sleep, specifically are there any patterns. For example, are they having trouble falling asleep, staying asleep, or waking early, and is there a time pattern to it? Looking at these kinds of patterns can give me a lot of information as to what is going on and what needs supporting.
Then we look at sleep hygiene. What needs improving and what needs avoiding?
Finally what needs to be included as extra supplemental support?
And that’s pretty much how I work. So, if you like the natural, holistic, very individualized approach, book a call to discuss my 1:1 menopause programme.
P.S. Not ready to commit to a programme? That’s cool, grab my free download ‘Ultimate Guide to Thriving in the Menopause’ instead.