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Sleep Difficulties

Hormone Therapy for Women in Massachusetts

Maybe you expected hot flashes and mood swings when you hit your 40s and found yourself in perimenopause. But you may not have anticipated the sleep disturbances and poor sleep quality that also often accompany the menopausal years. Sleep disturbances during perimenopause and menopause are very common and often last for the duration of this period. In fact, up to 61% of perimenopausal women experience sleep disturbances of some kind. These can include hot flashes, night sweats, and insomnia.

Fortunately, there are several options for treating the sleep disorders you may face at this time. Keep reading to learn more about sleep disruption during menopause and what you can do about i

Hormone Therapy Illustration

Sleep Disruption in Menopause

When you reach perimenopause, the years before you stop ovulating and enter menopause, your body’s production of estrogen decreases. The loss of estrogen has several surprising effects on your sleep. Estrogen helps keep your body temperature low at night, which leads to restful sleep. It also affects the production of serotonin, a neurotransmitter that helps regulate your sleep-wake cycle. In addition, estrogen helps elevate mood, so its loss can lead to mood swings and negative feelings, which can help disturb sleep as well.

When your production starts to decline during perimenopause, you can experience a variety of sleep-related symptoms. Among these are hot flashes and night sweats, which can disturb sleep. In addition, the inability to regulate body temperature optimally can lead to poorer quality sleep overall, and those mood swings can also affect sleep.

Sleep disruptions often continue into the postmenopausal years. Unfortunately, that makes it unlikely that you can just shrug your shoulders and expect this problem to go away on its own — especially when you consider the stresses that often hit around midlife and add in any medications you’re taking that might also hinder restful sleep.

Hot Flashes, Night Sweats, and Sleep

Hot flashes are unexpected sensations of heat that sweep first across the face and chest and then over your whole body. They’re a result of the body’s inability to regulate its temperature correctly due to fluctuating levels of estrogen, and they’re experienced by up to 85% of women during menopause. They’re often accompanied by sweating, which is why hot flashes during sleep are often called night sweats.

You may think you woke up because you were having a hot flash, but research shows that your brain wakes you up just before the hot flash begins (so you can enjoy the whole experience!). Because hot flashes are accompanied by a burst of energy, thanks to the heat and adrenaline coursing through your body, it’s often tough to fall back asleep after they occur. Even if you do fall asleep, your sleep quality suffers from having awakened repeatedly during the night. About 44% of women who experience severe hot flashes can be diagnosed with chronic insomnia.

Other Sleep Disruptors During Menopause

Some women also develop sleep apnea as a result of menopause. In fact, the risk of sleep apnea increases by 4% per year for menopausal women. Sleep apnea occurs when you temporarily stop breathing during sleep, and it can manifest as snoring and gasping. Research shows that it may result when your upper airways relax due to the drop in progesterone, which helps keep those airways clear. However, because women’s sleep apnea is often more subtle than the same condition in men, they’re often less likely to seek help for it.

Some women also experience a rise in restless leg syndrome at menopause, which can hinder sleep. In addition, the depression and anxiety that sometimes accompany menopause can also disrupt sleep — which becomes a vicious cycle, since lack of sleep can also contribute to depression and anxiety.

Treatment for Sleep Difficulties in Menopause

You have many options for treating your sleep disruption during the perimenopausal and menopausal years, ranging from hormone replacement therapy, which treats many symptoms of menopause all at once, to simple sleep hygiene steps.

Hormone Replacement Therapy

Hormone replacement therapy treats the symptoms of menopause by replacing the estrogen (and, for most women, progesterone) that your body is no longer producing naturally. With these hormones in your system, you can avoid the unpleasant symptoms of menopause, including hot flashes, night sweats, mood swings — and insomnia. You can take hormone replacement therapy via a pill or opt for patches, creams, or gels as a delivery system. As an added bonus, women who take hormone replacement therapy are less likely to show signs of sleep apnea.

Sleep Medications

Several medications are available to women who experience sleep difficulties during menopause. Some women find that over-the-counter melatonin helps them sleep, though it appears to be less effective in regulating sleep during menopause than during other stages of life. Other women turn to prescription medications. Low levels of antidepressants, including Prozac, Paxil, and Effexor, can help increase sleep quality. Some anti-seizure drugs (notably gabapentin) and clonidine, a blood pressure medication, also help some women sleep.

While some women turn to over-the-counter sleep aids or soy products (such as black cohosh) for help with sleep disruption
during menopause, many of these are not government-approved and may be ineffective. Some may even be harmful. So if you’re considering any non-prescription remedy for sleep, discuss it with a doctor first.

Cognitive Behavioral Therapy

Cognitive behavioral therapy for insomnia (CBTi) helps many women suffering from insomnia due to menopause. Trained therapists work with women one-on-one or in classes to help them recognize behaviors that negatively impact sleep and learn to control thoughts and behaviors to encourage restful sleep.

Lifestyle Changes and Sleep Hygiene

Practicing good sleep hygiene and making some healthy lifestyle changes can also help you when you experience difficulty sleeping. Follow these tips to enjoy a more restful night’s sleep:

  • Establish a regular bedtime and waking time—that way, your body knows when to expect to sleep.
  • Wear loose clothing made of natural fibers, such as cotton or bamboo, to sleep in.
  • Reserve your bed for sleep and sex — no reading, eating, watching TV or scrolling through your phone.
  • Avoid eating spicy foods in the evening, as they can trigger hot flashes.
  • Don’t take naps. They can disrupt your nighttime sleep schedule.
  • Turn down the thermostat to keep your bedroom cool at night.
  • Get plenty of regular exercise — but don’t exercise right before bedtime.
  • If worrying keeps you awake, try writing down all the things you’re concerned about during the day to get them off your mind.
  • Don’t drink alcohol before bedtime.
  • Develop a relaxing bedtime routine. Yours might include listening to calming music, taking a warm bath, or meditating.
  • Avoid caffeine starting in the late afternoon.
  • Don’t drink lots of liquids at night, and use the bathroom before bed.
  • Turn off all screens about an hour before bedtime. The blue light from your phone, computer, or TV can signal your brain to stay awake. Opt for “night shift” yellow lighting on your phone if available.
  • Don’t eat large meals close to bedtime; your body will stay awake trying to digest.
  • Seek medical treatment if depression, anxiety, or stress keeps you awake at night.
  • Block out all noise as much as possible, wearing earplugs if necessary.
  • Develop a routine for falling back asleep if you wake up in the middle of the night.
  • Keep your bedroom dark, hanging blackout curtains to keep out the dawn’s early light.

Would you like to learn more?

Feel free to call us or take our short women's health questionnaire.

Boston Hormone Therapy for Women

Help With the Symptoms of Menopause in Boston, MA

If you’re facing insomnia and other symptoms of menopause here in the greater Boston area, there’s help and hope for you. At Hormonally Balanced, we understand what you’re going through, and we have all the tools you need to help you not only get a restful night’s sleep, but also deal with hot flashes, mood swings and night sweats, and the other uncomfortable symptoms of menopause. So contact us today to see how we can help.

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