Sleep your way through the menopause
By Kathryn Pinkham – founder of The Insomnia Clinic
November 15th, 2023
If you’re going through the menopause and suffering from sleep problems, you’re not alone. Around two in three women experience disturbed sleep at this time. Changes in your sleeping patterns are linked to fluctuating hormone levels. As your body produces less oestrogen, you may find an increase in menopausal symptoms like hot flushes, night sweats, anxiety and palpitations. All of which are likely to disturb your sleep patterns even more. Joint aches and pains, and bladder problems such as passing urine at night, are also common consequences of oestrogen decline and can cause further sleep disruption.
You may struggle to fall asleep, wake up frequently in the night and then find it difficult to go back to sleep. This often leads to what feels like a never-ending cycle of anxiety and stress exacerbated by lack of sleep and daytime tiredness. Lying awake at night worrying about how tired you’ll feel the next day keeps the insomnia cycle going. HRT may help control some of the symptoms which disturb your sleep, but your insomnia may still persist.
There are simple positive changes you can make which will help put you back in control of your sleeping patterns. You’ll be able to fall asleep more quickly, wake in the night less often and reduce your sleep anxiety levels.
The first step is to understand that your sleep patterns are regulated by your body clock. If you set your alarm for 3am every morning for a week, your body clock would soon start waking you at 3am, without an alarm sounding. So you can reprogramme your body clock – in the same way you would do if crossing over time zones on a long flight.
Step one is to go to bed later, not earlier. If you go too early you’ll wake up too early and also struggle to fall asleep. Your natural appetite for sleep builds all day – from the moment you wake up. You need to increase your sleep drive by resisting the temptation to have an early night. By pushing back your bedtime you’ll build your body’s appetite for sleep. This will help you fall asleep faster and give you a deeper quality of sleep.
Step two is to get up earlier. Every morning, including weekends, set your alarm for 6 or 7am, even if you don’t need to get up this early. This will also help reset your body clock to understand this is the morning. Your sleep drive will start earlier and be more intense when you go to bed at night.
Whilst going to bed later and getting up earlier sounds counter-intuitive, it will help to condense sleep into one quality portion. It’s the quality of your time asleep that makes the difference, not the quantity. Eight hours sleep is not essential. Six restful hours is better than eight hours of broken sleep. Don’t forget your body is designed to cope with periods of sleep loss such as when you have a baby.
The third step is to take control of your sleep anxiety patterns. If you wake up every night with hot flushes, palpitations, sweating and anxiety, your body clock will quickly adjust to this waking up time and it will become a pattern. As you lie awake, watching the clock and feeling under pressure to fall asleep, you’ll start to feel stressed and worried about how you’ll feel the next day. This creates a physical adrenalin response in your body, as your fight or flight mechanism is triggered. As you feel hotter and more panicked, sleep will seem even further away.
The answer is to find a quiet time to yourself during the day. Make a list of everything which makes you feel anxious and particularly anything which causes sleep disruption. This is a highly therapeutic way to start dispelling anxieties. Look at your list and see how many ‘What-ifs’ it contains. ‘What if my partner leaves me because I’m so irritable and stressed?’ ‘What if I never have a full night’s sleep ever again?’, ‘What if I never lose my menopausal weight gain?’ Remind yourself that the ‘What ifs’ have not happened and may never happen. Acknowledge these worries, be kind to yourself and the let them go. They might feel awful and stressful but they are hypothetical. Focus on the concerns that have happened or are actually happening. Concentrate on resolving these worries. If your hot flushes are becoming more intense, contact your doctor about HRT, you may need to increase your dose or there may be alternative therapies to try. Gradually you’ll be able to re-programme your mind to sleep better.
If you need some additional support, Cognitive Behavioural Therapy for insomnia (CBT-i) can help improve poor sleep, improve sleep patterns and manage anxiety around sleep.
Using this step-by-step process will help you improve the quality of your sleep and could transform your menopausal years. Insomnia is curable!
Watch Kathryn’s 6 minute video!
Kathryn Pinkham – founder of The Insomnia Clinic. Kathryn started the Insomnia Clinic after working in mental health and seeing the impact of poor sleep on people’s lives. For the past 15 years she has focussed on helping improve sleep, particularly for women going through the menopause.