Sleep tight, feel alright! 

Rock a bye maybe? Count on sleep and not your sheep!  All you need is sleep (Insomnia song)

The slogans are endless, but sleep does matter and not getting enough sleep has detrimental effects on women, particularly during their menopause journey, including the challenge of insomnia.

So, why is sleep important? 

Sleep disturbance is a big topic with several causes and different ways to help manage this. Several health-related conditions can impact sleep, which in turn can influence other health conditions. 

The optimum amount of sleep is around 7 – 9 hours and is longer in children. Sleep can affect all aspects of our life including relationships, work and mood. Too little (or too much!) can impact both our overall physical and mental well-being, resulting in deterioration in mental health, altered cognition (impaired memory and concentration) and reduced heart health.

What is insomnia?

Insomnia means you have difficulty sleeping regularly.

There are various forms of sleep disturbance which may include:

Difficulty initiating sleep, difficulty maintaining sleep & interrupted sleep and early morning waking. 

During menopause, perimenopause or post-menopause studies have shown that more women may experience changes to their sleep patterns. This is very variable and maybe because of reduced hormone levels. 

Reduction in oestrogen levels may cause symptoms such as anxiety, hot sweats, aches & pains and passing urine at night, all of which may interfere with our sleep. 

In addition, the decline of another hormone produced by our body, progesterone (which has a sleep-inducing effect), may also be associated with sleep disturbance or insomnia. This lack of sleep may then in turn result in increasing levels of anxiety or contribute to depression or insomnia.

Other hormones such as melatonin are influenced by a reduction of oestrogen and progesterone during perimenopause and can often influence sleep. 

Insomnia may also be a symptom of another underlying health condition such as sleep apnoea or thyroid disturbance. It is important to consider other factors such as weight gain, diet, alcohol and caffeine intake when addressing sleep and ensuring a more holistic approach is adopted when managing insomnia. 

How can we help improve sleep?

It usually gets better by changing your sleeping habits. Exercise, diet and behavioural therapies have all been shown to be effective at managing sleep disturbance. Sometimes a referral to a specialist may be required.  

Top tips:

• Routine is key in helping to improve sleep in the long term. Try and go to bed at the same time every night. 
• Perhaps build in a pre-bedtime routine like having a warm bath or reading to help with this.
• Avoid caffeine, alcohol and fizzy drinks in the evening and ensure you do not eat too late either – avoid being hungry, a small snack is ok. 
• Use your bedroom for sleep only and avoid using devices with bright lights such as your phone, laptop and TV when in bed. 
• Good quality comfortable bedding and mattresses/pillows can also help ensure good quality sleep
• Regular exercise can be really effective at managing sleep but should be avoided within 4 hours of bedtime. 

Can I use medications? 

HRT (hormone replacement therapy) can be really useful to help women experiencing sleep disturbance as a result of a decline in oestrogen. Women with a uterus require both oestrogen and progesterone to protect the lining of their womb and body identical progesterone (as opposed to more synthetic progestogens) may also have a mild sedative effect, promoting sleep. Other medications such as antidepressants and chronic pain medications can be used to manage some menopause symptoms in women who cannot take HRT and these may also help with insomnia. 

Hypnotics are not generally prescribed by doctors due to their adverse effects but there may be special circumstances where this can be considered. Please talk to your doctor about this. 

Some products may be available to purchase over the counter from a pharmacy and contain either a sedating antihistamine or other more natural ingredients such as lavender. These may have side effects of making you feel drowsy and impairing your performance of driving etc so please discuss these with a healthcare professional before using.

Some other complementary or herbal remedies may help but these may contain mixed ingredients, varying in quality and purity. These may interact with other medications and the safety of these products is unknown. Please ensure you discuss any herbal remedies with a herbal remedy specialist. 

Behavioural therapies

You may benefit from cognitive behavioural therapy (CBT) to help change your thoughts, behaviours and encourage relaxation to help improve sleep. 

If you are struggling with Insomnia please make an appointment to discuss this with one of our doctors, use the button above to make an appointment.

Please note we are unable to prescribe any hypnotic medications here at Extracellular due to the nature of these controlled medications.

Thanks for Reading our Understanding Insomnia and Improving Sleep Quality blog!

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