How Perimenopause & Menopause Disrupt Sleep—And How to Fix It!

As women, we know it’s coming.  And in some ways, menopause seems like something to look forward to; I mean, who will actually miss a monthly period, with the mood swings, cramps, and need to carry tampons or pads?  Not me, or so I thought.

When perimenopause hit me in my mid forties, I didn’t even know it was a thing.  I’d heard all about the hot flashes and night sweats that come with menopause, but no one was talking about perimenopause and what that looked like.  I think I was in perimenopause for 3 or 4 years before I realized.  Looking back, there were a lot of not so fun symptoms, including the overall sense that I just wasn’t myself.  I felt less capable, more easily stressed/overwhelmed, but the worst part was the impact on my sleep.  I’d always struggled with sleep, so it wasn’t new, but tried and true things didn’t work anymore.  I practiced good sleep hygiene, I took melatonin, and I ate really well, with zero caffeine after midday.  But it wasn’t working anymore; not only was it difficult to fall asleep, I was waking most nights at 2:30 am and taking hours to get back to sleep, if I got back to sleep at all.  And that made every part of life worse. Small stressors became completely overwhelming, the brain fog made me feel incompetent a lot of the time, and I was so irritable and angry. All the time. Maybe this sounds familiar?

There are a lot more resources now, only a few years later, and #perimenopause and #menopause are big topics that are becoming far more normalized than they once were.  Just check out those hashtags on any social media platform.  And with good reason – there are an estimated 93 million women over age 40 in North America, and 95% of women will experience at least one of the 50+ symptoms of peri & menopause. Typically, we enter perimenopause in our forties (but it can be earlier), hit menopause (defined as 12 full months with no period) between 45 and 55, and then stay in postmenopause for the remainder of our lives.  And yet 48% of women feel unprepared when it starts, and were not very aware of the symptoms, beyond the main ones (hot flashes, night sweats, period changes and mood swings).

In terms of sleep disturbances, 57% of women will experience this; even those who have always slept well. So if this is where you are, you are not alone. 

Perimenopausal and Menopausal Sleep Issues are Real

Hormonal Rollercoaster

The hormonal fluctuations that characterize perimenopause and menopause can disrupt sleep patterns. Estrogen and progesterone, two hormones that influence the sleep-wake cycle, change dramatically. Declining estrogen levels can lead to hot flashes and night sweats, which can interrupt sleep and make it challenging to achieve deep, restorative rest. Less progesterone can cause elevated cortisol levels, leading to insomnia and more stress.

Mood Swings and Anxiety

The emotional rollercoaster associated with perimenopause and menopause, including mood swings and heightened anxiety, can contribute to sleep disturbances. Many women find themselves lying awake at night, their minds racing with thoughts and worries. Fluctuating hormone levels, particularly the decline in estrogen, can impact cortisol, serotonin and norepinephrine, intensifying feelings of unease and stress.

Physical Changes

Beyond hormonal shifts, perimenopause and menopause bring about physical changes that can affect sleep. Changes in metabolism, weight gain, and alterations in body composition may result in discomfort or the development of sleep disorders such as sleep apnea. Additionally, joint and muscle pain, common during this life stage, can make finding a comfortable sleeping position a nightly challenge.

Sleep Cycle Changes

Research suggests that hormonal changes associated with perimenopause and menopause can disrupt our natural sleep architecture or cycle. This may result in difficulty falling asleep, maintaining deep sleep, or experiencing restorative REM (rapid eye movement) sleep. Sleep quality becomes compromised, leading to feelings of fatigue and irritability during daytime hours. (Sound familiar?)

Strategies and Supplements that Can Help

1. Sleep Hygiene: Doubling down on sleep hygiene is crucial.  It may not be sexy, but it’s so worth it.  We’ve got lots of blogs on sleep hygiene (it’s my passion!) so check out the following: Sleep Hygiene 101, 6 Sleep Habits to put on Repeat, Night Waking and What to do

2. Daily Exercise: Not too close to bedtime, which can be stimulating.  Try for 20 minutes or more a day, even if it’s just a brisk walk. Find something you love so you don’t want to skip it. I’m loving Pilates, barre, yoga and strength training and kind of do abit of each throughout the week

3. Caffeine & Alcohol: No coffee/caffeine after noon. And start to track the impact alcohol has on your sleep. (Sorry!) I love wine, but I know now that when I have it, I won’t sleep well.  I still imbibe, but a lot less, and way less frequently.  

4. Magnesium bisglycinate (or glycinate, same thing!): An absolute must during these years! It helps with sleep and relaxation, but also so many other vital functions, and magnesium deficiency is very common. The glycinate form is the best for stress and sleep, absorbs well and has no digestive side effects. Hey Relax Magnesium from Niyama also has tart cherry, inositol, and GABA for sleep, mood, and brain support. It’s also delicious and makes a great after dinner nightcap.

5. Natural sleep supplements: Melatonin used to be magic for me, but it stopped working well for me in my forties.  It didn’t seem to address the root cause of my insomnia, which was stress – specifically cortisol spikes at the wrong times.  Sleep Like Buddha uses 3 proven ingredients to help with stress-related insomnia. Our hormonal fluctuations in peri/menopause cause cortisol to spike, and tend to respond well to Sleep Like Buddha. I love that I can take one at bedtime and a second at 2:30 in the morning if I need to, without any next day grogginess.  It takes up to a week to work though, so don’t judge by the first night.

There is hope! When you combine the above strategies and supplements, you should notice a big difference.  And always talk to your healthcare practitioner about what you are experiencing, and the steps you are taking.  Hormone therapy is incredibly helpful for many women, and can be combined with all of the above, if you are a candidate for it. Be sure to follow all supplement directions and check with your pharmacist if you are taking other medications.

Jillian Mariani is a certified sleep coach, menopause warrior and the founder of Niyama Wellness. 

Sources:

1. https://menopausefoundationcanada.ca/wp-content/uploads/2022/10/MFC-Report_The-Silence-and-the-Stigma_Menopause-in-Canada_October-2022.pdf