Story by: David Steen Martin; Reviewed by Kris E. Barnsfather, M.D. on January 25, 2024
Difficulty falling asleep or staying asleep can be an issue during menopause and in the months or years leading up to menopause.
Complaints of poor sleep quality, waking up during the night, not enough sleep and night sweats are common. So are mood changes, including depression and anxiety, which can contribute to poor sleep.
“If you are going through menopause or are in menopause, and lack of sleep or poor sleep quality is affecting you during the day, talk to your provider,” said Kris E. Barnsfather, M.D., obstetrician/gynecologist with Norton Women’s Care. “There are things you can do and treatments available that can help.”
According to data from the National Institutes of Health, for about half of all women, difficulty sleeping doubles in the lead up to menopause and increases further after menopause. Women transitioning to menopause experience a drop in their estrogen levels. This is what causes hot flashes, night sweats and mood changes.
It’s not entirely clear how menopause disrupts sleep. What you eat also can affect the likelihood you will have insomnia after menopause. A study of 50,000 postmenopausal women found women who ate more fruits and vegetables had a lower chance of experiencing insomnia, while consuming sugars and carbohydrates increased the risk.
Our team of OB/GYNs provide care based on each woman’s unique needs — during the childbearing years, menopause and beyond.
Helpful strategies include a regular sleep schedule and a bedtime routine, such as listening to soothing music or taking a warm bath before bed. Avoid large meals close to bedtime and caffeine late in the day, do not nap in the late afternoon or evening, and try not watching TV or using your computer or mobile device in the bedroom. Keeping your bedroom at a comfortable temperature can help too, usually a couple degrees colder than you like it during the day.
Regular exercise also can help with your sleep quality, as long as it’s not too close to bedtime.
Cognitive behavioral therapy may be an option for women with insomnia as the result of menopause. Research has shown it is as effective as prescription sleep medications in the short term and better tolerated in the long term. There is also a technique called sleep restriction therapy that is designed to reduce middle-of-the-night awakenings.
Supplements and medications also are available for menopause-related insomnia. Some women use over-the-counter sleep aids such as melatonin for insomnia related to menopause. Prescription sleep aids may help, but these are designed for short-term use only.
Antidepressants called serotonin reuptake inhibitors, used to treat depression and anxiety, also have been shown to reduce the symptoms that cause sleep issues in women during the transition to menopause. Another drug that can help is gabapentin, which may decrease the menopause symptoms.
Drugs called benzodiazepines are used frequently for insomnia, but they may not be a good long-term solution because of concerns about their use in older patients. These drugs have been linked to lethargy, confusion, an increased risk of falls and impaired driving among the elderly. Estrogen replacement therapy can improve sleep, along with other menopausal symptoms, but carries risks associated with long-term use.
Insomnia can affect all aspects of your life, and lack of sleep has been linked to a higher risk of high blood pressure, diabetes, obesity, depression, heart attack and stroke. It’s important to speak with your health care provide to address your insomnia rather than hoping it will pass on its own. Your provider can help you consider options for treating your insomnia and what will work best for you.
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