If you can’t sleep at night, then you’re not alone. While sleep is so essential for our health, it can also be so elusive. It’s often one of the first signs and symptoms of peri menopause – quickly followed by exhaustion and fatigue, and can last well beyond menopause (really…did it ever come back after kids??!!). Here we look at why you’re struggling to get a decent night’s sleep and what you can do about it.  

Sleep is one of the fundamental building blocks towards health. Poor sleep has clinically been shown to increase the risk of developing;

• Weight gain
• Blood pressure and cardiovascular disease
• Poor work performance
• Fatigue
• Hormonal imbalances
• Accelerated ageing
• Diabetes
• Mood swings, anxiety and depression.

Oh the joys!

While sleeping tablets and even antidepressants are commonly prescribed for women struggling to sleep, it might help with short term relief…but to really make a lasting change, we need to get to the underlying causes of why we are waking up in the first place. Otherwise it’s going to be a constant struggle!

Common Reasons You Can’t Sleep At Night…

Every major process in our body works in cycles. From short term cycles such as blood sugar regulation, to our 24 hour circadian rhythm, and our longer monthly reproductive cycle. And YES – you still have a monthly cycle regardless of whether you are still menstruating or not! 

All these cycles are interconnected and when one cycle is disrupted there is a cascade effect. Too much sugar for example, can disrupt sleep and then the reproductive cycle. During perimenopause, it’s reduced progesterone levels that affect the duration and quality of our sleep. Testosterone levels dropping in men has a similar effect. 

Stress and adrenal function

Stress is a daily challenge for many women. Work, relationships, children and financial pressures constantly add up, leading to elevated cortisol levels. Cortisol is designed to come in quick bursts (fight or flight) but chronic daily stress leads to a long term elevation of cortisol which disrupts your circadian rhythm.

Cortisol levels should spike early in the morning allowing us to wake refreshed and energised. Then they should slowly drop throughout the day and melatonin increases leading to tiredness before sleep. Chronic stress flips this situation with cortisol remaining elevated into the evening and not allowing melatonin to kick in – leaving us unable to sleep.

Finally cortisol levels drop through the night leaving you feeling fatigued in the morning and struggling to get out of bed.

 

Anxiety and nervous tension

Along with stress, anxiety and nervous tension can impact our sleep. This can trigger our nervous system to always be “on”, leaving us feeling tired but wired and unable to sleep. 

 

Hot flushes and night sweats

For peri and menopausal women,  hot flushes are one of the most common disruptors of sleep. During sleep the body moves through different phases or levels of sleep. Any disruption to these phases such as an unwanted thermic event (fancy name for hot flush) causes the body to come out of these phases, leading to chronic insomnia. 

Hot flushes are due to reduced levels of oestrogen. This reduction in oestrogen is a natural transition where the production of oestrogen moves from the ovaries to the adrenals. To reduce the impact of hot flushes and night sweats, we want to stimulate this natural process…but if your adrenals are prioritising the production of stress hormones – then this process is disrupted. 

 

Weak Bladder

Getting up for the loo is one of the most common disruptors of sleep patterns. This can be from simply drinking too much liquid in the evening – so aim to drink at least 2L of fluid before late afternoon. 

50% of women over 50 suffer also from some form of urinary urgency or incontinence. Having to get up to urinate more than twice during the night will disrupt normal sleep cycles and make it difficult to get back to sleep. I can highly recommend a visit to a pelvic physiotherapist for support with this. 

Restless Legs Syndrome – RLS

Finally Restless Leg Syndrome affects around 20% of women during perimenopause and menopause and can be a common factor in sleep disturbances. There are many causes of RLS, but it can be a nutritional deficiency, so it’s always worth getting your iron checked. Magnesium – supplements and topically, as well as zinc and B vitamins can also help. 

 

Conclusion

So while you still need good sleep habits, if you’re struggling to get a good night’s sleep then it’s definitely worth investigating the cause, as this will help create a lasting and more effective solution.